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
('820432465', 'SACN00901', 'SACN00901', 'SACN', 'Family Care Physicians', 'Joshua', 'W', 'Kern', 'MD', 'Family Practice', '', '', NULL, 'B', '112 5th Ave W', 'Jerome', 'Jerome', 'ID', '83338', '2083241157', '2083243406', '112 5th Ave W', 'Jerome', 'Jerome', 'ID', '83338', '2083241157', '2083243406', 'IDSINCLAIRL', NULL, NULL, '0.00', '15.00', '0.00', 3, '2011-01-01', NULL, 0, 0, 1, NULL, '', '', '', 'HCFA|UB|', '1366486003', 0, 'Y', 0, '2013-06-24', NULL, NULL, 0, 0, NULL, NULL),
('820432465', 'SACN00902', 'SACN00902', 'SACN', 'Family Care Physicians', 'Joshua', 'W', 'Kern', 'MD', 'Family Practice', '', '', NULL, 'O', '112 5th Ave West', 'Jerome', 'Jerome', 'ID', '83338', '2083241157', '2083243406', '112 5th Ave West', 'Jerome', 'Jerome', 'ID', '83338', '2083241157', '2083243406', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 3, '2011-01-01', NULL, 0, 0, 1, NULL, '', '', '', 'HCFA|UB|', '1366486003', 0, 'Y', 0, '2013-06-24', NULL, NULL, 0, 0, NULL, NULL),
('820432465', 'SACN00903', 'SACN00903', 'SACN', 'Family Care Physicians', 'Joshua', 'W', 'Kern', 'MD', 'Family Practice', '', '', NULL, 'B', '112 W 5th', 'Jerome', 'Jerome', 'ID', '83338', '2083241157', '2083243406', '112 W 5th', 'Jerome', 'Jerome', 'ID', '83338', '2083241157', '2083243406', 'IDSINCLAIRL', NULL, NULL, '0.00', '15.00', '0.00', 3, '2011-01-01', NULL, 0, 0, 1, NULL, '', '', '', 'HCFA|UB|', '1366486003', 0, 'Y', 0, '2013-06-24', NULL, NULL, 0, 0, NULL, NULL),
('820200895', 'SACN01181', 'SACN01181', 'SACN', 'Saint Alphonsus Medical Group Shoreline Family Medicine', 'Lisa', 'M', 'Kern', 'MD', 'Family Practice', '', '', NULL, 'O', '1673 W Shoreline Dr Ste 120', 'Boise', 'Ada', 'ID', '83702', '2083678383', '2083677171', '1673 W Shoreline Dr Ste 120', 'Boise', 'Ada', 'ID', '83702', '2083678383', '2083677171', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Regional Medical Center', '', '', '', 'HCFA|', '1588618219', 0, 'N', 0, '2014-06-20', NULL, NULL, 43.6171, -116.222, NULL, NULL),
('264333033', 'TX0115581', 'TX0115581', 'TXSATSTD', 'Consultants in Womens Health', 'Jerome', 'T', 'Washington', 'MD', 'Obstetrics and Gynecology', '', '', NULL, 'O', '3903 Wiseman Blvd Ste 200', 'San Antonio', 'Bexar', 'TX', '78251', '2106844100', '2105216799', '3903 Wiseman Blvd Ste 200', 'San Antonio', 'Bexar', 'TX', '78251', '2106844100', '2105216799', 'TXOBG', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2012-08-20', '2013-05-24', 0, 0, 0, 'Baptist Medical Center', '', '', '', 'HCFA|UB|', '1861598971', 0, 'N', 0, '2013-05-24', NULL, NULL, 29.4776, -98.695, NULL, NULL),
('820161600', 'SACN00381', 'SACN00381', 'SACN', 'Cascade Medical Center', 'Benjamin', 'T', 'Kerns', 'PA-C This Provider will terminate on July 1st', 'Orthopedic Surgery', '', '', NULL, 'B', '402 Old State Hwy', 'Cascade', 'Valley', 'ID', '83611', '2083232600', NULL, '402 Old State Hwy', 'Cascade', 'Valley', 'ID', '83611', '2083232600', '          ', 'IDSINCLAIRL', 'WUSTDHCPC5', '', '0.00', '15.00', '0.00', 8, '2011-01-01', '2012-07-01', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1659388783', 0, 'N', 0, '2012-05-31', NULL, NULL, 0, 0, NULL, NULL),
('820161600', 'SACN00382', 'SACN00382', 'SACN', 'Boise Orthopedic Clinic', 'Benjamin', 'T', 'Kerns', 'PA-C This Provider will terminate on July 1st', 'Orthopedic Surgery', '', '', NULL, 'O', '520 S Eagle Rd Ste 3213', 'Meridian', 'Ada', 'ID', '83642', '2088980100', NULL, '520 S Eagle Rd Ste 3213', 'Meridian', 'Ada', 'ID', '83642', '2088980100', '          ', 'IDSINCLAIRL', 'WUSTDHCPC5', '', '0.00', '15.00', '0.00', 8, '2011-01-01', '2012-07-01', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1659388783', 0, 'N', 0, '2012-05-31', NULL, NULL, 43.5995, -116.352, NULL, NULL),
('820161600', 'SACN00383', 'SACN00383', 'SACN', 'Boise Orthopedic Clinic', 'Benjamin', 'T', 'Kerns', 'PA-C This Provider will terminate on July 1st', 'Orthopedic Surgery', '', '', NULL, 'O', '703 S Americana Blvd Ste 120', 'Boise', 'Ada', 'ID', '83702', '2083232600', NULL, '703 S Americana Blvd Ste 120', 'Boise', 'Ada', 'ID', '83702', '2083232600', '          ', 'IDSINCLAIRL', 'WUSTDHCPC5', '', '0.00', '15.00', '0.00', 8, '2011-01-01', '2012-07-01', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1659388783', 0, 'N', 0, '2012-05-31', NULL, NULL, 0, 0, NULL, NULL),
('264333033', 'TX0115579', 'TX0115579', 'TXSATSTD', 'Consultants in Womens Health', 'Jerome', 'T', 'Washington', 'MD', 'Obstetrics and Gynecology', '', '', NULL, 'B', '1210 Arion Pkwy', 'San Antonio', 'Bexar', 'TX', '78216', '2103499300', '2103662558', '1210 Arion Pkwy', 'San Antonio', 'Bexar', 'TX', '78216', '2103499300', '2103662558', 'TXOBG', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2012-08-20', '2013-11-30', 0, 0, 0, 'Baptist Medical Center', '', '', '', 'HCFA|UB|', '1861598971', 0, 'N', 0, '2013-11-25', NULL, NULL, 0, 0, NULL, NULL),
('820200895', 'SACN01608', 'SACN01608', 'SACN', 'Saint Alphonsus Medical Group Boise Pediatrics', 'John', 'J', 'Kiehl', 'MD', 'Pediatrics', '', '', NULL, 'O', '999 N Curtis Ste 407', 'Boise', 'Ada', 'ID', '83706', '2083674321', '2083674525', '999 N Curtis Ste 407', 'Boise', 'Ada', 'ID', '83706', '2083674321', '2083674525', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Regional Medical Center', '', '', '', 'HCFA|', '1902940570', 0, 'N', 0, '2014-06-20', NULL, NULL, 43.6132, -116.255, NULL, NULL),
('264333033', 'W12015580', 'W12015580', 'TX01', 'Consultants in Womens Health', 'Jerome', 'T', 'Washington', 'MD', 'Obstetrics and Gynecology', '', '', NULL, 'O', '7940 Floyd Curl Dr Ste 900', 'San Antonio', 'Bexar', 'TX', '78229', '2106141000', '2106151236', '7940 Floyd Curl Dr Ste 900', 'San Antonio', 'Bexar', 'TX', '78229', '2106141000', '2106151236', 'TXOBG', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2012-03-01', '2012-08-19', 0, 0, 0, 'Baptist Medical Center', '', '', '', 'HCFA|UB|', '1861598971', 0, 'N', 0, '2013-05-24', NULL, NULL, 29.5117, -98.5756, NULL, NULL),
('264333033', 'W12015581', 'W12015581', 'TX01', 'Consultants in Womens Health', 'Jerome', 'T', 'Washington', 'MD', 'Obstetrics and Gynecology', '', '', NULL, 'O', '3903 Wiseman Blvd Ste 200', 'San Antonio', 'Bexar', 'TX', '78251', '2106844100', '2105216799', '3903 Wiseman Blvd Ste 200', 'San Antonio', 'Bexar', 'TX', '78251', '2106844100', '2105216799', 'TXOBG', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2012-03-01', '2012-08-19', 0, 0, 0, 'Baptist Medical Center', '', '', '', 'HCFA|UB|', '1861598971', 0, 'N', 0, '2013-05-24', NULL, NULL, 29.4776, -98.695, NULL, NULL),
('820312175', 'SACN00927', 'SACN00927', 'SACN', 'Idaho Emergency Physicians PA', 'David', 'T', 'Kim', 'MD', 'Emergency Medicine', '', '', NULL, 'o', '1055 N Curtis Rd', 'Boise', 'Ada', 'ID', '83704', '2083221730', '2083221731', '1055 N Curtis Rd', 'Boise', 'Ada', 'ID', '83704', '2083221730', '2083221731', 'IDSINCLAIRL', NULL, NULL, '0.00', '15.00', '0.00', 3, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Regional Medical Center', 'West Valley Medical Center', NULL, NULL, 'HCFA|UB|', '1386681336', 0, 'n', 0, '2012-01-31', NULL, NULL, 43.6136, -116.256, NULL, NULL),
('820312175', 'SACN00928', 'SACN00928', 'SACN', 'Idaho Emergency Physicians PA', 'David', 'T', 'Kim', 'MD', 'Emergency Medicine', '', '', NULL, 'O', '1717 Arlington', 'Caldwell', 'Canyon', 'ID', '83605', '2083221730', '2083221731', '1717 Arlington', 'Caldwell', 'Canyon', 'ID', '83605', '2083221730', '2083221731', 'IDSINCLAIRL', NULL, NULL, '0.00', '15.00', '0.00', 3, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Regional Medical Center', 'West Valley Medical Center', NULL, NULL, 'HCFA|UB|', '1386681336', 0, 'N', 0, '2012-01-31', NULL, NULL, 0, 0, NULL, NULL),
('820312175', 'SACN00929', 'SACN00929', 'SACN', 'Idaho Emergency Physicians PA', 'David', 'T', 'Kim', 'MD', 'Emergency Medicine', '', '', NULL, 'B', '2963 E Copper Point Dr', 'Meridian', 'Ada', 'ID', '83642', '2083221730', NULL, '2963 E Copper Point Dr', 'Meridian', 'Ada', 'ID', '83642', '2083221730', '          ', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 3, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Regional Medical Center', 'West Valley Medical Center', NULL, NULL, 'HCFA|UB|', '1386681336', 0, 'Y', 0, '2012-01-31', NULL, NULL, 0, 0, NULL, NULL),
('820312175', 'SACN00930', 'SACN00930', 'SACN', 'Idaho Emergency Physicians PA', 'David', 'T', 'Kim', 'MD', 'Emergency Medicine', '', '', NULL, 'o', '323 E Riverside Dr', 'Eagle', 'Ada', 'ID', '83616', '2083221730', '2083221731', '323 E Riverside Dr', 'Eagle', 'Ada', 'ID', '83616', '2083221730', '2083221731', 'IDSINCLAIRL', NULL, NULL, '0.00', '15.00', '0.00', 3, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Regional Medical Center', 'West Valley Medical Center', NULL, NULL, 'HCFA|UB|', '1386681336', 0, 'n', 0, '2012-01-31', NULL, NULL, 43.6892, -116.351, NULL, NULL),
('460500210', 'SACN00935', 'SACN00935', 'SACN', 'Saint Alphonsus Pathology Physician Services', 'Edward', 'J', 'Kim', 'MD', 'Pathology', '', '', NULL, 'B', '1055 N Curtis Rd', 'Boise', 'Ada', 'ID', '83706', '2083672153', '2083673991', '1055 N Curtis Rd', 'Boise', 'Ada', 'ID', '83706', '2083672153', '2083673991', 'IDSINCLAIRL', NULL, NULL, '0.00', '15.00', '0.00', 6, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Regional Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1396785531', 0, 'Y', 0, '2012-10-26', NULL, NULL, 43.6127, -116.254, NULL, NULL),
('205934739', 'SACN00220', 'SACN00220', 'SACN', 'Family Medicine Health Center', 'Susan', 'C', 'Kim', 'MD', 'Family Practice', 'Pediatrics', '', NULL, 'O', '121 E Fort St', 'Boise', 'Ada', 'ID', '83712', '2083811775', NULL, '121 E Fort St', 'Boise', 'Ada', 'ID', '83712', '2083811775', '          ', 'IDSINCLAIRL', 'WUSTDHCPC5', '', '0.00', '15.00', '0.00', 3, '2011-01-01', '2012-04-05', 0, 0, 1, 'Saint Alphonsus Medical Center Nampa', NULL, '', '', 'HCFA|UB|', '1265478531', 0, 'N', 0, '2012-04-05', NULL, NULL, 0, 0, NULL, NULL),
('205934739', 'SACN00221', 'SACN00221', 'SACN', 'Family Medicine Health Center', 'Susan', 'C', 'Kim', 'MD', 'Family Practice', 'Pediatrics', '', NULL, 'O', '777 N Raymond St', 'Boise', 'Ada', 'ID', '83704', '2085142500', NULL, '777 N Raymond St', 'Boise', 'Ada', 'ID', '83704', '2085142500', '          ', 'IDSINCLAIRL', 'WUSTDHCPC5', '', '0.00', '15.00', '0.00', 3, '2011-01-01', '2012-04-05', 0, 0, 1, 'Saint Alphonsus Medical Center Nampa', NULL, '', '', 'HCFA|UB|', '1265478531', 0, 'N', 0, '2012-04-05', NULL, NULL, 0, 0, NULL, NULL),
('201300128', 'SACN01162', 'SACN01162', 'SACN', 'Idaho Urologic Institute', 'Dawn', 'K', 'King Menzner', 'MD', 'Urology', '', '', NULL, 'O', '2855 E Magic View Dr', 'Meridian', 'Ada', 'ID', '83642', '2086394900', NULL, '2855 E Magic View Dr', 'Meridian', 'Ada', 'ID', '83642', '2086394900', '', 'IDSINCLAIRL', 'WUSTDHCPC5', NULL, '0.00', '15.00', '0.00', 3, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Medical Center Nampa', NULL, NULL, NULL, 'HCFA|UB|', '1568413763', 0, 'n', 0, '2013-07-31', NULL, NULL, 43.599, -116.36, NULL, NULL),
('201300128', 'SACN01163', 'SACN01163', 'SACN', 'Idaho Urologic Institute', 'Dawn', 'K', 'King Menzner', 'MD', 'Urology', '', '', NULL, 'O', '333 N 1st Ste 100', 'Boise', 'Ada', 'ID', '83702', '2086394900', NULL, '333 N 1st Ste 100', 'Boise', 'Ada', 'ID', '83702', '2086394900', '          ', 'IDSINCLAIRL', 'WUSTDHCPC5', '', '0.00', '15.00', '0.00', 3, '2011-01-01', '2012-02-24', 0, 0, 0, 'Saint Alphonsus Medical Center Nampa', NULL, NULL, NULL, 'HCFA|UB|', '1568413763', 0, 'N', 0, '2013-07-31', NULL, NULL, 43.6135, -116.194, NULL, NULL),
('205934739', 'SACN00413', 'SACN00413', 'SACN', 'Family Medicine Residency of Idaho', 'Rebecca', 'G', 'Kinney', 'MD', 'Family Practice', '', '', NULL, 'O', '121 E Fort St', 'Boise', 'Ada', 'ID', '83712', '2083811775', NULL, '121 E Fort St', 'Boise', 'Ada', 'ID', '83712', '2083811775', '          ', 'IDSINCLAIRL', 'WUSTDHCPC5', '', '0.00', '15.00', '0.00', 3, '2011-01-01', '2011-08-01', 0, 0, 1, '', '', '', '', 'HCFA|UB|', '1669670170', 0, 'N', 0, '2011-09-20', NULL, NULL, 0, 0, NULL, NULL),
('205934739', 'SACN00414', 'SACN00414', 'SACN', 'Family Medicine Residency of Idaho', 'Rebecca', 'G', 'Kinney', 'MD', 'Family Practice', '', '', NULL, 'O', '777 N Raymond St', 'Boise', 'Ada', 'ID', '83704', '2083676042', NULL, '777 N Raymond St', 'Boise', 'Ada', 'ID', '83704', '2083676042', '          ', 'IDSINCLAIRL', 'WUSTDHCPC5', '', '0.00', '15.00', '0.00', 3, '2011-01-01', '2011-08-01', 0, 0, 1, '', '', '', '', 'HCFA|UB|', '1669670170', 0, 'N', 0, '2011-09-20', NULL, NULL, 0, 0, NULL, NULL),
('518624525', 'SACN01358', 'SACN01358', 'SACN', '', 'Mark', 'L', 'Kircher', 'LCPC', 'Mental Health', 'Counseling', '', NULL, 'O', '3350 Americana Terrace Ste 300', 'Boise', 'Ada', 'ID', '83706', '2083431113', NULL, '3350 Americana Terrace Ste 300', 'Boise', 'Ada', 'ID', '83706', '2083431113', '          ', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 3, '2011-01-01', '2012-08-01', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1710081765', 0, 'N', 0, '2012-08-07', NULL, NULL, 0, 0, NULL, NULL),
('201300128', 'SACN00151', 'SACN00151', 'SACN', 'Idaho Urologic Institute', 'Eric', 'W', 'Klein', 'MD', 'Urology', '', '', NULL, 'O', '1613 12th Ave Rd Ste B', 'Nampa', 'Canyon', 'ID', '83686', '2086394900', NULL, '1613 12th Ave Rd Ste B', 'Nampa', 'Canyon', 'ID', '83686', '2086394900', '', 'IDSINCLAIRL', 'WUSTDHCPC5', NULL, '0.00', '15.00', '0.00', 3, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Medical Center Nampa', NULL, NULL, NULL, 'HCFA|UB|', '1023013109', 0, 'n', 0, '2014-03-20', NULL, NULL, 43.5533, -116.573, NULL, NULL),
('201300128', 'SACN00152', 'SACN00152', 'SACN', 'Idaho Urologic Institute', 'Eric', 'W', 'Klein', 'MD', 'Urology', '', '', NULL, 'O', '2855 E Magic View Dr', 'Meridian', 'Ada', 'ID', '83642', '2086394900', NULL, '2855 E Magic View Dr', 'Meridian', 'Ada', 'ID', '83642', '2086394900', '', 'IDSINCLAIRL', 'WUSTDHCPC5', NULL, '0.00', '15.00', '0.00', 3, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Medical Center Nampa', NULL, NULL, NULL, 'HCFA|UB|', '1023013109', 0, 'n', 0, '2014-03-20', NULL, NULL, 43.599, -116.36, NULL, NULL),
('820312175', 'SACN00693', 'SACN00693', 'SACN', 'Idaho Emergency Physicians PA', 'Frederick', 'J', 'Klein', 'MD', 'Emergency Medicine', '', '', NULL, 'o', '1055 N Curtis Rd', 'Boise', 'Ada', 'ID', '83704', '2083221730', '2083221731', '1055 N Curtis Rd', 'Boise', 'Ada', 'ID', '83704', '2083221730', '2083221731', 'IDSINCLAIRL', NULL, NULL, '0.00', '15.00', '0.00', 3, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Regional Medical Center', 'West Valley Medical Center', NULL, NULL, 'HCFA|UB|', '1144273079', 0, 'n', 0, '2012-10-26', NULL, NULL, 43.6136, -116.256, NULL, NULL),
('820312175', 'SACN00694', 'SACN00694', 'SACN', 'Idaho Emergency Physicians PA', 'Frederick', 'J', 'Klein', 'MD', 'Emergency Medicine', '', '', NULL, 'O', '1717 Arlington', 'Caldwell', 'Canyon', 'ID', '83605', '2083221730', '2083221731', '1717 Arlington', 'Caldwell', 'Canyon', 'ID', '83605', '2083221730', '2083221731', 'IDSINCLAIRL', NULL, NULL, '0.00', '15.00', '0.00', 3, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Regional Medical Center', 'West Valley Medical Center', NULL, NULL, 'HCFA|UB|', '1144273079', 0, 'N', 0, '2012-10-26', NULL, NULL, 0, 0, NULL, NULL),
('820312175', 'SACN00695', 'SACN00695', 'SACN', 'Idaho Emergency Physicians PA', 'Frederick', 'J', 'Klein', 'MD', 'Emergency Medicine', '', '', NULL, 'B', '2963 E Copper Point Dr', 'Meridian', 'Ada', 'ID', '83642', '2083221730', NULL, '2963 E Copper Point Dr', 'Meridian', 'Ada', 'ID', '83642', '2083221730', '          ', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 3, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Regional Medical Center', 'West Valley Medical Center', NULL, NULL, 'HCFA|UB|', '1144273079', 0, 'Y', 0, '2012-10-26', NULL, NULL, 0, 0, NULL, NULL),
('820312175', 'SACN00696', 'SACN00696', 'SACN', 'Idaho Emergency Physicians PA', 'Frederick', 'J', 'Klein', 'MD', 'Emergency Medicine', '', '', NULL, 'o', '323 E Riverside Dr', 'Eagle', 'Ada', 'ID', '83616', '2083221730', '2083221731', '323 E Riverside Dr', 'Eagle', 'Ada', 'ID', '83616', '2083221730', '2083221731', 'IDSINCLAIRL', NULL, NULL, '0.00', '15.00', '0.00', 3, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Regional Medical Center', 'West Valley Medical Center', NULL, NULL, 'HCFA|UB|', '1144273079', 0, 'n', 0, '2012-10-26', NULL, NULL, 43.6892, -116.351, NULL, NULL),
('820200895', 'SACN01141', 'SACN01141', 'SACN', 'Saint Alphonsus Medical Group Elm Family Medicine', 'Daniel', 'S', 'Knorpp', 'DO', 'Family Practice', '', '', NULL, 'O', '315 E Elm St Ste 100', 'Caldwell', 'Canyon', 'ID', '83605', '2084597415', '2084533307', '315 E Elm St Ste 100', 'Caldwell', 'Canyon', 'ID', '83605', '2084597415', '2084533307', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', NULL, 0, 0, 0, 'West Valley Medical Center', '', '', '', 'HCFA|', '1538214184', 0, 'N', 0, '2014-06-20', NULL, NULL, 43.6539, -116.695, NULL, NULL),
('820477852', 'SACN01142', 'SACN01142', 'SACN', 'Saint Alphonsus Medical Group Elm Family Medicine', 'Daniel', 'S', 'Knorpp', 'DO', 'Family Practice', '', '', NULL, 'O', '315 E Elm St Ste 100', 'Caldwell', 'Canyon', 'ID', '83605', '2084597415', '2084533307', '315 E Elm St Ste 100', 'Caldwell', 'Canyon', 'ID', '83605', '2084597415', '2084533307', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', NULL, 0, 0, 0, 'West Valley Medical Center', '', '', '', 'HCFA|UB|', '1538214184', 0, 'N', 0, '2014-06-20', NULL, NULL, 43.6539, -116.695, NULL, NULL),
('820200895', 'SACN01236', 'SACN01236', 'SACN', 'Saint Alphonsus Medical Group Cherry Lane- do not post on we', 'Christina', 'M', 'Knutson', 'MD', 'Obstetrics and Gynecology', '', '', NULL, 'O', '3025 W Cherry Ln Ste B', 'Meridian', 'Ada', 'ID', '83642', '2083678550', '2083678555', '3025 W Cherry Ln Ste B', 'Meridian', 'Ada', 'ID', '83642', '2083678550', '2083678555', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', '2011-12-01', 0, 0, 0, 'Saint Alphonsus Regional Medical Center', NULL, NULL, NULL, 'HCFA|', '1649212119', 0, 'Y', 0, '2014-03-18', NULL, NULL, 43.6188, -116.431, NULL, NULL),
('820200895', 'SACN01237', 'SACN01237', 'SACN', 'Saint Alphonsus Medical Group Eagle Health Plaza - do not po', 'Christina', 'M', 'Knutson', 'MD', 'Obstetrics and Gynecology', '', '', NULL, 'O', '323 E Riverside Dr Ste 224', 'Eagle', 'Ada', 'ID', '83616', '2083675750', '2083675765', '323 E Riverside Dr Ste 224', 'Eagle', 'Ada', 'ID', '83616', '2083675750', '2083675765', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', '2011-12-01', 0, 0, 0, 'Saint Alphonsus Regional Medical Center', NULL, NULL, NULL, 'HCFA|', '1649212119', 0, 'Y', 0, '2014-03-18', NULL, NULL, 43.6892, -116.351, NULL, NULL),
('820200895', 'SACN01238', 'SACN01238', 'SACN', 'Saint Alphonsus Medical Group Womens Health- do not post on', 'Christina', 'M', 'Knutson', 'MD', 'Obstetrics and Gynecology', '', '', NULL, 'O', '6140 W Curtisian Ste 100', 'Boise', 'Ada', 'ID', '83704', '2083674224', '2083677806', '6140 W Curtisian Ste 100', 'Boise', 'Ada', 'ID', '83704', '2083674224', '2083677806', 'IDSINCLAIRL', NULL, NULL, '0.00', '15.00', '0.00', 6, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Regional Medical Center', NULL, NULL, NULL, 'HCFA|', '1649212119', 0, 'Y', 0, '2014-03-18', NULL, NULL, 43.6151, -116.256, NULL, NULL),
('820200895', 'SACN01239', 'SACN01239', 'SACN', 'Saint Alphonsus Medical Group OB/GYN Boise Liberty Bldg', 'Christina', 'M', 'Knutson', 'MD', 'Obstetrics and Gynecology', '', '', NULL, 'O', '900 N Liberty Ste 204', 'Boise', 'Ada', 'ID', '83704', '2083672229', '2083674242', '900 N Liberty Ste 204', 'Boise', 'Ada', 'ID', '83704', '2083672229', '2083674242', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Regional Medical Center', NULL, NULL, NULL, 'HCFA|', '1649212119', 0, 'N', 0, '2014-03-18', NULL, NULL, 43.6133, -116.259, NULL, NULL),
('820200895', 'SACN01240', 'SACN01240', 'SACN', 'CARE Maternal/Child Health Program - Do Not Publish', 'Christina', 'M', 'Knutson', 'MD', 'Obstetrics and Gynecology', '', '', NULL, 'O', '900 N Liberty St Ste 100', 'Boise', 'Ada', 'ID', '83704', '2083672126', '2083674505', '900 N Liberty St Ste 100', 'Boise', 'Ada', 'ID', '83704', '2083672126', '2083674505', 'IDSINCLAIRL', NULL, NULL, '0.00', '15.00', '0.00', 6, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Regional Medical Center', NULL, NULL, NULL, 'HCFA|', '1649212119', 0, 'Y', 0, '2014-03-18', NULL, NULL, 43.6133, -116.259, NULL, NULL),
('820477852', 'SACN01241', 'SACN01241', 'SACN', 'Saint Alphonsus Medical Group Womens Health', 'Christina', 'M', 'Knutson', 'MD', 'Obstetrics and Gynecology', '', '', NULL, 'B', '3025 W Cherry Ln', 'Meridian', 'Ada', 'ID', '83642', '2083674224', '2083674765', '3025 W Cherry Ln', 'Meridian', 'Ada', 'ID', '83642', '2083674224', '2083674765', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', '2011-12-01', 0, 0, 0, 'Saint Alphonsus Regional Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1649212119', 0, 'Y', 0, '2014-03-18', NULL, NULL, 43.6188, -116.431, NULL, NULL),
('820477852', 'SACN01242', 'SACN01242', 'SACN', 'Saint Alphonsus Medical Group Eagle Health Plaza - do not po', 'Christina', 'M', 'Knutson', 'MD', 'Obstetrics and Gynecology', '', '', NULL, 'O', '323 E Riverside Dr Ste 224', 'Eagle', 'Ada', 'ID', '83616', '2083675750', '2083675765', '323 E Riverside Dr Ste 224', 'Eagle', 'Ada', 'ID', '83616', '2083675750', '2083675765', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', '2011-12-01', 0, 0, 0, 'Saint Alphonsus Regional Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1649212119', 0, 'Y', 0, '2014-03-18', NULL, NULL, 43.6892, -116.351, NULL, NULL),
('820477852', 'SACN01243', 'SACN01243', 'SACN', 'Saint Alphonsus Medical Group Womens Health- do not post on', 'Christina', 'M', 'Knutson', 'MD', 'Obstetrics and Gynecology', '', '', NULL, 'O', '6140 W Curtisian Ste 100', 'Boise', 'Ada', 'ID', '83704', '2083674224', '2083677806', '6140 W Curtisian Ste 100', 'Boise', 'Ada', 'ID', '83704', '2083674224', '2083677806', 'IDSINCLAIRL', NULL, NULL, '0.00', '15.00', '0.00', 6, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Regional Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1649212119', 0, 'Y', 0, '2014-03-18', NULL, NULL, 43.6151, -116.256, NULL, NULL),
('820477852', 'SACN01244', 'SACN01244', 'SACN', 'Saint Alphonsus Medical Group Womens Health', 'Christina', 'M', 'Knutson', 'MD', 'Obstetrics and Gynecology', '', '', NULL, 'o', '900 N Liberty Ste 204', 'Boise', 'Ada', 'ID', '83704', '2083672229', '2083674242', '900 N Liberty Ste 204', 'Boise', 'Ada', 'ID', '83704', '2083672229', '2083674242', 'IDSINCLAIRL', NULL, NULL, '0.00', '15.00', '0.00', 6, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Regional Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1649212119', 0, 'n', 0, '2014-03-18', NULL, NULL, 43.6133, -116.259, NULL, NULL),
('820477852', 'SACN01245', 'SACN01245', 'SACN', 'CARE Maternal/Child Health Program - Do Not Publish', 'Christina', 'M', 'Knutson', 'MD', 'Obstetrics and Gynecology', '', '', NULL, 'O', '900 N Liberty St Ste 100', 'Boise', 'Ada', 'ID', '83704', '2083672126', '2083674505', '900 N Liberty St Ste 100', 'Boise', 'Ada', 'ID', '83704', '2083672126', '2083674505', 'IDSINCLAIRL', NULL, NULL, '0.00', '15.00', '0.00', 6, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Regional Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1649212119', 0, 'Y', 0, '2014-03-18', NULL, NULL, 43.6133, -116.259, NULL, NULL),
('460500210', 'SACN00896', 'SACN00896', 'SACN', 'Saint Alphonsus Pathology Physician Services', 'Nancy', 'C', 'Kois', 'MD', 'Pathology', '', '', NULL, 'O', '1055 N Curtis Rd', 'Boise', 'Ada', 'ID', '83706', '2083672153', '2083673991', '1055 N Curtis Rd', 'Boise', 'Ada', 'ID', '83706', '2083672153', '2083673991', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Regional Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1356397491', 0, 'Y', 0, '2013-06-25', NULL, NULL, 43.6127, -116.254, NULL, NULL),
('260553931', 'SACN01261', 'SACN01261', 'SACN', 'Saint Alphonsus Medical Groug Heart Care Garrity', 'Carolyn', '', 'Kolb', 'NP-C', 'Cardiovascular Disease', 'Nurse Practitioner', '', NULL, 'O', '1200 Garrity Blvd', 'Nampa', 'Canyon', 'ID', '83687', '2083674278', '2083675200', '1200 Garrity Blvd', 'Nampa', 'Canyon', 'ID', '83687', '2083674278', '2083675200', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Medical Center Nampa', '', '', '', 'HCFA|UB|', '1649297532', 0, 'Y', 0, '2011-08-17', NULL, NULL, 43.587, -116.549, NULL, NULL),
('260553931', 'SACN01262', 'SACN01262', 'SACN', 'Saint Alphonsus Medical Goup Heart Care Meridian', 'Carolyn', '', 'Kolb', 'NP-C', 'Cardiovascular Disease', 'Nurse Practitioner', '', NULL, 'O', '3025 W Cherry Ln Ste 205', 'Meridian', 'Ada', 'ID', '83642', '2083678484', '2083678456', '3025 W Cherry Ln Ste 205', 'Meridian', 'Ada', 'ID', '83642', '2083678484', '2083678456', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Medical Center Nampa', '', '', '', 'HCFA|UB|', '1649297532', 0, 'Y', 0, '2011-08-17', NULL, NULL, 43.6188, -116.431, NULL, NULL),
('260553931', 'SACN01263', 'SACN01263', 'SACN', 'Saint Alphonsus Specialty Services, Inc', 'Carolyn', '', 'Kolb', 'NP-C', 'Cardiovascular Disease', 'Nurse Practitioner', '', NULL, 'O', '315 E Elm St Ste 100', 'Caldwell', 'Canyon', 'ID', '83605', '2083674278', '2083675200', '315 E Elm St Ste 100', 'Caldwell', 'Canyon', 'ID', '83605', '2083674278', '2083675200', 'IDSINCLAIRL', NULL, NULL, '0.00', '15.00', '0.00', 6, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Medical Center Nampa', '', '', '', 'HCFA|UB|', '1649297532', 0, 'Y', 0, '2011-08-17', NULL, NULL, 43.6539, -116.695, NULL, NULL),
('260553931', 'SACN01264', 'SACN01264', 'SACN', 'Saint Alphonsu Medical Group Heart Care Eagle', 'Carolyn', '', 'Kolb', 'NP-C', 'Cardiovascular Disease', 'Nurse Practitioner', '', NULL, 'O', '323 E Riverside Dr Ste 224', 'Eagle', 'Ada', 'ID', '83616', '2083674278', '2083675765', '323 E Riverside Dr Ste 224', 'Eagle', 'Ada', 'ID', '83616', '2083674278', '2083675765', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Medical Center Nampa', '', '', '', 'HCFA|UB|', '1649297532', 0, 'Y', 0, '2011-08-17', NULL, NULL, 43.6892, -116.351, NULL, NULL),
('260553931', 'SACN01265', 'SACN01265', 'SACN', 'Saint Alphonsus Medical Group Heart Cae Boise Moreau Bldg', 'Carolyn', '', 'Kolb', 'NP-C', 'Cardiovascular Disease', 'Nurse Practitioner', '', NULL, 'O', '6140 W Curtisian Ste 200', 'Boise', 'Ada', 'ID', '83704', '2083674278', '2083675200', '6140 W Curtisian Ste 200', 'Boise', 'Ada', 'ID', '83704', '2083674278', '2083675200', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Medical Center Nampa', '', '', '', 'HCFA|UB|', '1649297532', 0, 'N', 0, '2011-08-17', NULL, NULL, 43.6151, -116.256, NULL, NULL),
('331078261', 'SACN01266', 'SACN01266', 'SACN', 'Saint Alphonsus Physicians PA', 'Carolyn', '', 'Kolb', 'NP-C', 'Cardiovascular Disease', 'Nurse Practitioner', '', NULL, 'B', '1200 Garrity Blvd', 'Nampa', 'Canyon', 'ID', '83687', '2083674278', NULL, '1200 Garrity Blvd', 'Nampa', 'Canyon', 'ID', '83687', '2083674278', '', 'IDSINCLAIRL', NULL, NULL, '0.00', '15.00', '0.00', 3, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Medical Center Nampa', '', '', '', 'HCFA|UB|', '1649297532', 0, 'y', 0, '2011-08-17', NULL, NULL, 43.587, -116.549, NULL, NULL),
('331078261', 'SACN01267', 'SACN01267', 'SACN', 'Saint Alphonsus Physicians PA', 'Carolyn', '', 'Kolb', 'NP-C', 'Cardiovascular Disease', 'Nurse Practitioner', '', NULL, 'B', '3025 W Cherry Ln Ste 205', 'Meridian', 'Ada', 'ID', '83642', '2083678484', NULL, '3025 W Cherry Ln Ste 205', 'Meridian', 'Ada', 'ID', '83642', '2083678484', '', 'IDSINCLAIRL', NULL, NULL, '0.00', '15.00', '0.00', 3, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Medical Center Nampa', '', '', '', 'HCFA|UB|', '1649297532', 0, 'y', 0, '2011-08-17', NULL, NULL, 43.6188, -116.431, NULL, NULL),
('331078261', 'SACN01268', 'SACN01268', 'SACN', 'Saint Alphonsus Physicians PA', 'Carolyn', '', 'Kolb', 'NP-C', 'Cardiovascular Disease', 'Nurse Practitioner', '', NULL, 'O', '315 E Elm St Ste 100', 'Caldwell', 'Canyon', 'ID', '83605', '2083674278', '2083675200', '315 E Elm Ste 100', 'Caldwell', 'Canyon', 'ID', '83605', '2083674278', '2083675200', 'IDSINCLAIRL', NULL, NULL, '0.00', '15.00', '0.00', 3, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Medical Center Nampa', '', '', '', 'HCFA|UB|', '1649297532', 0, 'y', 0, '2011-08-17', NULL, NULL, 43.6539, -116.695, NULL, NULL),
('331078261', 'SACN01269', 'SACN01269', 'SACN', 'Saint Alphonsus Physicians PA', 'Carolyn', '', 'Kolb', 'NP-C', 'Cardiovascular Disease', 'Nurse Practitioner', '', NULL, 'B', '323 E Riverside Dr Ste 224', 'Eagle', 'Ada', 'ID', '83616', '2083675750', NULL, '323 E Riverside Dr Ste 224', 'Eagle', 'Ada', 'ID', '83616', '2083675750', '', 'IDSINCLAIRL', NULL, NULL, '0.00', '15.00', '0.00', 3, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Medical Center Nampa', '', '', '', 'HCFA|UB|', '1649297532', 0, 'y', 0, '2011-08-17', NULL, NULL, 43.6892, -116.351, NULL, NULL),
('331078261', 'SACN01270', 'SACN01270', 'SACN', 'Saint Alphonsus Physicians PA', 'Carolyn', '', 'Kolb', 'NP-C', 'Cardiovascular Disease', 'Nurse Practitioner', '', NULL, 'o', '6140 W Curtisian Ste 200', 'Boise', 'Ada', 'ID', '83704', '2083674278', NULL, '6140 W Curtisian Ste 200', 'Boise', 'Ada', 'ID', '83704', '2083674278', '', 'IDSINCLAIRL', NULL, NULL, '0.00', '15.00', '0.00', 3, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Medical Center Nampa', '', '', '', 'HCFA|UB|', '1649297532', 0, 'n', 0, '2011-08-17', NULL, NULL, 43.6151, -116.256, NULL, NULL),
('820200895', 'SACN01465', 'SACN01465', 'SACN', 'Saint Alphonsus Medical Group Garrity Family Medicine', 'Anne', 'M', 'Koster', 'NP-C', 'Nurse Practitioner', '', '', NULL, 'O', '1200 Garrity Blvd', 'Nampa', 'Canyon', 'ID', '83687', '2084669092', '2084665322', '1200 Garrity Blvd', 'Nampa', 'Canyon', 'ID', '83687', '2084669092', '2084665322', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', '2011-10-31', 0, 0, 0, '', '', '', '', 'HCFA|', '1790739951', 0, 'Y', 0, '2011-12-19', NULL, NULL, 43.587, -116.549, NULL, NULL),
('820200895', 'SACN01466', 'SACN01466', 'SACN', 'Saint Alphonsus Express Care, Inc.', 'Anne', 'M', 'Koster', 'NP-C', 'Nurse Practitioner', '', '', NULL, 'O', '1515 W State St', 'Boise', 'Ada', 'ID', '83702', '2083456768', NULL, '1515 W State St', 'Boise', 'Ada', 'ID', '83702', '2083456768', '          ', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', '2011-10-31', 0, 0, 0, '', '', '', '', 'HCFA|', '1790739951', 0, 'Y', 0, '2011-12-19', NULL, NULL, 43.6228, -116.21, NULL, NULL),
('820200895', 'SACN01467', 'SACN01467', 'SACN', 'Saint Alphonsus Medical Group MHP Urgent Care', 'Anne', 'M', 'Koster', 'NP-C', 'Nurse Practitioner', '', '', NULL, 'O', '3025 W Cherry Ln Ste B', 'Meridian', 'Ada', 'ID', '83642', '2083678550', '2083678555', '3025 W Cherry Ln Ste B', 'Meridian', 'Ada', 'ID', '83642', '2083678550', '2083678555', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', '2011-10-31', 0, 0, 0, '', '', '', '', 'HCFA|', '1790739951', 0, 'Y', 0, '2011-12-19', NULL, NULL, 43.6188, -116.431, NULL, NULL),
('820200895', 'SACN01468', 'SACN01468', 'SACN', 'Saint Alphonsus Medical Group Elm Family Medicine', 'Anne', 'M', 'Koster', 'NP-C', 'Nurse Practitioner', '', '', NULL, 'O', '315 E Elm St Ste 100', 'Caldwell', 'Canyon', 'ID', '83605', '2084597415', '2084533307', '315 E Elm Ste 100', 'Caldwell', 'Canyon', 'ID', '83605', '2084597415', '2084533307', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', '2011-10-31', 0, 0, 0, '', '', '', '', 'HCFA|', '1790739951', 0, 'Y', 0, '2011-12-19', NULL, NULL, 43.6539, -116.695, NULL, NULL),
('820200895', 'SACN01469', 'SACN01469', 'SACN', 'Saint Alphonsus Express Care, Inc.', 'Anne', 'M', 'Koster', 'NP-C', 'Nurse Practitioner', '', '', NULL, 'O', '4700 N Eagle Rd', 'Boise', 'Ada', 'ID', '83713', '2089384797', NULL, '4700 N Eagle Rd', 'Boise', 'Ada', 'ID', '83713', '2089384797', '          ', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', '2011-10-31', 0, 0, 0, '', '', '', '', 'HCFA|', '1790739951', 0, 'Y', 0, '2011-12-19', NULL, NULL, 43.6474, -116.352, NULL, NULL),
('820200895', 'SACN01470', 'SACN01470', 'SACN', 'Saint Alphonsus Medical Group Emerald Family Medicine', 'Anne', 'M', 'Koster', 'NP-C', 'Nurse Practitioner', '', '', NULL, 'O', '6533 Emerald St', 'Boise', 'Ada', 'ID', '83704', '2083674170', '2083678135', '6533 Emerald St', 'Boise', 'Ada', 'ID', '83704', '2083674170', '2083678135', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', '2011-10-31', 0, 0, 0, '', '', '', '', 'HCFA|', '1790739951', 0, 'Y', 0, '2011-12-19', NULL, NULL, 43.6119, -116.268, NULL, NULL),
('820200895', 'SACN00891', 'SACN00891', 'SACN', 'Saint Alphonsus Inpatient Medicine', 'Tanya', 'S', 'Krafft', 'MD', 'Hospitalist', '', '', NULL, 'o', '1055 N Curtis Rd', 'Boise', 'Ada', 'ID', '83706', '2083672121', '2083675180', '1055 N Curtis Rd', 'Boise', 'Ada', 'ID', '83706', '2083672121', '2083675180', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Regional Medical Center', '', '', '', 'HCFA|', '1356370563', 0, 'Y', 0, '2014-06-20', NULL, NULL, 43.6127, -116.254, NULL, NULL),
('261253824', 'SACN01669', 'SACN01669', 'SACN', 'Idaho Hand Center', 'Darrell', 'E', 'Krall', 'PT', 'Physical Therapy', '', '', NULL, 'O', '901 N Curtis Ste 304', 'Boise', 'Ada', 'ID', '83706', '2083424263', NULL, '901 N Curtis Ste 304', 'Boise', 'Ada', 'ID', '83706', '2083424263', '', 'IDSINCLAIRL', NULL, NULL, '0.00', '15.00', '0.00', 3, '2011-01-01', NULL, 0, 0, 1, '', '', '', '', 'HCFA|UB|', '1972686087', 0, 'n', 0, '2012-02-07', NULL, NULL, 43.6126, -116.255, NULL, NULL),
('841370759', 'SACN01700', 'SACN01700', 'SACN', 'Kranz Chiropractic Chartered', 'James', 'W', 'Kranz', 'DC', 'Chiropractic', 'Acupuncture', '', NULL, 'O', '910 N Curtis Rd', 'Boise', 'Ada', 'ID', '83706', '2083773777', NULL, '910 N Curtis Rd', 'Boise', 'Ada', 'ID', '83706', '2083773777', '', 'IDSINCLAIRM', NULL, NULL, '0.00', '10.00', '0.00', 3, '2011-01-01', NULL, 0, 0, 1, '', '', '', '', 'HCFA|UB|', '1972614485', 0, 'n', 0, '2012-02-14', NULL, NULL, 0, 0, NULL, NULL),
('820161600', 'SACN00202', 'SACN00202', 'SACN', 'Cascade Medical Center', 'Ronald', 'M', 'Kristensen', 'MD This Provider will terminate on July 1st', 'Orthopedic Surgery', '', '', NULL, 'B', '402 Old State Hwy', 'Cascade', 'Valley', 'ID', '83611', '2083232600', NULL, '402 Old State Hwy', 'Cascade', 'Valley', 'ID', '83611', '2083232600', '          ', 'IDSINCLAIRL', 'WUSTDHCPC5', '', '0.00', '15.00', '0.00', 8, '2011-01-01', '2012-07-01', 0, 0, 0, 'Saint Alphonsus Medical Center Nampa', NULL, '', '', 'HCFA|UB|', '1215948807', 0, 'N', 0, '2012-05-31', NULL, NULL, 0, 0, NULL, NULL),
('820161600', 'SACN00203', 'SACN00203', 'SACN', 'Boise Orthopedic Clinic', 'Ronald', 'M', 'Kristensen', 'MD This Provider will terminate on July 1st', 'Orthopedic Surgery', '', '', NULL, 'O', '520 S Eagle Rd Ste 3213', 'Meridian', 'Ada', 'ID', '83642', '2088980100', NULL, '520 S Eagle Rd Ste 3213', 'Meridian', 'Ada', 'ID', '83642', '2088980100', '          ', 'IDSINCLAIRL', 'WUSTDHCPC5', '', '0.00', '15.00', '0.00', 8, '2011-01-01', '2012-07-01', 0, 0, 0, 'Saint Alphonsus Medical Center Nampa', NULL, '', '', 'HCFA|UB|', '1215948807', 0, 'N', 0, '2012-05-31', NULL, NULL, 43.5995, -116.352, NULL, NULL),
('820161600', 'SACN00204', 'SACN00204', 'SACN', 'Boise Orthopedic Clinic', 'Ronald', 'M', 'Kristensen', 'MD This Provider will terminate on July 1st', 'Orthopedic Surgery', '', '', NULL, 'O', '703 S Americana Blvd Ste 120', 'Boise', 'Ada', 'ID', '83702', '2083232600', NULL, '703 S Americana Blvd Ste 120', 'Boise', 'Ada', 'ID', '83702', '2083232600', '          ', 'IDSINCLAIRL', 'WUSTDHCPC5', '', '0.00', '15.00', '0.00', 8, '2011-01-01', '2012-07-01', 0, 0, 0, 'Saint Alphonsus Medical Center Nampa', NULL, '', '', 'HCFA|UB|', '1215948807', 0, 'N', 0, '2012-05-31', NULL, NULL, 0, 0, NULL, NULL),
('201300128', 'SACN00889', 'SACN00889', 'SACN', 'Idaho Urologic Institute', 'Helen', 'J', 'Kuo', 'MD', 'Urology', '', '', NULL, 'O', '2855 E Magic View Dr', 'Meridian', 'Ada', 'ID', '83642', '2086394900', '2086394901', '2855 E Magic View Dr', 'Meridian', 'Ada', 'ID', '83642', '2086394900', '2086394901', 'IDSINCLAIRL', 'WUSTDHCPC5', '', '0.00', '15.00', '0.00', 3, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Medical Center Nampa', NULL, NULL, NULL, 'HCFA|UB|', '1346407921', 0, 'N', 0, '2013-06-25', NULL, NULL, 43.599, -116.36, NULL, NULL),
('201300128', 'SACN00890', 'SACN00890', 'SACN', 'Idaho Urologic Institute', 'Helen', 'J', 'Kuo', 'MD', 'Urology', '', '', NULL, 'O', '333 N 1st Ste 100', 'Boise', 'Ada', 'ID', '83702', '2086394900', '2086394901', '333 N 1st Ste 100', 'Boise', 'Ada', 'ID', '83702', '2086394900', '2086394901', 'IDSINCLAIRL', 'WUSTDHCPC5', '', '0.00', '15.00', '0.00', 3, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Medical Center Nampa', NULL, NULL, NULL, 'HCFA|UB|', '1346407921', 0, 'N', 0, '2013-06-25', NULL, NULL, 43.6135, -116.194, NULL, NULL),
('202456406', 'SACN01315', 'SACN01315', 'SACN', 'Eagle Orthopedic Clinic', 'Michael', 'D', 'Lahey', 'MD', 'Orthopedic Surgery', NULL, NULL, NULL, 'O', '323 E Riverside Dr Ste 234', 'Eagle', 'Ada', 'ID', '83616', '2089384080', '2089388922', '323 E Riverside Dr Ste 234', 'Eagle', 'Ada', 'ID', '83616', '2089384080', '2089388922', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 3, '2011-01-01', '2012-01-19', 0, 0, 1, 'Saint Alphonsus Medical Center Nampa', NULL, '', '', 'HCFA|UB|', '1679510903', 0, 'N', 0, '2012-02-22', NULL, NULL, 43.6892, -116.351, NULL, NULL),
('202456406', 'SACN01316', 'SACN01316', 'SACN', '', 'Michael', 'D', 'Lahey', 'MD', 'Orthopedic Surgery', NULL, NULL, NULL, 'O', '8854 W Emerald Ste 140', 'Boise', 'Ada', 'ID', '83704', '2089384080', '2089388922', '8854 W Emerald Ste 140', 'Boise', 'Ada', 'ID', '83704', '2089384080', '2089388922', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 3, '2011-01-01', '2012-01-19', 0, 0, 1, 'Saint Alphonsus Medical Center Nampa', NULL, '', '', 'HCFA|UB|', '1679510903', 0, 'N', 0, '2012-02-22', NULL, NULL, 43.6123, -116.292, NULL, NULL),
('820514419', 'SACN00650', 'SACN00650', 'SACN', 'Horizon Health', 'Katherine', '', 'Laible', 'PAC', 'Physician Assistant', '', '', NULL, 'O', '311 W Idaho St', 'Boise', NULL, 'ID', '83702', '2088468616', '2088884296', '311 W Idaho St', 'Boise', '', 'ID', '83702', '2088468616', '2088884296', 'IDSINCLAIRL', NULL, NULL, '0.00', '15.00', '0.00', 3, '2011-01-01', NULL, 0, 0, 1, '', '', '', '', 'HCFA|UB|', '1083739049', 0, 'N', 0, '2012-02-02', NULL, NULL, 0, 0, NULL, NULL),
('820312175', 'SACN01224', 'SACN01224', 'SACN', 'Idaho Emergency Physicians PA', 'Michael', 'J', 'Lamers', 'MD', 'Emergency Medicine', '', '', NULL, 'o', '1055 N Curtis Rd', 'Boise', 'Ada', 'ID', '83704', '2083221730', '2083221731', '1055 N Curtis Rd', 'Boise', 'Ada', 'ID', '83704', '2083221730', '2083221731', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 3, '2011-01-01', '2011-09-15', 0, 0, 0, 'Saint Alphonsus Regional Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1629091491', 0, 'N', 0, '2012-01-30', NULL, NULL, 43.6136, -116.256, NULL, NULL),
('820312175', 'SACN01225', 'SACN01225', 'SACN', 'Idaho Emergency Physicians PA', 'Michael', 'J', 'Lamers', 'MD', 'Emergency Medicine', '', '', NULL, 'O', '1717 Arlington', 'Caldwell', 'Canyon', 'ID', '83605', '2083221730', '2083221731', '1717 Arlington', 'Caldwell', 'Canyon', 'ID', '83605', '2083221730', '2083221731', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 3, '2011-01-01', '2011-09-15', 0, 0, 0, 'Saint Alphonsus Regional Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1629091491', 0, 'N', 0, '2012-01-30', NULL, NULL, 0, 0, NULL, NULL),
('820312175', 'SACN01226', 'SACN01226', 'SACN', 'Idaho Emergency Physicians PA', 'Michael', 'J', 'Lamers', 'MD', 'Emergency Medicine', '', '', NULL, 'B', '2963 E Copper Point Dr', 'Meridian', 'Ada', 'ID', '83642', '2083221730', NULL, '2963 E Copper Point Dr', 'Meridian', 'Ada', 'ID', '83642', '2083221730', '          ', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 3, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Regional Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1629091491', 0, 'Y', 0, '2012-01-30', NULL, NULL, 0, 0, NULL, NULL),
('820312175', 'SACN01227', 'SACN01227', 'SACN', 'Idaho Emergency Physicians PA', 'Michael', 'J', 'Lamers', 'MD', 'Emergency Medicine', '', '', NULL, 'o', '323 E Riverside Dr', 'Eagle', 'Ada', 'ID', '83616', '2083221730', '2083221731', '323 E Riverside Dr', 'Eagle', 'Ada', 'ID', '83616', '2083221730', '2083221731', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 3, '2011-01-01', '2011-09-15', 0, 0, 0, 'Saint Alphonsus Regional Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1629091491', 0, 'N', 0, '2012-01-30', NULL, NULL, 43.6892, -116.351, NULL, NULL),
('820200895', 'SACN00544', 'SACN00544', 'SACN', 'Saint Alphonsus Medical Group MHP Family Medicine', 'Stacy', 'J', 'Lamers', 'MD', 'Family Practice', '', '', NULL, 'O', '3025 W Cherry Ln Ste B', 'Meridian', 'Ada', 'ID', '83642', '2083678550', '2083678555', '3025 W Cherry Ln Ste B', 'Meridian', 'Ada', 'ID', '83642', '2083678550', '2083678555', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Regional Medical Center', '', '', '', 'HCFA|', '1003867094', 0, 'N', 0, '2014-06-20', NULL, NULL, 43.6188, -116.431, NULL, NULL),
('820477852', 'SACN00545', 'SACN00545', 'SACN', 'Saint Alphonsus Medical Group Cherry Lane', 'Stacy', 'J', 'Lamers', 'MD', 'Family Practice', '', '', NULL, 'o', '3025 W Cherry Ln Ste  B', 'Meridian', 'Ada', 'ID', '83642', '2083678550', '2083678555', '3025 W Cherry Ln Ste  B', 'Meridian', 'Ada', 'ID', '83642', '2083678550', '2083678555', 'IDSINCLAIRL', NULL, '', '0.00', '15.00', '0.00', 6, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Regional Medical Center', '', '', '', 'HCFA|UB|', '1003867094', 0, 'n', 0, '2014-06-20', NULL, NULL, 43.6188, -116.431, NULL, NULL),
('261253824', 'SACN00686', 'SACN00686', 'SACN', 'Idaho Hand Center', 'David', 'M', 'Lamey', 'MD: OSM', 'Orthopedic Surgery', '', '', NULL, 'O', '901 N Curtis Ste 304', 'Boise', 'Ada', 'ID', '83706', '2083424263', NULL, '901 N Curtis Ste 304', 'Boise', 'Ada', 'ID', '83706', '2083424263', '', 'IDSINCLAIRL', NULL, NULL, '0.00', '15.00', '0.00', 3, '2011-01-01', NULL, 0, 0, 1, 'Saint Alphonsus Medical Center Nampa', NULL, '', '', 'HCFA|UB|', '1124073549', 0, 'n', 0, '2012-10-17', NULL, NULL, 43.6126, -116.255, NULL, NULL),
('263770372', 'SACN01441', 'SACN01441', 'SACN', '', 'Amy', 'E', 'Latta', 'PHD', 'Mental Health', 'Psychology', '', NULL, 'O', '1020 W Main St Ste 100B', 'Boise', 'Ada', 'ID', '83702', '2082508939', '2082293099', '1020 W Main St Ste 100B', 'Boise', 'Ada', 'ID', '83702', '2082508939', '2082293099', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 3, '2011-01-01', '2012-02-03', 0, 0, 1, '', '', '', '', 'HCFA|UB|', '1750536264', 0, 'N', 0, '2013-01-09', NULL, NULL, 0, 0, NULL, NULL),
('263770372', 'SACN01442', 'SACN01442', 'SACN', '', 'Amy', 'E', 'Latta', 'PHD', 'Mental Health', 'Psychology', '', NULL, 'B', '7154 W State St Ste 106', 'Boise', 'Ada', 'ID', '83714', '2082508939', '2082293099', '7154 W State St Ste 106', 'Boise', 'Ada', 'ID', '83714', '2082508939', '2082293099', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 3, '2011-01-01', '2012-02-03', 0, 0, 1, '', '', '', '', 'HCFA|UB|', '1750536264', 0, 'Y', 0, '2013-01-09', NULL, NULL, 0, 0, NULL, NULL),
('820161600', 'SACN00459', 'SACN00459', 'SACN', 'Boise Orthopedic Clinic', 'Christopher', 'T', 'Lawler', 'MD This Provider will terminate on July 1st', 'Sports Medicine', 'Emergency Medicine', '', NULL, 'O', '1075 N Curtis Rd Ste 300', 'Boise', 'Ada', 'ID', '83706', '2083232600', NULL, '1075 N Curtis Rd Ste 300', 'Boise', 'Ada', 'ID', '83706', '2083232600', '          ', 'IDSINCLAIRL', 'WUSTDHCPC5', '', '0.00', '15.00', '0.00', 8, '2011-01-01', '2012-07-01', 0, 0, 0, 'Saint Alphonsus Regional Medical Center', 'West Valley Medical Center', NULL, NULL, 'HCFA|UB|', '1801801576', 0, 'N', 0, '2012-05-31', NULL, NULL, 43.6143, -116.258, NULL, NULL),
('820161600', 'SACN00460', 'SACN00460', 'SACN', 'Boise Orthopedic Clinic', 'Christopher', 'T', 'Lawler', 'MD This Provider will terminate on July 1st', 'Sports Medicine', 'Emergency Medicine', '', NULL, 'O', '520 S Eagle Rd Ste 3213', 'Meridian', 'Ada', 'ID', '83642', '2088980100', NULL, '520 S Eagle Rd Ste 3213', 'Meridian', 'Ada', 'ID', '83642', '2088980100', '          ', 'IDSINCLAIRL', 'WUSTDHCPC5', '', '0.00', '15.00', '0.00', 8, '2011-01-01', '2012-07-01', 0, 0, 0, 'Saint Alphonsus Regional Medical Center', 'West Valley Medical Center', NULL, NULL, 'HCFA|UB|', '1801801576', 0, 'N', 0, '2012-05-31', NULL, NULL, 43.5995, -116.352, NULL, NULL),
('820312175', 'SACN00461', 'SACN00461', 'SACN', 'Idaho Emergency Physicians PA', 'Christopher', 'T', 'Lawler', 'MD This Provider will terminate on July 1st', 'Sports Medicine', 'Emergency Medicine', '', NULL, 'o', '1055 N Curtis Rd', 'Boise', 'Ada', 'ID', '83704', '2083221730', '2083221731', '1055 N Curtis Rd', 'Boise', 'Ada', 'ID', '83704', '2083221730', '2083221731', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 3, '2011-01-01', '2012-07-01', 0, 0, 0, 'Saint Alphonsus Regional Medical Center', 'West Valley Medical Center', NULL, NULL, 'HCFA|UB|', '1801801576', 0, 'N', 0, '2012-05-31', NULL, NULL, 43.6136, -116.256, NULL, NULL),
('820312175', 'SACN00462', 'SACN00462', 'SACN', 'Idaho Emergency Physicians PA', 'Christopher', 'T', 'Lawler', 'MD This Provider will terminate on July 1st', 'Sports Medicine', 'Emergency Medicine', '', NULL, 'O', '1717 Arlington', 'Caldwell', 'Canyon', 'ID', '83605', '2083221730', '2083221731', '1717 Arlington', 'Caldwell', 'Canyon', 'ID', '83605', '2083221730', '2083221731', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 3, '2011-01-01', '2012-07-01', 0, 0, 0, 'Saint Alphonsus Regional Medical Center', 'West Valley Medical Center', NULL, NULL, 'HCFA|UB|', '1801801576', 0, 'N', 0, '2012-05-31', NULL, NULL, 0, 0, NULL, NULL),
('820312175', 'SACN00463', 'SACN00463', 'SACN', 'Idaho Emergency Physicians PA', 'Christopher', 'T', 'Lawler', 'MD This Provider will terminate on July 1st', 'Sports Medicine', 'Emergency Medicine', '', NULL, 'B', '2963 E Copper Point Dr', 'Meridian', 'Ada', 'ID', '83642', '2083221730', NULL, '2963 E Copper Point Dr', 'Meridian', 'Ada', 'ID', '83642', '2083221730', '          ', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 3, '2011-01-01', '2012-07-01', 0, 0, 0, 'Saint Alphonsus Regional Medical Center', 'West Valley Medical Center', NULL, NULL, 'HCFA|UB|', '1801801576', 0, 'Y', 0, '2012-05-31', NULL, NULL, 0, 0, NULL, NULL),
('820312175', 'SACN00464', 'SACN00464', 'SACN', 'Idaho Emergency Physicians PA', 'Christopher', 'T', 'Lawler', 'MD This Provider will terminate on July 1st', 'Sports Medicine', 'Emergency Medicine', '', NULL, 'o', '323 E Riverside Dr', 'Eagle', 'Ada', 'ID', '83616', '2083221730', '2083221731', '323 E Riverside Dr', 'Eagle', 'Ada', 'ID', '83616', '2083221730', '2083221731', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 3, '2011-01-01', '2012-07-01', 0, 0, 0, 'Saint Alphonsus Regional Medical Center', 'West Valley Medical Center', NULL, NULL, 'HCFA|UB|', '1801801576', 0, 'N', 0, '2012-05-31', NULL, NULL, 43.6892, -116.351, NULL, NULL),
('820425454', 'SACN00050', 'SACN00050', 'SACN', 'Boise Anesthesia, PA', 'Darin', '', 'Lee', 'CRNA', 'Nurse Anesthetist', '', '', NULL, 'o', '1055 N Curtis Rd', 'Boise', 'Ada', 'ID', '83706', '2083676416', '2083759530', '1055 N Curtis Rd', 'Boise', 'Ada', 'ID', '83706', '2083676416', '2083759530', '', '', '', '58.45', '10.00', '0.00', 3, '2011-01-01', NULL, 1, 15, 0, '', '', '', '', 'HCFA|UB|', '1578519542', 0, 'N', 0, '2012-11-01', NULL, NULL, 43.6127, -116.254, NULL, NULL),
('820425454', 'SACN00051', 'SACN00051', 'SACN', 'Boise Anesthesia, PA', 'Darin', '', 'Lee', 'CRNA', 'Nurse Anesthetist', '', '', NULL, 'o', '1717 Arlington Ave', 'Caldwell', 'Canyon', 'ID', '83605', '2084594641', NULL, '1717 Arlington Ave', 'Caldwell', 'Canyon', 'ID', '83605', '2084594641', '0         ', '', '', '', '58.45', '10.00', '0.00', 3, '2011-01-01', NULL, 1, 15, 0, '', '', '', '', 'HCFA|UB|', '1578519542', 0, 'N', 0, '2012-11-01', NULL, NULL, 0, 0, NULL, NULL);
INSERT INTO `providers_new` (`Provider_Tax_ID`, `Provider_Suffix`, `Provider_Network_ID`, `Provider_Region`, `Provider_Name`, `Provider_Doctor_First_Name`, `Provider_Doctor_Middle_Name`, `Provider_Doctor_Last_Name`, `Provider_Doctor_Degree`, `Provider_Specialty_1`, `Provider_Specialty_2`, `Provider_Specialty_3`, `Provider_Specialty_4`, `Provider_Address_Type`, `Provider_Address`, `Provider_City`, `Provider_County`, `Provider_State`, `Provider_Zip`, `Provider_Phone`, `Provider_Fax`, `Provider_Mailing_Address`, `Provider_Mailing_City`, `Provider_Mailing_County`, `Provider_Mailing_State`, `Provider_Mailing_Zip`, `Provider_Mailing_Phone`, `Provider_Mailing_Fax`, `Provider_Primary_Schedule`, `Provider_Secondary_Schedule`, `Provider_Rate_Sheet`, `Provider_Anes_Rate`, `Provider_Default_Rate`, `Provider_Max_DOS`, `Provider_Min_Match_Value`, `Provider_Effective_Date`, `Provider_Term_Date`, `Provider_Pend`, `Provider_Anes_Minutes`, `Provider_PPO`, `Provider_Hospital_1`, `Provider_Hospital_2`, `Provider_Hospital_3`, `Provider_Hospital_4`, `Provider_Type`, `Provider_NPI`, `Provider_Check_Override`, `Exclude_Dir`, `Audit_Status`, `Last_Change_Date`, `Medicare_ID`, `Provider_Lang`, `Provider_Latitude`, `Provider_Longitude`, `Provider_school`, `Provider_cert`) VALUES
('820200895', 'SACN01649', 'SACN01649', 'SACN', 'Saint Alphonsus Medical Group McMillan Family Practice', 'David', '', 'Lee', 'MD', 'Internal Medicine', '', '', NULL, 'O', '12273 W McMillan Rd', 'Boise', 'Ada', 'ID', '83713', '2083676330', '2083674765', '12273 W McMillan Rd', 'Boise', 'Ada', 'ID', '83713', '2083676330', '2083674765', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Regional Medical Center', '', '', '', 'HCFA|', '1962501890', 0, 'N', 0, '2014-06-20', NULL, NULL, 43.6481, -116.335, NULL, NULL),
('820200895', 'SACN01650', 'SACN01650', 'SACN', 'Saint Alphonsus Medical Group Occupational Medicine Associat', 'David', '', 'Lee', 'MD', 'Internal Medicine', '', '', NULL, 'B', '3340 E Goldstone', 'Meridian', 'Ada', 'ID', '83642', '2083675170', NULL, '3340 E Goldstone', 'Meridian', 'Ada', 'ID', '83642', '2083675170', '', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Regional Medical Center', '', '', '', 'HCFA|', '1962501890', 0, 'N', 0, '2014-06-20', NULL, NULL, 0, 0, NULL, NULL),
('820200895', 'SACN01651', 'SACN01651', 'SACN', 'Saint Alphonsus Medical Group Curtisian Internal Medicine (Moreau Bldg) ', 'David', '', 'Lee', 'MD', 'Internal Medicine', '', '', NULL, 'O', '6140 Curtisian Ste 300', 'Boise', 'Ada', 'ID', '83704', '2083676575', '2083676597', '6140 Curtisian Ste 300', 'Boise', 'Ada', 'ID', '83704', '2083676575', '2083676597', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Regional Medical Center', '', '', '', 'HCFA|', '1962501890', 0, 'N', 0, '2014-06-20', NULL, NULL, 43.615, -116.256, NULL, NULL),
('264333033', 'W12015579', 'W12015579', 'TX01', 'Consultants in Womens Health', 'Jerome', 'T', 'Washington', 'MD', 'Obstetrics and Gynecology', '', '', NULL, 'B', '1210 Arion Pkwy', 'San Antonio', 'Bexar', 'TX', '78216', '2103499300', '2103662558', '1210 Arion Pkwy', 'San Antonio', 'Bexar', 'TX', '78216', '2103499300', '2103662558', 'TXOBG', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2012-03-01', '2012-08-19', 0, 0, 0, 'Baptist Medical Center', '', '', '', 'HCFA|UB|', '1861598971', 0, 'N', 0, '2013-05-24', NULL, NULL, 0, 0, NULL, NULL),
('271524083', 'W12019379', 'W12019379', 'WY01', 'Big Horn Health Network', 'Mark', 'O', 'Walter', 'MD', 'Psychiatry', 'Mental Health', '', NULL, 'O', '944 Jackson', 'Sheridan', 'Sheridan', 'WY', '82801', '3076754630', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '', '', 'BHHN', '0.00', '0.00', '0.00', 3, '2012-03-01', NULL, NULL, 0, NULL, 'Sheridan Memorial Hospital', NULL, NULL, NULL, 'HCFA|', '1205910643', 0, 'N', 0, '2013-02-28', NULL, NULL, 44.8068, -106.976, NULL, NULL),
('271524083', 'W12019378', 'W12019378', 'WYT1', 'Big Horn Health Network', 'Mark', 'O', 'Walter', 'MD', 'Psychiatry', 'Mental Health', '', NULL, 'O', '944 Jackson', 'Sheridan', 'Sheridan', 'WY', '82801', '3076754630', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, 'BHHNMD', 'BHHNMA', '', '0.00', '0.00', '0.00', 3, '2012-03-01', NULL, NULL, 0, NULL, 'Sheridan Memorial Hospital', NULL, NULL, NULL, 'HCFA|', '1205910643', 0, 'N', 0, '2013-02-28', NULL, NULL, 0, 0, NULL, NULL),
('263091124', 'ELHCA0238', 'ELHCA0238', 'TXHOUSTD', 'Complete Womens Care Center', 'Brandi', NULL, 'Wachel', 'NP', 'Obstetrics and Gynecology', '', '', NULL, 'B', 'PO Box 405477     ', 'Atlanta', 'Fulton', 'GA', '30384', NULL, NULL, 'PO Box 405477     ', 'Atlanta', 'Fulton', 'GA', '30384', '', '', 'HCA', 'TXHCPC13', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'The Womans Hospital of Texas', NULL, NULL, NULL, 'HCFA|UB|', '1972562916', 0, 'Y', 0, '2013-05-01', NULL, NULL, 0, 0, NULL, NULL),
('263091124', 'ELHCA0237', 'ELHCA0237', 'TXHOUSTD', 'Complete Womens Care Center', 'Brandi', NULL, 'Wachel', 'NP', 'Obstetrics and Gynecology', '', '', NULL, 'O', '7900 Fannin St Ste 3000', 'Houston', 'Harris', 'TX', '77030', '7137919100', '7137911016', '7900 Fannin St Ste 3000', 'Houston', 'Harris', 'TX', '77030', '7137919100', '7137911016', 'HCA', 'TXHCPC13', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'The Womans Hospital of Texas', NULL, NULL, NULL, 'HCFA|UB|', '1972562916', 0, 'Y', 0, '2013-05-01', NULL, NULL, 29.6896, -95.4034, NULL, NULL),
('820478504', 'SACN01464', 'SACN01464', 'SACN', 'Personal Solutions', 'Alan', 'J', 'Leschinski', 'LCPC LMFT', 'Mental Health', 'Marriage and Family Therapy', 'Counseling', NULL, 'O', '2596 N Stokesberry Pl Ste 100', 'Meridian', 'Ada', 'ID', '83646', '2089383837', NULL, '2596 N Stokesberry Pl Ste 100', 'Meridian', 'Ada', 'ID', '83646', '2089383837', '          ', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 3, '2011-01-01', '2012-12-01', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1780775882', 0, 'N', 0, '2012-11-27', NULL, NULL, 0, 0, NULL, NULL),
('820425454', 'SACN00063', 'SACN00063', 'SACN', 'Boise Anesthesia, PA', 'Bryan', 'W', 'Leuenhagen', 'CRNA', 'Nurse Anesthetist', '', '', NULL, 'o', '1055 N Curtis Rd', 'Boise', 'Ada', 'ID', '83706', '2083676416', '2083759530', '1055 N Curtis Rd', 'Boise', 'Ada', 'ID', '83706', '2083676416', '2083759530', '', '', '', '58.45', '10.00', '0.00', 3, '2011-01-01', NULL, 1, 15, 0, '', '', '', '', 'HCFA|UB|', '1649226168', 0, 'N', 0, '2013-10-29', NULL, NULL, 43.6127, -116.254, NULL, NULL),
('820425454', 'SACN00064', 'SACN00064', 'SACN', 'Boise Anesthesia, PA', 'Bryan', 'W', 'Leuenhagen', 'CRNA', 'Nurse Anesthetist', '', '', NULL, 'o', '1717 Arlington Ave', 'Caldwell', 'Canyon', 'ID', '83605', '2084594641', NULL, '1717 Arlington Ave', 'Caldwell', 'Canyon', 'ID', '83605', '2084594641', '0         ', '', '', '', '58.45', '10.00', '0.00', 3, '2011-01-01', NULL, 1, 15, 0, '', '', '', '', 'HCFA|UB|', '1649226168', 0, 'N', 0, '2013-10-29', NULL, NULL, 0, 0, NULL, NULL),
('820200895', 'SACN01281', 'SACN01281', 'SACN', 'Saint Alphonsus Medical Group Overland Family Medicine', 'Gregory', 'S', 'Lewer', 'MD', 'Family Practice', '', '', NULL, 'O', '10255 W Overland Rd', 'Boise', 'Ada', 'ID', '83709', '2083677205', '2083677204', '10255 W Overland Rd', 'Boise', 'Ada', 'ID', '83709', '2083677205', '2083677204', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Medical Center Nampa', NULL, '', '', 'HCFA|', '1669414975', 0, 'N', 0, '2013-10-07', NULL, NULL, 43.5899, -116.31, NULL, NULL),
('820477852', 'SACN01282', 'SACN01282', 'SACN', 'Saint Alphonsus Medical Group Overland', 'Gregory', 'S', 'Lewer', 'MD', 'Family Practice', '', '', NULL, 'O', '10255 W Overland Rd', 'Boise', 'Ada', 'ID', '83709', '2083677205', '2083677204', '10255 W Overland Rd', 'Boise', 'Ada', 'ID', '83709', '2083677205', '2083677204', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', '2013-08-11', 0, 0, 0, 'Saint Alphonsus Medical Center Nampa', NULL, '', '', 'HCFA|UB|', '1669414975', 0, 'N', 0, '2013-10-07', NULL, NULL, 43.5899, -116.31, NULL, NULL),
('202523793', 'SACN00521', 'SACN00521', 'SACN', 'Ada Orthopaedic Clinic ', 'William', 'C', 'Lindner', 'MD; Shoulder, General', 'Orthopedic Surgery', '', '', NULL, 'O', '6500 W Emerald St', 'Boise', 'Ada', 'ID', '83704', '2083770777', NULL, '6500 W Emerald St', 'Boise', 'Ada', 'ID', '83704', '2083770777', '', 'IDSINCLAIRL', 'WUSTDHCPC5', NULL, '0.00', '15.00', '0.00', 3, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Regional Medical Center', '', '', '', 'HCFA|UB|', '1982649927', 0, 'n', 0, '2014-03-27', NULL, NULL, 43.612, -116.262, NULL, NULL),
('820200895', 'SACN00167', 'SACN00167', 'SACN', 'Idaho Neurology Saint Alphonsus', 'Karin', 'M', 'Lindholm', 'DO', 'Neurology', '', '', NULL, 'O', '1818 S 10th Ave Ste 200', 'Caldwell', 'Canyon', 'ID', '83605', '2083677272', '2083677111', '1818 S 10th Ave Ste 200', 'Caldwell', 'Canyon', 'ID', '83605', '2083677272', '2083677111', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', '2012-01-01', 0, 0, 0, 'Saint Alphonsus Medical Center Nampa', '', '', '', 'HCFA|', '1083660583', 0, 'N', 0, '2012-12-28', NULL, NULL, 43.6538, -116.693, NULL, NULL),
('820200895', 'SACN00168', 'SACN00168', 'SACN', 'Saint Alphonsus Medical Group Neurology Hailey', 'Karin', 'M', 'Lindholm', 'DO', 'Neurology', '', '', NULL, 'O', '706 S Main St', 'Hailey', 'Blaine', 'ID', '83333', '2083677272', '2083677111', '706 S Main St', 'Hailey', 'Blaine', 'ID', '83333', '2083677272', '2083677111', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', '2012-01-01', 0, 0, 0, 'Saint Alphonsus Medical Center Nampa', '', '', '', 'HCFA|', '1083660583', 0, 'Y', 0, '2012-12-28', NULL, NULL, 43.5137, -114.31, NULL, NULL),
('820200895', 'SACN00169', 'SACN00169', 'SACN', 'Saint Alphonsus Medical Group Neurology Boise', 'Karin', 'M', 'Lindholm', 'DO', 'Neurology', '', '', NULL, 'O', '901 N Curtis Ste 403', 'Boise', 'Ada', 'ID', '83706', '2083677272', '2083677111', '901 N Curtis Ste 403', 'Boise', 'Ada', 'ID', '83706', '2083677272', '2083677111', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', '2012-01-01', 0, 0, 0, 'Saint Alphonsus Medical Center Nampa', '', '', '', 'HCFA|', '1083660583', 0, 'N', 0, '2012-12-28', NULL, NULL, 43.6126, -116.255, NULL, NULL),
('820425454', 'SACN00133', 'SACN00133', 'SACN', 'Boise Anesthesia, PA', 'Derek', '', 'Lish', 'CRNA', 'Anesthesiology', '', '', NULL, 'o', '1055 N Curtis Rd', 'Boise', 'Ada', 'ID', '83706', '2083676416', NULL, '1055 N Curtis Rd', 'Boise', 'Ada', 'ID', '83706', '2083676416', '          ', '', '', '', '58.45', '10.00', '0.00', 3, '2011-01-01', NULL, 1, 15, 0, '', '', '', '', 'HCFA|UB|', '1699914044', 0, 'N', 0, '2013-06-24', NULL, NULL, 43.6127, -116.254, NULL, NULL),
('820425454', 'SACN00134', 'SACN00134', 'SACN', 'Boise Anesthesia, PA', 'Derek', '', 'Lish', 'CRNA', 'Anesthesiology', '', '', NULL, 'o', '1717 Arlington Ave', 'Caldwell', 'Canyon', 'ID', '83605', '2084554009', NULL, '1717 Arlington Ave', 'Caldwell', 'Canyon', 'ID', '83605', '2084554009', '          ', '', '', '', '58.45', '10.00', '0.00', 3, '2011-01-01', NULL, 1, 15, 0, '', '', '', '', 'HCFA|UB|', '1699914044', 0, 'N', 0, '2013-06-24', NULL, NULL, 0, 0, NULL, NULL),
('820425454', 'SACN00135', 'SACN00135', 'SACN', 'Boise Anesthesia, PA', 'Derek', '', 'Lish', 'CRNA', 'Anesthesiology', '', '', NULL, 'o', '900 N Liberty St Ste 450', 'Boise', 'Ada', 'ID', '83704', '2053677431', NULL, '900 N Liberty St Ste 450', 'Boise', 'Ada', 'ID', '83704', '2053677431', '          ', '', '', '', '58.45', '10.00', '0.00', 3, '2011-01-01', NULL, 1, 15, 0, '', '', '', '', 'HCFA|UB|', '1699914044', 0, 'N', 0, '2013-06-24', NULL, NULL, 43.6133, -116.259, NULL, NULL),
('571690226', 'SACN00579', 'SACN00579', 'SACN', '', 'Kenneth', 'M', 'Little', 'MD', 'Neurosurgery', '', '', NULL, 'O', '520 S Eagle Rd Ste 1245', 'Meridian', 'Ada', 'ID', '83642', '2083673500', NULL, '520 S Eagle Rd Ste 1245', 'Meridian', 'Ada', 'ID', '83642', '2083673500', '          ', 'IDSINCLAIRL', 'WUSTDHCPC5', '', '0.00', '15.00', '0.00', 3, '2011-01-01', '2012-02-28', 0, 0, 1, '', '', '', '', 'HCFA|UB|', '1023039468', 0, 'N', 0, '2013-10-25', NULL, NULL, 43.5995, -116.352, NULL, NULL),
('571690226', 'SACN00580', 'SACN00580', 'SACN', '', 'Kenneth', 'M', 'Little', '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, '2011-01-01', '2012-02-28', 0, 0, 1, '', '', '', '', 'HCFA|UB|', '1023039468', 0, 'N', 0, '2013-10-25', NULL, NULL, 43.6151, -116.256, NULL, NULL),
('942938348', 'W40018462', 'W40018462', 'UTMH1', 'Valley Mental Health  Inc', 'Samuel', 'B', 'Vincent', 'APRN', 'Mental Health', '', '', NULL, 'B', '5965 S 900 E Ste 430', 'Salt Lake City', 'Salt Lake', 'UT', '84121', '8012637100', NULL, '5965 S 900 E Ste 430', 'Salt Lake City', 'Salt Lake', 'UT', '84121', '8012637100', '          ', 'UTVMHMA', '', '', '0.00', '40.00', '0.00', 6, '2013-02-15', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1538350749', 0, 'N', 0, '2013-07-09', NULL, NULL, 0, 0, NULL, NULL),
('202630141', 'W40013479', 'W40013479', 'IDBOISTD', 'Primary Health Medical Group', 'Jennifer', '', 'Vincent', 'DO', 'Family Practice', '', '', NULL, 'O', '435 S Eagle Rd', 'Eagle', 'Ada', 'ID', '83616', '2089398200', '2089398222', '435 S Eagle Rd', 'Eagle', 'Ada', 'ID', '83616', '2089398200', '2089398222', 'IDPRIMARY', 'WUSTDHCPC5', '', '0.00', '30.00', '0.00', 3, '2013-03-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1215972831', 0, 'Y', 0, '2013-06-10', NULL, NULL, 43.6918, -116.354, NULL, NULL),
('820432465', 'SACN01373', 'SACN01373', 'SACN', 'Family Care Physicians', 'James', 'D', 'Lohmann', 'MD', 'Family Practice', '', '', NULL, 'B', '112 5th Ave W', 'Jerome', 'Jerome', 'ID', '83338', '2083241157', '2083243406', '112 5th Ave W', 'Jerome', 'Jerome', 'ID', '83338', '2083241157', '2083243406', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 3, '2011-01-01', NULL, 0, 0, 1, '', '', '', '', 'HCFA|UB|', '1720077175', 0, 'Y', 0, '2013-06-24', NULL, NULL, 0, 0, NULL, NULL),
('820200895', 'SACN01589', 'SACN01589', 'SACN', 'Saint Alphonsus Medical Group Elm Family Medicine', 'Kari', '', 'Loomis', 'MD', 'Pediatrics', '', '', NULL, 'O', '315 E Elm St Ste 100', 'Caldwell', 'Canyon', 'ID', '83605', '2084597415', '2084533307', '315 E Elm St Ste 100', 'Caldwell', 'Canyon', 'ID', '83605', '2084597415', '2084533307', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', NULL, 0, 0, 0, 'West Valley Medical Center', '', '', '', 'HCFA|', '1881637452', 0, 'N', 0, '2014-06-20', NULL, NULL, 43.6539, -116.695, NULL, NULL),
('820477852', 'SACN01590', 'SACN01590', 'SACN', 'Saint Alphonsus Medical Group Elm Family Medicine', 'Kari', '', 'Loomis', 'MD', 'Pediatrics', '', '', NULL, 'o', '315 E Elm St Ste 100', 'Caldwell', 'Canyon', 'ID', '83605', '2084597415', '2084545113', '315 E Elm St Ste 100', 'Caldwell', 'Canyon', 'ID', '83605', '2084597415', '2084545113', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', NULL, 0, 0, 0, 'West Valley Medical Center', '', '', '', 'HCFA|UB|', '1881637452', 0, 'N', 0, '2014-06-20', NULL, NULL, 43.6539, -116.695, NULL, NULL),
('260553931', 'SACN00616', 'SACN00616', 'SACN', 'Saint Alphonsus Medical Group OB Hospitalist Boise', 'Martha', 'H', 'Lund', 'MD', 'Obstetrics and Gynecology', 'Hospitalist', '', NULL, 'O', '1055 N Curtis Rd', 'Boise', 'Ada', 'ID', '83706', '2083676222', NULL, '1055 N Curtis Rd', 'Boise', 'Ada', 'ID', '83706', '2083676222', '', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Medical Center Nampa', '', '', '', 'HCFA|UB|', '1053356923', 0, 'N', 0, '2014-06-20', NULL, NULL, 43.6127, -116.254, NULL, NULL),
('260553931', 'SACN00617', 'SACN00617', 'SACN', 'Saint Alphonsus Maternal-Fetal Medicine', 'Martha', 'H', 'Lund', 'MD', 'Obstetrics and Gynecology', 'Hospitalist', '', NULL, 'O', '900 N Liberty Ste 206', 'Boise', 'Ada', 'ID', '83704', '2083675544', '2083675543', '900 N Liberty Ste 206', 'Boise', 'Ada', 'ID', '83704', '2083675544', '2083675543', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', '2013-08-01', 0, 0, 0, 'Saint Alphonsus Medical Center Nampa', '', '', '', 'HCFA|UB|', '1053356923', 0, 'Y', 0, '2014-06-20', NULL, NULL, 43.6133, -116.259, NULL, NULL),
('820200895', 'SACN00618', 'SACN00618', 'SACN', 'Saint Alphonsus Medical Group OB/GYN Boise Moreau Bldg ', 'Martha', 'H', 'Lund', 'MD', 'Obstetrics and Gynecology', 'Hospitalist', '', NULL, 'O', '6140 W Curtisian Ste 100', 'Boise', 'Ada', 'ID', '83704', '2083674224', '2083677806', '6140 W Curtisian Ste 100', 'Boise', 'Ada', 'ID', '83704', '2083674224', '2083677806', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', '2013-08-01', 0, 0, 0, 'Saint Alphonsus Medical Center Nampa', '', '', '', 'HCFA|', '1053356923', 0, 'Y', 0, '2014-06-20', NULL, NULL, 43.6151, -116.256, NULL, NULL),
('820200895', 'SACN00619', 'SACN00619', 'SACN', 'Saint Alphonsus Medical Group  OB/GYN Liberty Bldg', 'Martha', 'H', 'Lund', 'MD', 'Obstetrics and Gynecology', 'Hospitalist', '', NULL, 'O', '900 N Liberty Ste 204', 'Boise', 'Ada', 'ID', '83704', '2083672229', '2083674242', '900 N Liberty Ste 204', 'Boise', 'Ada', 'ID', '83704', '2083672229', '2083674242', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Medical Center Nampa', '', '', '', 'HCFA|', '1053356923', 0, 'Y', 0, '2014-06-20', NULL, NULL, 43.6133, -116.259, NULL, NULL),
('820477852', 'SACN00620', 'SACN00620', 'SACN', 'Saint Alphonsus OB Hospitalist Program', 'Martha', 'H', 'Lund', 'MD', 'Obstetrics and Gynecology', 'Hospitalist', '', NULL, 'B', '1055 N Curtis', 'Boise', 'Ada', 'ID', '83706', '2083672121', NULL, '1055 N Curtis', 'Boise', 'Ada', 'ID', '83706', '2083672121', '', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', '2013-08-01', 0, 0, 0, 'Saint Alphonsus Medical Center Nampa', '', '', '', 'HCFA|UB|', '1053356923', 0, 'Y', 0, '2014-06-20', NULL, NULL, 43.6127, -116.254, NULL, NULL),
('942938348', 'W40006868', 'W40006868', 'UTMH1', 'Valley Mental Health  Inc', 'LINDA', NULL, 'VERNON', 'LCSW', 'Mental Health', 'Social Worker', '', NULL, 'B', '5965 S 900 E Ste 430', 'Salt Lake City', 'Salt Lake', 'UT', '84121', '8012637100', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, 'UTVMHMA', NULL, NULL, '0.00', '40.00', '0.00', 6, '2013-02-15', NULL, NULL, 0, NULL, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1629028162', 0, 'Y', 0, '2013-02-28', NULL, NULL, 0, 0, NULL, NULL),
('200603465', 'SACN00230', 'SACN00230', 'SACN', 'Summit Chiropractic', 'Laurisa', 'R', 'Lusby', 'LCSW', 'Mental Health', 'Social Worker', '', NULL, 'O', '413 N Allumbaugh St Ste 102', 'Boise', 'Ada', 'ID', '83704', '2082870993', NULL, '413 N Allumbaugh St Ste 102', 'Boise', 'Ada', 'ID', '83704', '2082870993', '', 'IDSINCLAIRL', NULL, NULL, '0.00', '15.00', '0.00', 3, '2011-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1306974365', 0, 'n', 0, '2013-02-27', NULL, NULL, 43.6086, -116.268, NULL, NULL),
('263031859', 'SACN00231', 'SACN00231', 'SACN', 'Connections Counseling Center', 'Laurisa', 'R', 'Lusby', 'LCSW', 'Mental Health', 'Social Worker', '', NULL, 'B', '2584 E Bergeson', 'Boise', 'Ada', 'ID', '83706', '2089213501', NULL, '2584 E Bergeson', 'Boise', 'Ada', 'ID', '83706', '2089213501', '', 'IDSINCLAIRL', NULL, NULL, '0.00', '15.00', '0.00', 3, '2011-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1306974365', 0, 'y', 0, '2013-02-27', NULL, NULL, 0, 0, NULL, NULL),
('263031859', 'SACN00232', 'SACN00232', 'SACN', 'Connections Counseling Center', 'Laurisa', 'R', 'Lusby', 'LCSW', 'Mental Health', 'Social Worker', '', NULL, 'O', '6550 W Emerald St Ste 110', 'Boise', 'Ada', 'ID', '83704', '2089213501', '8883098143', '6550 W Emerald St Ste 110', 'Boise', 'Ada', 'ID', '83704', '2089213501', '8883098143', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 3, '2011-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1306974365', 0, 'N', 0, '2013-02-27', NULL, NULL, 0, 0, NULL, NULL),
('208501652', 'SACN00916', 'SACN00916', 'SACN', 'Boise Neurological Consultants', 'George', 'R', 'Lyons', 'MD', 'Neurology', '', '', NULL, 'O', '999 N Curtis Rd Ste 506', 'Boise', 'Ada', 'ID', '83706', '2083672800', NULL, '999 N Curtis Rd Ste 506', 'Boise', 'Ada', 'ID', '83706', '2083672800', '', 'IDSINCLAIRL', 'WUSTDHCPC5', '', '0.00', '15.00', '0.00', 3, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Regional Medical Center', '', '', '', 'HCFA|UB|', '1386630465', 0, 'n', 0, '2014-05-19', NULL, NULL, 43.6132, -116.255, NULL, NULL),
('205934739', 'SACN00517', 'SACN00517', 'SACN', 'Family Medicine Health Center', 'Julie', 'Anne', 'Lyons', 'MD', 'Family Practice', 'Obstetrics and Gynecology', '', NULL, 'O', '121 E Fort St', 'Boise', 'Ada', 'ID', '83712', '2083811775', NULL, '121 E Fort St', 'Boise', 'Ada', 'ID', '83712', '2083811775', '          ', 'IDSINCLAIRL', 'WUSTDHCPC5', '', '0.00', '15.00', '0.00', 3, '2011-01-01', '2012-04-05', 0, 0, 1, 'Saint Alphonsus Medical Center Nampa', '', '', '', 'HCFA|UB|', '1982620787', 0, 'N', 0, '2012-12-28', NULL, NULL, 0, 0, NULL, NULL),
('205934739', 'SACN00519', 'SACN00519', 'SACN', 'Family Medicine Health Center', 'Julie', 'Anne', 'Lyons', 'MD', 'Family Practice', 'Obstetrics and Gynecology', '', NULL, 'O', '777 N Raymond St', 'Boise', 'Ada', 'ID', '83704', '2085142500', NULL, '777 N Raymond St', 'Boise', 'Ada', 'ID', '83704', '2085142500', '          ', 'IDSINCLAIRL', 'WUSTDHCPC5', '', '0.00', '15.00', '0.00', 3, '2011-01-01', '2012-04-05', 0, 0, 1, 'Saint Alphonsus Medical Center Nampa', '', '', '', 'HCFA|UB|', '1982620787', 0, 'N', 0, '2012-12-28', NULL, NULL, 0, 0, NULL, NULL),
('820200895', 'SACN01312', 'SACN01312', 'SACN', 'Saint Alphonsus Medical Group Pulmonary & Sleep Boise ', 'Brekk', '', 'Macpherson', 'NP-C', 'Nurse Practitioner', '', '', NULL, 'O', '1075 N Curtis Ste 200 Bldg 6', 'Boise', 'Ada', 'ID', '83706', '2083678333', '2083672003', '1075 N Curtis Ste 200 Bldg 6', 'Boise', 'Ada', 'ID', '83706', '2083678333', '2083672003', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Medical Center Nampa', '', '', '', 'HCFA|', '1669798286', 0, 'N', 0, '2011-09-19', NULL, NULL, 43.6143, -116.258, NULL, NULL),
('820200895', 'SACN01313', 'SACN01313', 'SACN', 'Northwest Pulmonary Saint Alphonsus ', 'Brekk', '', 'Macpherson', 'NP-C', 'Nurse Practitioner', '', '', NULL, 'B', '3340 E Goldstone', 'Meridian', 'Ada', 'ID', '83642', '2083675170', '2083672003', '3340 E Goldstone', 'Meridian', 'Ada', 'ID', '83642', '2083675170', '2083672003', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Medical Center Nampa', '', '', '', 'HCFA|', '1669798286', 0, 'N', 0, '2011-09-19', NULL, NULL, 0, 0, NULL, NULL),
('820200895', 'SACN01314', 'SACN01314', 'SACN', 'Northwest Pulmonary Saint Alphonsus ', 'Brekk', '', 'Macpherson', 'NP-C', 'Nurse Practitioner', '', '', NULL, 'O', '6140 W Curtisian Ste B10', 'Boise', 'Ada', 'ID', '83704', '2083678333', '2083672003', '6140 W Curtisian Ste B10', 'Boise', 'Ada', 'ID', '83704', '2083678333', '2083672003', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', '2011-05-01', 0, 0, 0, 'Saint Alphonsus Medical Center Nampa', '', '', '', 'HCFA|', '1669798286', 0, 'N', 0, '2011-09-19', NULL, NULL, 43.6151, -116.256, NULL, NULL),
('820200895', 'SACN00690', 'SACN00690', 'SACN', 'Saint Alphonsus Medical Group Hosptialist Boise', 'Alan', 'M', 'Maderious', 'MD', 'Internal Medicine', '', '', NULL, 'B', '1055 N Curtis Rd', 'Boise', 'Ada', 'ID', '83706', '2083676279', '2083675180', '1055 N Curtis Rd', 'Boise', 'Ada', 'ID', '83706', '2083676279', '2083675180', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Regional Medical Center', '', '', '', 'HCFA|', '1134162530', 0, 'N', 0, '2014-06-20', NULL, NULL, 43.6127, -116.254, NULL, NULL),
('820200895', 'SACN00691', 'SACN00691', 'SACN', 'Saint Alphonsus Medical Group Curtisian Internal Medicine (Moreau Bldg) ', 'Alan', 'M', 'Maderious', 'MD', 'Internal Medicine', '', '', NULL, 'O', '6140 Curtisian Ste 300', 'Boise', 'Ada', 'ID', '83704', '2083676575', '2083676597', '6140 Curtisian Ste 300', 'Boise', 'Ada', 'ID', '83704', '2083676575', '2083676597', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Regional Medical Center', '', '', '', 'HCFA|', '1134162530', 0, 'N', 0, '2014-06-20', NULL, NULL, 43.615, -116.256, NULL, NULL),
('820477852', 'SACN00692', 'SACN00692', 'SACN', 'Saint Alphonsus Medical Group Internal Medicine', 'Alan', 'M', 'Maderious', 'MD', 'Internal Medicine', '', '', NULL, 'o', '6140 Curtisian Ste 300', 'Boise', 'Ada', 'ID', '83704', '2083676575', '2083676597', '6140 Curtisian Ste 300', 'Boise', 'Ada', 'ID', '83704', '2083676575', '2083676597', 'IDSINCLAIRL', NULL, '', '0.00', '15.00', '0.00', 6, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Regional Medical Center', '', '', '', 'HCFA|UB|', '1134162530', 0, 'n', 0, '2014-06-20', NULL, NULL, 43.615, -116.256, NULL, NULL),
('820200895', 'SACN01059', 'SACN01059', 'SACN', 'Saint Alphonsus Medical Group Womens Health', 'William', 'T', 'Madland', 'MD', 'Obstetrics and Gynecology', '', '', NULL, 'O', '3025 W Cherry Ln Ste B', 'Meridian', 'Ada', 'ID', '83642', '2083674224', '2083677806', '3025 W Cherry Ln Ste B', 'Meridian', 'Ada', 'ID', '83642', '2083674224', '2083677806', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', '2011-12-01', 0, 0, 0, '', '', '', '', 'HCFA|', '1487742151', 0, 'Y', 0, '2014-06-20', NULL, NULL, 43.6188, -116.431, NULL, NULL),
('820200895', 'SACN01060', 'SACN01060', 'SACN', 'Saint Alphonsus Medical Group Eagle Health Plaza', 'William', 'T', 'Madland', 'MD', 'Obstetrics and Gynecology', '', '', NULL, 'O', '323 E Riverside Dr Ste 224', 'Eagle', 'Ada', 'ID', '83616', '2083675750', '2083677806', '323 E Riverside Dr Ste 224', 'Eagle', 'Ada', 'ID', '83616', '2083675750', '2083677806', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', '2011-12-01', 0, 0, 0, '', '', '', '', 'HCFA|', '1487742151', 0, 'Y', 0, '2014-06-20', NULL, NULL, 43.6892, -116.351, NULL, NULL),
('820200895', 'SACN01061', 'SACN01061', 'SACN', 'Saint Alphonsus Medical GroupOB/GYN Boise Moreau Bldg', 'William', 'T', 'Madland', 'MD', 'Obstetrics and Gynecology', '', '', NULL, 'O', '6140 W Curtisian Ste 100', 'Boise', 'Ada', 'ID', '83704', '2083674224', '2083677806', '6140 W Curtisian Ste 100', 'Boise', 'Ada', 'ID', '83704', '2083674224', '2083677806', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|', '1487742151', 0, 'N', 0, '2014-06-20', NULL, NULL, 43.6151, -116.256, NULL, NULL),
('820200895', 'SACN01062', 'SACN01062', 'SACN', 'Saint Alphonsus Medical Group Womens Health', 'William', 'T', 'Madland', 'MD', 'Obstetrics and Gynecology', '', '', NULL, 'O', '900 N Liberty Ste 204', 'Boise', 'Ada', 'ID', '83704', '2083672229', '2083677806', '900 N Liberty Ste 204', 'Boise', 'Ada', 'ID', '83704', '2083672229', '2083677806', 'IDSINCLAIRL', NULL, '', '0.00', '15.00', '0.00', 6, '2011-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|', '1487742151', 0, 'Y', 0, '2014-06-20', NULL, NULL, 43.6133, -116.259, NULL, NULL),
('820200895', 'SACN01063', 'SACN01063', 'SACN', 'CARE Maternal/Child Health Program - Do Not Publish', 'William', 'T', 'Madland', 'MD', 'Obstetrics and Gynecology', '', '', NULL, 'O', '900 N Liberty St Ste 100', 'Boise', 'Ada', 'ID', '83704', '2083672126', '2083677806', '900 N Liberty St Ste 100', 'Boise', 'Ada', 'ID', '83704', '2083672126', '2083677806', 'IDSINCLAIRL', NULL, '', '0.00', '15.00', '0.00', 6, '2011-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|', '1487742151', 0, 'Y', 0, '2014-06-20', NULL, NULL, 43.6133, -116.259, NULL, NULL),
('820477852', 'SACN01064', 'SACN01064', 'SACN', 'Saint Alphonsus Medical Group Womens Health', 'William', 'T', 'Madland', 'MD', 'Obstetrics and Gynecology', '', '', NULL, 'o', '6140 W Curtisian Ste 100', 'Boise', 'Ada', 'ID', '83704', '2083674224', '2083677806', '6140 W Curtisian Ste 100', 'Boise', 'Ada', 'ID', '83704', '2083674224', '2083677806', 'IDSINCLAIRL', NULL, '', '0.00', '15.00', '0.00', 6, '2011-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1487742151', 0, 'n', 0, '2014-06-20', NULL, NULL, 43.6151, -116.256, NULL, NULL),
('204186533', 'SACN01234', 'SACN01234', 'SACN', 'Fazzio Clinic', 'Julie', '', 'Madsen', 'MD', 'General Surgery', '', '', NULL, 'O', '7301 W Emerald St Ste 102', 'Boise', 'Ada', 'ID', '83704', '2083218600', '2083218626', '7301 W Emerald St Ste 102', 'Boise', 'Ada', 'ID', '83704', '2083218600', '2083218626', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 3, '2011-01-01', '2012-01-01', 0, 0, 1, '', '', '', '', 'HCFA|UB|', '1639287865', 0, 'N', 0, '2012-01-31', NULL, NULL, 0, 0, NULL, NULL),
('820161600', 'SACN00371', 'SACN00371', 'SACN', 'Boise Orthopedic Clinic', 'Stefanie', 'J', 'Magee', 'PA', 'Orthopedic Surgery', '', '', NULL, 'O', '520 S Eagle Rd Ste 3213', 'Meridian', 'Ada', 'ID', '83642', '2088980100', NULL, '520 S Eagle Rd Ste 3213', 'Meridian', 'Ada', 'ID', '83642', '2088980100', '          ', 'IDSINCLAIRL', 'WUSTDHCPC5', '', '0.00', '15.00', '0.00', 8, '2011-01-01', '2012-07-01', 0, 0, 0, 'Saint Alphonsus Regional Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1639403041', 0, 'N', 0, '2013-11-22', NULL, NULL, 43.5995, -116.352, NULL, NULL),
('820161600', 'SACN00372', 'SACN00372', 'SACN', 'Boise Orthopedic Clinic', 'Stefanie', 'J', 'Magee', 'PA', 'Orthopedic Surgery', '', '', NULL, 'O', '703 S Americana Blvd Ste 120', 'Boise', 'Ada', 'ID', '83702', '2083232600', NULL, '703 S Americana Blvd Ste 120', 'Boise', 'Ada', 'ID', '83702', '2083232600', '          ', 'IDSINCLAIRL', 'WUSTDHCPC5', '', '0.00', '15.00', '0.00', 8, '2011-01-01', '2012-07-01', 0, 0, 0, 'Saint Alphonsus Regional Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1639403041', 0, 'N', 0, '2013-11-22', NULL, NULL, 0, 0, NULL, NULL),
('820200895', 'SACN00873', 'SACN00873', 'SACN', 'Saint Alphonsus Medical Group Hosptialist Boise', 'John', 'W', 'Mahan', 'MD', 'Hospitalist', '', '', NULL, 'B', '1055 N Curtis Rd', 'Boise', 'Ada', 'ID', '83706', '2083676279', '2083675180', '1055 N Curtis Rd', 'Boise', 'Ada', 'ID', '83706', '2083676279', '2083675180', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Medical Center Nampa', '', '', '', 'HCFA|', '1346241296', 0, 'Y', 0, '2013-04-03', NULL, NULL, 43.6127, -116.254, NULL, NULL),
('820477852', 'SACN00874', 'SACN00874', 'SACN', 'Saint Alphonsus Medical Group Internal Medicine', 'John', 'W', 'Mahan', 'MD', 'Hospitalist', '', '', NULL, 'o', '6140 Curtisian Ste 300', 'Boise', 'Ada', 'ID', '83704', '2083676575', '2083676597', '6140 Curtisian Ste 300', 'Boise', 'Ada', 'ID', '83704', '2083676575', '2083676597', 'IDSINCLAIRL', NULL, NULL, '0.00', '15.00', '0.00', 6, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Medical Center Nampa', '', '', '', 'HCFA|UB|', '1346241296', 0, 'Y', 0, '2013-04-03', NULL, NULL, 43.615, -116.256, NULL, NULL),
('260553931', 'SACN01386', 'SACN01386', 'SACN', 'Saint Alphonsus Medical Group Heart Care Caldwell', 'Beth', '', 'Malasky', 'MD', 'Cardiology', '', '', NULL, 'O', '1818 S 10th Ave Ste 200', 'Caldwell', 'Canyon', 'ID', '83605', '2083675734', '2083675744', '1818 S 10th Ave Ste 200', 'Caldwell', 'Canyon', 'ID', '83605', '2083675734', '2083675744', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Regional Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1730285719', 0, 'N', 0, '2013-10-07', NULL, NULL, 43.6538, -116.693, NULL, NULL),
('260553931', 'SACN01387', 'SACN01387', 'SACN', 'Saint Alponsus Medical Group Heart Care Meridian', 'Beth', '', 'Malasky', 'MD', 'Cardiology', '', '', NULL, 'O', '3025 W Cherry Ln Ste 205', 'Meridian', 'Ada', 'ID', '83642', '2083674278', '2083675200', '3025 W Cherry Ln Ste 205', 'Meridian', 'Ada', 'ID', '83642', '2083674278', '2083675200', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Regional Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1730285719', 0, 'N', 0, '2013-10-07', NULL, NULL, 43.6188, -116.431, NULL, NULL),
('260553931', 'SACN01388', 'SACN01388', 'SACN', 'Saint Alponsus Medical Group Heart Care Elm', 'Beth', '', 'Malasky', 'MD', 'Cardiology', '', '', NULL, 'O', '315 E Elm St', 'Caldwell', 'Canyon', 'ID', '83605', '2083674278', '2083675200', '315 E Elm St', 'Caldwell', 'Canyon', 'ID', '83605', '2083674278', '2083675200', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Regional Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1730285719', 0, 'N', 0, '2013-10-07', NULL, NULL, 43.6539, -116.695, NULL, NULL),
('260553931', 'SACN01389', 'SACN01389', 'SACN', 'Saint Alponsus Medical Group Heart Care Boise', 'Beth', '', 'Malasky', 'MD', 'Cardiology', '', '', NULL, 'O', '6140 Curtisian Ste 200', 'Boise', 'Ada', 'ID', '83704', '2083674278', '2083675200', '6140 Curtisian Ste 200', 'Boise', 'Ada', 'ID', '83704', '2083674278', '2083675200', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Regional Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1730285719', 0, 'N', 0, '2014-01-24', NULL, NULL, 43.615, -116.256, NULL, NULL),
('820484706', 'SACN00608', 'SACN00608', 'SACN', 'Idaho Nephrology Associates', 'Michael', 'C', 'Mallea', 'MD', 'Nephrology', '', '', NULL, 'O', '5610 Gage St Ste A', 'Boise', 'Ada', 'ID', '83706', '2083673370', NULL, '5610 Gage St Ste A', 'Boise', 'Ada', 'ID', '83706', '2083673370', '', 'IDSINCLAIRL', NULL, NULL, '0.00', '15.00', '0.00', 3, '2011-01-01', NULL, 0, 0, 1, 'Saint Alphonsus Medical Center Nampa', NULL, '', '', 'HCFA|UB|', '1043235377', 0, 'N', 0, '2014-03-26', NULL, NULL, 0, 0, NULL, NULL),
('205294327', 'SACN00867', 'SACN00867', 'SACN', 'Digestive Health Clinic ', 'Mark', 'A', 'Mallory', 'MD', 'Gastroenterology', '', '', NULL, 'O', '6259 W Emerald St', 'Boise', 'Ada', 'ID', '83704', '2084891900', NULL, '6259 W Emerald St', 'Boise', 'Ada', 'ID', '83704', '2084891900', '', 'IDSINCLAIRL', 'WUSTDHCPC5', NULL, '0.00', '15.00', '0.00', 6, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Regional Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1336116888', 0, 'n', 0, '2011-10-03', NULL, NULL, 43.6114, -116.259, NULL, NULL),
('529231136', 'SACN00208', 'SACN00208', 'SACN', '', 'Lisa', 'M', 'Manery', 'LCSW', 'Mental Health', 'Social Worker', '', NULL, 'B', '12868 Dayside St', 'Caldwell', 'Canyon', 'ID', '83607', '2082836286', NULL, '12868 Dayside St', 'Caldwell', 'Canyon', 'ID', '83607', '2082836286', '          ', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 3, '2011-01-01', '2012-08-01', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1235216466', 0, 'Y', 0, '2013-01-08', NULL, NULL, 0, 0, NULL, NULL),
('529231136', 'SACN00209', 'SACN00209', 'SACN', '', 'Lisa', 'M', 'Manery', 'LCSW', 'Mental Health', 'Social Worker', '', NULL, 'O', '1303 N W 16th', 'Fruitland', 'Payette', 'ID', '83619', '2082836286', NULL, '1303 N W 16th', 'Fruitland', 'Payette', 'ID', '83619', '2082836286', '          ', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 3, '2011-01-01', '2012-08-01', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1235216466', 0, 'N', 0, '2013-01-08', NULL, NULL, 0, 0, NULL, NULL),
('529231136', 'SACN00210', 'SACN00210', 'SACN', '', 'Lisa', 'M', 'Manery', 'LCSW', 'Mental Health', 'Social Worker', '', NULL, 'O', '690 S Industry Way Ste 45', 'Meridian', 'Ada', 'ID', '83646', '2082836286', NULL, '690 S Industry Way Ste 45', 'Meridian', 'Ada', 'ID', '83646', '2082836286', '          ', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 3, '2011-01-01', '2012-08-01', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1235216466', 0, 'N', 0, '2013-01-08', NULL, NULL, 0, 0, NULL, NULL),
('529231136', 'SACN00211', 'SACN00211', 'SACN', '', 'Lisa', 'M', 'Manery', 'LCSW', 'Mental Health', 'Social Worker', '', NULL, 'O', '9703 W Ustick Rd Ste 100', 'Boise', 'Ada', 'ID', '83704', '2082836286', NULL, '9703 W Ustick Rd Ste 100', 'Boise', 'Ada', 'ID', '83704', '2082836286', '          ', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 3, '2011-01-01', '2012-08-01', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1235216466', 0, 'N', 0, '2013-01-08', NULL, NULL, 0, 0, NULL, NULL),
('461965952', 'SACN01576', 'SACN01576', '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, '2011-01-01', '2012-02-28', 0, 0, 1, 'Saint Alphonsus Medical Center Nampa', '', '', '', 'HCFA|UB|', '1861501637', 0, 'N', 0, '2014-02-10', NULL, NULL, 43.6151, -116.256, NULL, NULL),
('820482491', 'SACN01612', 'SACN01612', 'SACN', 'Intermountain Eye & Laser Centers PLLC', 'Molly', 'J', 'Mannschreck', 'MD', 'Ophthalmology', '', '', NULL, 'B', '6063 Corporal Ln', 'Boise', 'Ada', 'ID', '83704', '2083758799', '2083758798', '6063 Corporal Ln', 'Boise', 'Ada', 'ID', '83704', '2083758799', '2083758798', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 3, '2011-01-01', '2011-08-14', 0, 0, 1, 'Saint Alphonsus Medical Center Nampa', '', '', '', 'HCFA|UB|', '1912091455', 0, 'Y', 0, '2011-08-11', NULL, NULL, 0, 0, NULL, NULL),
('820482491', 'SACN01613', 'SACN01613', 'SACN', 'Intermountain Eye & Laser Centers', 'Molly', 'J', 'Mannschreck', 'MD', 'Ophthalmology', '', '', NULL, 'O', '999 N Curtis Ste 205', 'Boise', 'Ada', 'ID', '83706', '2083731200', '2083731216', '999 N Curtis Ste 205', 'Boise', 'Ada', 'ID', '83706', '2083731200', '2083731216', 'IDSINCLAIRL', NULL, NULL, '0.00', '15.00', '0.00', 3, '2011-01-01', NULL, 0, 0, 1, 'Saint Alphonsus Medical Center Nampa', '', '', '', 'HCFA|UB|', '1912091455', 0, 'N', 0, '2011-08-11', NULL, NULL, 43.6132, -116.255, NULL, NULL),
('820425454', 'SACN00112', 'SACN00112', 'SACN', 'Boise Anesthesia, PA', 'C Paul', '', 'Mansfield', 'CRNA', 'Nurse Anesthetist', '', '', NULL, 'o', '1055 N Curtis Rd', 'Boise', 'Ada', 'ID', '83706', '2083676416', '2083759530', '1055 N Curtis Rd', 'Boise', 'Ada', 'ID', '83706', '2083676416', '2083759530', '', '', '', '58.45', '10.00', '0.00', 3, '2011-01-01', NULL, 1, 15, 0, '', '', '', '', 'HCFA|UB|', '1972558393', 0, 'N', 0, '2012-11-01', NULL, NULL, 43.6127, -116.254, NULL, NULL),
('820425454', 'SACN00113', 'SACN00113', 'SACN', 'Boise Anesthesia, PA', 'C Paul', '', 'Mansfield', 'CRNA', 'Nurse Anesthetist', '', '', NULL, 'o', '1717 Arlington Ave', 'Caldwell', 'Canyon', 'ID', '83605', '2084594641', NULL, '1717 Arlington Ave', 'Caldwell', 'Canyon', 'ID', '83605', '2084594641', '0         ', '', '', '', '58.45', '10.00', '0.00', 3, '2011-01-01', NULL, 1, 15, 0, '', '', '', '', 'HCFA|UB|', '1972558393', 0, 'N', 0, '2012-11-01', NULL, NULL, 0, 0, NULL, NULL),
('820408266', 'SACN01055', 'SACN01055', 'SACN', 'Basin Community Health Center', 'Lynda', 'J', 'Marcile-Kuwahara', 'NP', 'Mental Health', 'Counseling', '', NULL, 'O', '3852 Hwy 21', 'Idaho City', 'Boise', 'ID', '83631', '2083924544', NULL, '3852 Hwy 21', 'Idaho City', 'Boise', 'ID', '83631', '2083924544', '', 'IDSINCLAIRL', 'WUSTDHCPC5', '', '0.00', '15.00', '0.00', 3, '2011-01-01', '2011-09-01', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1487633293', 0, 'N', 0, '2014-07-09', NULL, NULL, 0, 0, NULL, NULL),
('820408266', 'SACN01056', 'SACN01056', 'SACN', 'Basin Community Health Center', 'Lynda', 'J', 'Marcile-Kuwahara', 'NP', 'Mental Health', 'Counseling', '', NULL, 'B', 'PO Box 554', 'Idaho City', 'Boise', 'ID', '83631', '2083924544', NULL, 'PO Box 554', 'Idaho City', 'Boise', 'ID', '83631', '2083924544', '', 'IDSINCLAIRL', 'WUSTDHCPC5', '', '0.00', '15.00', '0.00', 3, '2011-01-01', '2011-09-01', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1487633293', 0, 'N', 0, '2014-07-09', NULL, NULL, 0, 0, NULL, NULL),
('260553931', 'SACN00258', 'SACN00258', 'SACN', 'Saint Alphonsus Medical Group Comprehensive Pain and Spine', 'Daniel', 'R', 'Marsh', 'MD', 'Pain Management', NULL, NULL, NULL, 'O', '1055 N Curtis Rd 6th Floor', 'Boise', 'Ada', 'ID', '83706', '2083674306', '2083677667', '1055 N Curtis Rd 6th Floor', 'Boise', 'Ada', 'ID', '83706', '2083674306', '2083677667', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', '2013-12-07', 0, 0, 0, 'Saint Alphonsus Medical Center Nampa', '', '', '', 'HCFA|UB|', '1356377535', 0, 'N', 0, '2013-12-26', NULL, NULL, 43.6127, -116.254, NULL, NULL),
('331078261', 'SACN00259', 'SACN00259', 'SACN', 'Saint Alphonsus Physicians PA', 'Daniel', 'R', 'Marsh', 'MD', 'Pain Management', NULL, NULL, NULL, 'o', '1055 N Curtis Rd 6th Floor', 'Boise', 'Ada', 'ID', '83706', '2083674306', NULL, '1055 N Curtis Rd 6th Floor', 'Boise', 'Ada', 'ID', '83706', '2083674306', '          ', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 3, '2011-01-01', '2013-12-07', 0, 0, 0, 'Saint Alphonsus Medical Center Nampa', '', '', '', 'HCFA|UB|', '1356377535', 0, 'N', 0, '2013-12-26', NULL, NULL, 43.6127, -116.254, NULL, NULL),
('820200895', 'SACN01460', 'SACN01460', 'SACN', 'Saint Alphonsus Medical Group Pulmonary & Sleep Boise ', 'Marian', 'M', 'Marsh', 'PA-C', 'Physician Assistant', '', '', NULL, 'O', '1075 N Curtis Ste 200 Bldg 6', 'Boise', 'Ada', 'ID', '83706', '2083678333', '2083672003', '1075 N Curtis Ste 200 Bldg 6', 'Boise', 'Ada', 'ID', '83706', '2083678333', '2083672003', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Medical Center Nampa', '', '', '', 'HCFA|', '1770733560', 0, 'N', 0, '2011-09-19', NULL, NULL, 43.6143, -116.258, NULL, NULL),
('820200895', 'SACN01461', 'SACN01461', 'SACN', 'Northwest Pulmonary Saint Alphonsus ', 'Marian', 'M', 'Marsh', 'PA-C', 'Physician Assistant', '', '', NULL, 'O', '6140 W Curtisian Ste B10', 'Boise', 'Ada', 'ID', '83704', '2083678333', '2083672003', '6140 W Curtisian Ste B10', 'Boise', 'Ada', 'ID', '83704', '2083678333', '2083672003', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', '2011-05-01', 0, 0, 0, 'Saint Alphonsus Medical Center Nampa', '', '', '', 'HCFA|', '1770733560', 0, 'N', 0, '2011-09-19', NULL, NULL, 43.6151, -116.256, NULL, NULL),
('263091562', 'ELHCA0236', 'ELHCA0236', 'TXHOUSTD', 'Bay Colony Physicians ', 'Gilbert', '', 'Veasey', 'MD', 'Family Practice', '', '', NULL, 'B', 'PO Box 405470      ', 'Atlanta', 'Fulton', 'GA', '30384', '          ', NULL, 'PO Box 405470      ', 'Atlanta', 'Fulton', 'GA', '30384', '          ', '          ', 'HCA', 'TXHCPC13', '', '0.00', '45.00', '0.00', 3, '2013-01-01', '2013-08-01', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1720297526', 0, 'Y', 0, '2013-09-09', NULL, NULL, 0, 0, NULL, NULL),
('263091562', 'ELHCA0235', 'ELHCA0235', 'TXHOUSTD', 'Bay Colony Physicians ', 'Gilbert', '', 'Veasey', 'MD', 'Family Practice', '', '', NULL, 'O', '1804 FM 646                    Ste J', 'Dickinson', 'Galveston', 'TX', '77539', '2815340400', '2815340440', '1804 FM 646                    Ste J', 'Dickinson', 'Galveston', 'TX', '77539', '2815340400', '2815340440', 'HCA', 'TXHCPC13', '', '0.00', '45.00', '0.00', 3, '2013-01-01', '2013-08-01', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1720297526', 0, 'N', 0, '2013-09-09', NULL, NULL, 0, 0, NULL, NULL),
('820425454', 'SACN00083', 'SACN00083', 'SACN', 'Boise Anesthesia, PA', 'John', 'T', 'Martin', 'MD', 'Anesthesiology', '', '', NULL, 'o', '1055 N Curtis Rd', 'Boise', 'Ada', 'ID', '83706', '2083676416', '2083759530', '1055 N Curtis Rd', 'Boise', 'Ada', 'ID', '83706', '2083676416', '2083759530', '', '', '', '58.45', '10.00', '0.00', 3, '2011-01-01', NULL, 1, 15, 0, 'Saint Alphonsus Regional Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1720031479', 0, 'N', 0, '2012-11-01', NULL, NULL, 43.6127, -116.254, NULL, NULL),
('820425454', 'SACN00084', 'SACN00084', 'SACN', 'Boise Anesthesia, PA', 'John', 'T', 'Martin', 'MD', 'Anesthesiology', '', '', NULL, 'o', '1717 Arlington Ave', 'Caldwell', 'Canyon', 'ID', '83605', '2084594641', NULL, '1717 Arlington Ave', 'Caldwell', 'Canyon', 'ID', '83605', '2084594641', '0         ', '', '', '', '58.45', '10.00', '0.00', 3, '2011-01-01', NULL, 1, 15, 0, 'Saint Alphonsus Regional Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1720031479', 0, 'N', 0, '2012-11-01', NULL, NULL, 0, 0, NULL, NULL),
('820425454', 'SACN00085', 'SACN00085', 'SACN', 'Boise Anesthesia, PA', 'John', 'T', 'Martin', 'MD', 'Anesthesiology', '', '', NULL, 'o', '3025 W Cherry Ln', 'Meridian', 'Ada', 'ID', '83642', '2083678500', NULL, '3025 W Cherry Ln', 'Meridian', 'Ada', 'ID', '83642', '2083678500', '0         ', '', '', '', '58.45', '10.00', '0.00', 3, '2011-01-01', NULL, 1, 15, 0, 'Saint Alphonsus Regional Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1720031479', 0, 'N', 0, '2012-11-01', NULL, NULL, 43.6188, -116.431, NULL, NULL),
('820200895', 'SACN01098', 'SACN01098', 'SACN', 'Saint Alphonsus Medical Group Family Medicine Dominican ', 'Mylynda', 'B', 'Massart', 'MD', 'Family Practice', '', '', NULL, 'O', '1118 NW 16th St Ste A', 'Fruitland', 'Payette', 'ID', '83619', '2084526851', '2084522140', '1118 NW 16th St Ste A', 'Fruitland', 'Payette', 'ID', '83619', '2084526851', '2084522140', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', NULL, 0, 0, 0, 'West Valley Medical Center', NULL, NULL, NULL, 'HCFA|', '1497936587', 0, 'Y', 0, '2013-09-05', NULL, NULL, 44.025, -116.928, NULL, NULL),
('820200895', 'SACN01099', 'SACN01099', 'SACN', 'Saint Alphonsus Medical Group Garrity Family Medicine', 'Mylynda', 'B', 'Massart', 'MD', 'Family Practice', '', '', NULL, 'O', '1200 Garrity Blvd', 'Nampa', 'Canyon', 'ID', '83687', '2084669092', '2084665322', '1200 Garrity Blvd', 'Nampa', 'Canyon', 'ID', '83687', '2084669092', '2084665322', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', NULL, 0, 0, 0, 'West Valley Medical Center', NULL, NULL, NULL, 'HCFA|', '1497936587', 0, 'Y', 0, '2013-09-05', NULL, NULL, 43.587, -116.549, NULL, NULL),
('820200895', 'SACN01100', 'SACN01100', 'SACN', 'Saint Alphonsus Medical Group Iowa', 'Mylynda', 'B', 'Massart', 'MD', 'Family Practice', '', '', NULL, 'O', '211 W Iowa Ave', 'Caldwell', 'Canyon', 'ID', '83686', '2084657377', '2084657397', '211 W Iowa Ave', 'Caldwell', 'Canyon', 'ID', '83686', '2084657377', '2084657397', 'IDSINCLAIRL', NULL, NULL, '0.00', '15.00', '0.00', 6, '2011-01-01', NULL, 0, 0, 0, 'West Valley Medical Center', NULL, NULL, NULL, 'HCFA|', '1497936587', 0, 'Y', 0, '2013-09-05', NULL, NULL, 43.554, -116.638, NULL, NULL),
('820200895', 'SACN01101', 'SACN01101', 'SACN', 'Saint Alphonsus Medical Group MHP Family Medicine', 'Mylynda', 'B', 'Massart', 'MD', 'Family Practice', '', '', NULL, 'O', '3025 W Cherry Ln Ste B', 'Meridian', 'Ada', 'ID', '83642', '2083678550', '2083678555', '3025 W Cherry Ln Ste B', 'Meridian', 'Ada', 'ID', '83642', '2083678550', '2083678555', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', NULL, 0, 0, 0, 'West Valley Medical Center', NULL, NULL, NULL, 'HCFA|', '1497936587', 0, 'Y', 0, '2013-09-05', NULL, NULL, 43.6188, -116.431, NULL, NULL),
('820200895', 'SACN01102', 'SACN01102', 'SACN', 'Saint Alphonsus Medical Group Elm Family Medicine', 'Mylynda', 'B', 'Massart', 'MD', 'Family Practice', '', '', NULL, 'O', '315 E Elm St Ste 100', 'Caldwell', 'Canyon', 'ID', '83605', '2084597415', '2084533307', '315 E Elm St Ste 100', 'Caldwell', 'Canyon', 'ID', '83605', '2084597415', '2084533307', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', NULL, 0, 0, 0, 'West Valley Medical Center', NULL, NULL, NULL, 'HCFA|', '1497936587', 0, 'N', 0, '2013-09-05', NULL, NULL, 43.6539, -116.695, NULL, NULL),
('820200895', 'SACN01103', 'SACN01103', 'SACN', 'Saint Alphonsus Medical Group Emerald Family Medicine', 'Mylynda', 'B', 'Massart', 'MD', 'Family Practice', '', '', NULL, 'O', '6533 Emerald St', 'Boise', 'Ada', 'ID', '83704', '2083674170', '2083678135', '6533 Emerald St', 'Boise', 'Ada', 'ID', '83704', '2083674170', '2083678135', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', NULL, 0, 0, 0, 'West Valley Medical Center', NULL, NULL, NULL, 'HCFA|', '1497936587', 0, 'Y', 0, '2013-09-05', NULL, NULL, 43.6119, -116.268, NULL, NULL),
('820200895', 'SACN01555', 'SACN01555', 'SACN', 'Saint Alphonsus Medical Group Hosptialist Boise', 'Katherine', 'A', 'Mathews', 'MD', 'Internal Medicine', '', '', NULL, 'O', '1055 N Curtis Rd', 'Boise', 'Ada', 'ID', '83706', '2083672121', '2083673951', '1055 N Curtis Rd', 'Boise', 'Ada', 'ID', '83706', '2083672121', '2083673951', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Regional Medical Center', '', '', '', 'HCFA|', '1841296902', 0, 'N', 0, '2014-06-20', NULL, NULL, 43.6127, -116.254, NULL, NULL),
('820425454', 'SACN00032', 'SACN00032', 'SACN', 'Boise Anesthesia, PA', 'Dorothy', 'L', 'Mattise', 'CRNA', 'Nurse Anesthetist', '', '', NULL, 'o', '1055 N Curtis Rd', 'Boise', 'Ada', 'ID', '83706', '2083676416', '2083759530', '1055 N Curtis Rd', 'Boise', 'Ada', 'ID', '83706', '2083676416', '2083759530', '', '', '', '58.45', '10.00', '0.00', 3, '2011-01-01', NULL, 1, 15, 0, '', '', '', '', 'HCFA|UB|', '1457306870', 0, 'N', 0, '2013-06-24', NULL, NULL, 43.6127, -116.254, NULL, NULL),
('820425454', 'SACN00033', 'SACN00033', 'SACN', 'Boise Anesthesia, PA', 'Dorothy', 'L', 'Mattise', 'CRNA', 'Nurse Anesthetist', '', '', NULL, 'o', '1717 Arlington Ave', 'Caldwell', 'Canyon', 'ID', '83605', '2084594641', NULL, '1717 Arlington Ave', 'Caldwell', 'Canyon', 'ID', '83605', '2084594641', '0         ', '', '', '', '58.45', '10.00', '0.00', 3, '2011-01-01', NULL, 1, 15, 0, '', '', '', '', 'HCFA|UB|', '1457306870', 0, 'N', 0, '2013-06-24', 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
('841394139', 'SACN01250', 'SACN01250', 'SACN', 'Southwest Idaho ENT ', 'DelRay', '', 'Maughan', 'MD', 'Ear, Nose and Throat', '', '', NULL, 'O', '900 N Liberty St Ste 400', 'Boise', 'Ada', 'ID', '83704', '2083673320', NULL, '900 N Liberty St Ste 400', 'Boise', 'Ada', 'ID', '83704', '2083673320', '          ', 'IDSINCLAIRL', 'WUSTDHCPC5', '', '0.00', '15.00', '0.00', 3, '2011-01-01', '2011-10-01', 0, 0, 0, 'Saint Alphonsus Medical Center Nampa', '', '', '', 'HCFA|UB|', '1649253188', 0, 'N', 0, '2014-01-24', NULL, NULL, 43.6133, -116.259, NULL, NULL),
('820200895', 'SACN00750', 'SACN00750', 'SACN', 'Saint Alphonsus Boise OB-Gyn', 'Rebecca', 'L', 'McCaffrey', 'MD', 'Obstetrics and Gynecology', '', '', NULL, 'B', '3340 E Goldstone', 'Meridian', 'Ada', 'ID', '83642', '2083675170', '2083778163', '3340 E Goldstone', 'Meridian', 'Ada', 'ID', '83642', '2083675170', '2083778163', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Regional Medical Center', '', '', '', 'HCFA|', '1215193263', 0, 'N', 0, '2014-06-20', NULL, NULL, 0, 0, NULL, NULL),
('820200895', 'SACN00751', 'SACN00751', 'SACN', 'Saint Alphonsus Medical Group OB/GYN Boise BOGA Bldg', 'Rebecca', 'L', 'McCaffrey', 'MD', 'Obstetrics and Gynecology', '', '', NULL, 'O', '5966 Curtisian', 'Boise', 'Ada', 'ID', '83704', '2083758100', '2083778163', '5966 Curtisian', 'Boise', 'Ada', 'ID', '83704', '2083758100', '2083778163', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', '2013-08-01', 0, 0, 0, 'Saint Alphonsus Regional Medical Center', '', '', '', 'HCFA|', '1215193263', 0, 'N', 0, '2014-06-20', NULL, NULL, 43.6149, -116.256, NULL, NULL),
('820200895', 'SACN00752', 'SACN00752', 'SACN', 'Saint Alphonsus Medical Group OB/GYN Boise Moreau Bldg', 'Rebecca', 'L', 'McCaffrey', 'MD', 'Obstetrics and Gynecology', '', '', NULL, 'O', '6140 W Curtisian Ste 100', 'Boise', 'Ada', 'ID', '83704', '2083674224', '2083677806', '6140 W Curtisian Ste 100', 'Boise', 'Ada', 'ID', '83704', '2083674224', '2083677806', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', '2013-10-10', 0, 0, 0, 'Saint Alphonsus Regional Medical Center', '', '', '', 'HCFA|', '1215193263', 0, 'N', 0, '2014-06-20', NULL, NULL, 43.6151, -116.256, NULL, NULL),
('820200895', 'SACN00753', 'SACN00753', 'SACN', 'Saint Alphonsus Medical Group  OB/GYN Liberty Bldg', 'Rebecca', 'L', 'McCaffrey', 'MD', 'Obstetrics and Gynecology', '', '', NULL, 'O', '900 N Liberty Ste 100', 'Boise', 'Ada', 'ID', '83704', '2083672229', '2083674242', '900 N Liberty Ste 100', 'Boise', 'Ada', 'ID', '83704', '2083672229', '2083674242', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Regional Medical Center', '', '', '', 'HCFA|', '1215193263', 0, 'N', 0, '2014-06-20', NULL, NULL, 43.6133, -116.259, NULL, NULL),
('820425454', 'SACN00101', 'SACN00101', 'SACN', 'Boise Anesthesia, PA', 'Lisa', 'A', 'Bootsma', 'CRNA', 'Nurse Anesthetist', '', '', NULL, 'o', '1055 N Curtis Rd', 'Boise', 'Ada', 'ID', '83706', '2083676416', '2083759530', '1055 N Curtis Rd', 'Boise', 'Ada', 'ID', '83706', '2083676416', '2083759530', '', '', '', '58.45', '10.00', '0.00', 3, '2011-01-01', NULL, 1, 15, 0, '', '', '', '', 'HCFA|UB|', '1891732475', 0, 'N', 0, '2013-06-10', NULL, NULL, 43.6127, -116.254, NULL, NULL),
('820425454', 'SACN00102', 'SACN00102', 'SACN', 'Boise Anesthesia, PA', 'Lisa', 'A', 'Bootsma', 'CRNA', 'Nurse Anesthetist', '', '', NULL, 'o', '1717 Arlington Ave', 'Caldwell', 'Canyon', 'ID', '83605', '2084594641', NULL, '1717 Arlington Ave', 'Caldwell', 'Canyon', 'ID', '83605', '2084594641', '0         ', '', '', '', '58.45', '10.00', '0.00', 3, '2011-01-01', NULL, 1, 15, 0, '', '', '', '', 'HCFA|UB|', '1891732475', 0, 'N', 0, '2013-06-10', NULL, NULL, 0, 0, NULL, NULL),
('820459157', 'SACN00172', 'SACN00172', 'SACN', 'Evaluative & Theraputic Services', 'Charles', 'B', 'McConnell', 'MSW', 'Mental Health', 'Counseling', '', NULL, 'O', '413 N Allumbaugh Ste 103', 'Boise', 'Ada', 'ID', '83704', '2086580800', NULL, '413 N Allumbaugh Ste 103', 'Boise', 'Ada', 'ID', '83704', '2086580800', '          ', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 3, '2011-01-01', '2009-12-31', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1104932383', 0, 'N', 0, '2012-07-03', NULL, NULL, 0, 0, NULL, NULL),
('203926185', 'SACN01136', 'SACN01136', 'SACN', 'Meridian Vision', 'Kevin', 'W', 'McElroy', 'OD', 'Optometry', '', '', NULL, 'O', '1012 N Main', 'Meridian', 'Ada', 'ID', '83642', '2088885252', '2088844280', '1012 N Main', 'Meridian', 'Ada', 'ID', '83642', '2088885252', '2088844280', 'IDSINCLAIRL', NULL, NULL, '0.00', '15.00', '0.00', 3, '2011-01-01', NULL, 0, 0, 1, '', '', '', '', 'HCFA|UB|', '1528154242', 0, 'N', 0, '2013-12-11', NULL, NULL, 0, 0, NULL, NULL),
('942938348', 'W40006867', 'W40006867', 'UTMH1', 'Valley Mental Health  Inc', 'FREDERICK', NULL, 'VAN DER VEUR', 'LCSW', 'Mental Health', 'Social Worker', '', NULL, 'B', '5965 S 900 E Ste 430', 'Salt Lake City', 'Salt Lake', 'UT', '84121', '8012637100', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, 'UTVMHMA', NULL, NULL, '0.00', '40.00', '0.00', 6, '2013-02-15', NULL, NULL, 0, NULL, 'University Health Care University Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1780655407', 0, 'Y', 0, '2013-02-28', NULL, NULL, 0, 0, NULL, NULL),
('275467500', 'W12009310', 'W12009310', 'UT01', 'Utah Valley Eye Center', '', '', 'Utah Valley Eye Center', 'GROUP', '', '', '', NULL, 'O', '1055 N 300 W', 'Provo', 'Utah', 'UT', '84604', '8013577373', NULL, '1055 N 300 W', 'Provo', 'Utah', 'UT', '84604', '8013577373', '          ', 'UVEC', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 3, '2011-07-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '0000009365', 0, 'Y', 0, '2013-04-19', NULL, NULL, 40.2476, -111.664, NULL, NULL),
('876000525', 'W12001385', 'W12001385', 'UT01', 'University of Utah', 'Stacey', 'N', 'Turner', '', 'Physical Therapy', '', '', NULL, 'B', 'PO Box 510721', 'Salt Lake City', 'Salt Lake', 'UT', '84151', '8015812121', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '', '', '1', '0.00', '0.00', '0.00', 6, '2010-03-19', NULL, NULL, 0, NULL, '', '', '', '', 'HCFA|UB|', '1821312950', 0, 'Y', 0, '2013-02-28', NULL, NULL, 0, 0, NULL, NULL),
('870542578', 'U77002819', 'U77002819', 'UT01', 'University of Utah Dialysis - Physicians', '', '', 'U Of U Dialysis Program', 'GROUP', 'Dialysis Center', '', '', NULL, 'B', 'PO Box 27071', 'Salt Lake City', 'Salt Lake', 'UT', '84127', '8015818578', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, 'WUUUMG5', 'WUSTDHCPC5', '', '0.00', '25.00', '0.00', 3, '2012-07-25', NULL, NULL, 0, NULL, '', '', '', '', 'HCFA|UB|', '1689770356', 0, 'Y', 0, '2013-02-28', NULL, NULL, 0, 0, NULL, NULL),
('870476172', 'W40009285', 'W40009285', 'UTMH1', 'Shepherds Staff Christian Counseling Center', 'Vinessa', 'K', 'Trotter', 'PHD', 'Mental Health', '', '', NULL, 'O', '731 E 8600 S', 'Sandy', 'Salt Lake', 'UT', '84094', '8015619987', '8015619987', NULL, NULL, NULL, NULL, NULL, NULL, NULL, 'PHD', '', '', '0.00', '40.00', '0.00', 6, '2013-02-15', NULL, NULL, 0, NULL, '', '', '', '', 'HCFA|UB|', '1952553794', 0, 'N', 0, '2013-02-28', NULL, NULL, 40.595, -111.871, NULL, NULL),
('202630141', 'W40017243', 'W40017243', 'IDBOISTD', 'Primary Health Medical Group', 'Martin', 'R', 'Tubach', 'MD', 'Ear, Nose and Throat', '', '', NULL, 'O', '6052 W State St', 'Boise', 'Ada', 'ID', '83703', '2089471947', '2089471945', '6052 W State St', 'Boise', 'Ada', 'ID', '83703', '2089471947', '2089471945', 'IDPRIMARY', 'WUSTDHCPC5', '', '0.00', '30.00', '0.00', 3, '2013-03-01', NULL, 0, 0, 0, NULL, NULL, '', '', 'HCFA|UB|', '1982656591', 0, 'N', 0, '2013-09-18', NULL, NULL, 43.6592, -116.264, NULL, NULL),
('452218152', 'ELHCA0234', 'ELHCA0234', 'TXHOUSTD', 'Cardiology Specialists of Houston', 'Bernardo', '', 'Treistman', 'MD', 'Cardiology', '', '', NULL, 'B', 'PO Box 741780', 'Atlanta', 'Fulton', 'GA', '30374', '          ', NULL, 'PO Box 741780', 'Atlanta', 'Fulton', 'GA', '30374', '          ', '          ', 'HCA', 'TXHCPC13', '', '0.00', '45.00', '0.00', 3, '2013-01-01', '2013-07-30', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1356386049', 0, 'Y', 0, '2013-09-17', NULL, NULL, 0, 0, NULL, NULL),
('452218152', 'ELHCA0233', 'ELHCA0233', 'TXHOUSTD', 'Cardiology Specialists of Houston', 'Bernardo', '', 'Treistman', 'MD', 'Cardiology', '', '', NULL, 'O', '1140 Westmont', 'Houston', 'Harris', 'TX', '77015', '7137971620', '7137971543', '1140 Westmont', 'Houston', 'Harris', 'TX', '77015', '7137971620', '7137971543', 'HCA', 'TXHCPC13', '', '0.00', '45.00', '0.00', 3, '2013-01-01', '2013-07-30', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1356386049', 0, 'N', 0, '2013-09-17', NULL, NULL, 29.772, -95.1953, NULL, NULL),
('202777185', 'SACN01690', 'SACN01690', 'SACN', 'Kinectic Chiropractic', 'James', 'B', 'Trapp', 'DC', 'Chiropractic', NULL, NULL, NULL, 'O', '1819 W State St', 'Boise', 'Ada', 'ID', '83702', '2083892225', '2083362827', NULL, NULL, NULL, NULL, NULL, NULL, NULL, 'IDSINCLAIRM', NULL, NULL, '0.00', '10.00', '0.00', 3, '2011-01-01', NULL, NULL, 0, 1, '', '', '', '', 'HCFA|UB|', '1194895276', 0, 'N', 0, '2013-02-28', NULL, NULL, 0, 0, NULL, NULL),
('264260933', 'ELHCA0232', 'ELHCA0232', 'TXHOUSTD', 'Houston  Women''s Care Associates', 'Nicole', NULL, 'Tran ', 'MD', 'Obstetrics and Gynecology', '', '', NULL, 'B', 'PO Box 281928', 'Atlanta', 'Fulton', 'GA', '30384', '          ', NULL, 'PO Box 281928', 'Atlanta', 'Fulton', 'GA', '30384', '          ', '          ', 'HCA', 'TXHCPC13', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'The Womans Hospital of Texas', NULL, NULL, NULL, 'HCFA|UB|', '1699768994', 0, 'Y', 0, '2014-01-14', NULL, NULL, 0, 0, NULL, NULL),
('540549986', 'SACN01551', 'SACN01551', 'SACN', '', 'Linda', 'M', 'McGuire', 'LCPC', 'Mental Health', 'Counseling', '', NULL, 'O', '2498 N stokesberry Pl Ste 140', 'Meridian', 'Ada', 'ID', '83646', '2088590464', '2086290409', '2498 N stokesberry Pl Ste 140', 'Meridian', 'Ada', 'ID', '83646', '2088590464', '2086290409', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 3, '2011-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1841253051', 0, 'N', 0, '2012-10-30', NULL, NULL, 0, 0, NULL, NULL),
('540549986', 'SACN01552', 'SACN01552', 'SACN', '', 'Linda', 'M', 'McGuire', 'LCPC', 'Mental Health', 'Counseling', '', NULL, 'B', '3043 E Dagger Falls Dr', 'Eagle', 'Ada', 'ID', '83616', '2088590464', '2086290409', '3043 E Dagger Falls Dr', 'Eagle', 'Ada', 'ID', '83616', '2088590464', '2086290409', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 3, '2011-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1841253051', 0, 'N', 0, '2012-10-30', NULL, NULL, 0, 0, NULL, NULL),
('820478504', 'SACN01553', 'SACN01553', 'SACN', 'Personal Solutions', 'Linda', 'M', 'McGuire', 'LCPC', 'Mental Health', 'Counseling', '', NULL, 'O', '2596 N Stokesberry Pl Ste 100', 'Meridian', 'Ada', 'ID', '83646', '2089383837', NULL, '2596 N Stokesberry Pl Ste 100', 'Meridian', 'Ada', 'ID', '83646', '2089383837', '          ', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 3, '2011-01-01', '2010-11-05', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1841253051', 0, 'N', 0, '2012-10-30', NULL, NULL, 0, 0, NULL, NULL),
('800010265', 'SACN01545', 'SACN01545', 'SACN', 'Cherry Lane Family Clinic', 'Timothy', 'E', 'McHugh', 'MD', 'Family Practice', '', '', NULL, 'O', '1001 N Meridian Rd', 'Meridian', 'Ada', 'ID', '83642', '2088844800', '2088844802', '1001 N Meridian Rd', 'Meridian', 'Ada', 'ID', '83642', '2088844800', '2088844802', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 3, '2011-01-01', '2013-10-01', 0, 0, 1, 'Saint Alphonsus Medical Center Nampa', NULL, '', 'Saint Alphonsus Medical Center Nampa', 'HCFA|UB|', '1831143692', 0, 'N', 0, '2013-09-12', NULL, NULL, 0, 0, NULL, NULL),
('800010265', 'SACN01546', 'SACN01546', 'SACN', 'Cherry Lane Family Clinic', 'Timothy', 'E', 'McHugh', 'MD', 'Family Practice', '', '', NULL, 'B', 'PO Box 44448', 'Boise', 'Ada', 'ID', '83711', '2083239130', '2083239070', 'PO Box 44448', 'Boise', 'Ada', 'ID', '83711', '2083239130', '2083239070', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 3, '2011-01-01', '2013-10-01', 0, 0, 1, 'Saint Alphonsus Medical Center Nampa', NULL, '', 'Saint Alphonsus Medical Center Nampa', 'HCFA|UB|', '1831143692', 0, 'Y', 0, '2013-09-12', NULL, NULL, 0, 0, NULL, NULL),
('264260933', 'ELHCA0231', 'ELHCA0231', 'TXHOUSTD', 'Houston  Women''s Care Associates', 'Nicole', NULL, 'Tran ', 'MD', 'Obstetrics and Gynecology', '', '', NULL, 'O', '7400 Fannin St Ste 1050', 'Houston', 'Harris', 'TX', '77054', '7137951000', '7137961087', '7400 Fannin St Ste 1050', 'Houston', 'Harris', 'TX', '77054', '7137951000', '7137961087', 'HCA', 'TXHCPC13', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'The Womans Hospital of Texas', NULL, NULL, NULL, 'HCFA|UB|', '1699768994', 0, 'N', 0, '2014-01-14', NULL, NULL, 29.6956, -95.4009, NULL, NULL),
('820200895', 'SACN01566', 'SACN01566', 'SACN', 'Saint Alphonsus Medical Group McMillan Family Medicine', 'Snehlata', 'K', 'Mehta', 'MD', 'Internal Medicine', '', '', NULL, 'O', '12273 W McMillan Rd', 'Boise', 'Ada', 'ID', '83713', '2083676330', '2083674765', '12273 W McMillan Rd', 'Boise', 'Ada', 'ID', '83713', '2083676330', '2083674765', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', '2013-03-31', 0, 0, 0, 'Saint Alphonsus Medical Center Nampa', '', '', '', 'HCFA|', '1851331045', 0, 'N', 0, '2014-04-14', NULL, NULL, 43.6481, -116.335, NULL, NULL),
('820477852', 'SACN01567', 'SACN01567', 'SACN', 'Saint Alphonsus Medical Group McMillan Family Medicine', 'Snehlata', 'K', 'Mehta', 'MD', 'Internal Medicine', '', '', NULL, 'o', '12273 W McMillan Rd', 'Boise', 'Ada', 'ID', '83713', '2083676330', '2083674765', '12273 W McMillan Rd', 'Boise', 'Ada', 'ID', '83713', '2083676330', '2083674765', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', '2013-03-31', 0, 0, 0, 'Saint Alphonsus Medical Center Nampa', '', '', '', 'HCFA|UB|', '1851331045', 0, 'N', 0, '2014-04-14', NULL, NULL, 43.6481, -116.335, NULL, NULL),
('820425454', 'SACN00074', 'SACN00074', 'SACN', 'Boise Anesthesia, PA', 'Eric', 'J', 'Melbihess', 'MD', 'Anesthesiology', '', '', NULL, 'o', '1055 N Curtis Rd', 'Boise', 'Ada', 'ID', '83706', '2083676416', '2083759530', '1055 N Curtis Rd', 'Boise', 'Ada', 'ID', '83706', '2083676416', '2083759530', '', '', '', '58.45', '10.00', '0.00', 3, '2011-01-01', NULL, 1, 15, 0, 'Saint Alphonsus Medical Center Nampa', '', 'West Valley Medical Center', '', 'HCFA|UB|', '1699782656', 0, 'N', 0, '2012-11-01', NULL, NULL, 43.6127, -116.254, NULL, NULL),
('820425454', 'SACN00075', 'SACN00075', 'SACN', 'Boise Anesthesia, PA', 'Eric', 'J', 'Melbihess', 'MD', 'Anesthesiology', '', '', NULL, 'o', '1717 Arlington Ave', 'Caldwell', 'Canyon', 'ID', '83605', '2084594641', '2083759530', '1717 Arlington Ave', 'Caldwell', 'Canyon', 'ID', '83605', '2084594641', '2083759530', '', '', '', '58.45', '10.00', '0.00', 3, '2011-01-01', NULL, 1, 15, 0, 'Saint Alphonsus Medical Center Nampa', '', 'West Valley Medical Center', '', 'HCFA|UB|', '1699782656', 0, 'N', 0, '2012-11-01', NULL, NULL, 0, 0, NULL, NULL),
('820425454', 'SACN00076', 'SACN00076', 'SACN', 'Boise Anesthesia, PA', 'Eric', 'J', 'Melbihess', 'MD', 'Anesthesiology', '', '', NULL, 'o', '3025 W Cherry Ln', 'Meridian', 'Ada', 'ID', '83642', '2083678500', NULL, '3025 W Cherry Ln', 'Meridian', 'Ada', 'ID', '83642', '2083678500', '0         ', '', '', '', '58.45', '10.00', '0.00', 3, '2011-01-01', NULL, 1, 15, 0, 'Saint Alphonsus Medical Center Nampa', '', 'West Valley Medical Center', '', 'HCFA|UB|', '1699782656', 0, 'N', 0, '2012-11-01', NULL, NULL, 43.6188, -116.431, NULL, NULL),
('481264511', 'SACN01223', 'SACN01223', 'SACN', 'A Family Place PA', 'Jeanne', 'L', 'Melton', 'LCSW', 'Mental Health', 'Social Worker', '', NULL, 'O', '6003 W Overland Rd Ste 101', 'Boise', 'Ada', 'ID', '83709', '2083458861', NULL, '6003 W Overland Rd Ste 101', 'Boise', 'Ada', 'ID', '83709', '2083458861', '', 'IDSINCLAIRL', NULL, NULL, '0.00', '15.00', '0.00', 3, '2011-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1619986957', 0, 'n', 0, '2011-12-22', NULL, NULL, 0, 0, NULL, NULL),
('820161600', 'SACN00324', 'SACN00324', 'SACN', 'Boise Orthopedic Clinic', 'Jeffry', 'P', 'Menzner', 'MD This Provider will terminate on July 1st', 'Orthopedic Surgery', 'Hematology and Oncology', '', NULL, 'O', '520 S Eagle Rd Ste 3213', 'Meridian', 'Ada', 'ID', '83642', '2088980100', NULL, '520 S Eagle Rd Ste 3213', 'Meridian', 'Ada', 'ID', '83642', '2088980100', '          ', 'IDSINCLAIRL', 'WUSTDHCPC5', '', '0.00', '15.00', '0.00', 8, '2011-01-01', '2012-07-01', 0, 0, 0, 'Saint Alphonsus Medical Center Nampa', NULL, '', '', 'HCFA|UB|', '1487607198', 0, 'N', 0, '2012-05-31', NULL, NULL, 43.5995, -116.352, NULL, NULL),
('820161600', 'SACN00325', 'SACN00325', 'SACN', 'Boise Orthopedic Clinic', 'Jeffry', 'P', 'Menzner', 'MD This Provider will terminate on July 1st', 'Orthopedic Surgery', 'Hematology and Oncology', '', NULL, 'O', '703 S Americana Blvd Ste 120', 'Boise', 'Ada', 'ID', '83702', '2083232600', NULL, '703 S Americana Blvd Ste 120', 'Boise', 'Ada', 'ID', '83702', '2083232600', '          ', 'IDSINCLAIRL', 'WUSTDHCPC5', '', '0.00', '15.00', '0.00', 8, '2011-01-01', '2012-07-01', 0, 0, 0, 'Saint Alphonsus Medical Center Nampa', NULL, '', '', 'HCFA|UB|', '1487607198', 0, 'N', 0, '2012-05-31', NULL, NULL, 0, 0, NULL, NULL),
('200324983', 'SACN00777', 'SACN00777', 'SACN', 'Idaho Sports Medicine Institute PA', 'Jennifer', 'R', 'Miller', 'MD; Shoulder, General, Sports Med', 'Orthopedic Surgery', NULL, NULL, NULL, 'O', '1188 University Dr', 'Boise', 'Ada', 'ID', '83706', '2083368250', '2083459514', '1188 University Dr', 'Boise', 'Ada', 'ID', '83706', '2083368250', '2083459514', 'IDSINCLAIRL', NULL, NULL, '0.00', '15.00', '0.00', 3, '2011-01-01', NULL, 0, 0, 1, 'Saint Alphonsus Regional Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1245236983', 0, 'N', 0, '2012-10-17', NULL, NULL, 43.601, -116.196, NULL, NULL),
('942938348', 'W40017423', 'W40017423', 'UTMH1', ' Valley Mental Health Inc', 'David', 'A', 'Tomb', 'MD', 'Mental Health', 'Psychiatry', 'Pediatric Psychiatry', NULL, 'B', '5965 S 900 E Ste 430', 'Salt Lake City', 'Salt Lake', 'UT', '84121', '8012637100', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, 'UTMD-2', NULL, NULL, '0.00', '40.00', '0.00', 6, '2013-02-15', NULL, NULL, 0, NULL, '', '', '', '', 'HCFA|UB|', '1639269269', 0, 'Y', 0, '2013-02-28', NULL, NULL, 0, 0, NULL, NULL),
('201312583', 'W12006971', 'W12006971', 'ID01', 'Life Counseling Center', 'Andrea', 'N', 'Torrez', 'LSCW', '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', '35.00', '0.00', 6, '2010-12-15', '2013-02-14', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1710288014', 0, 'N', 0, '2014-04-01', NULL, NULL, 0, 0, NULL, NULL),
('820440995', 'SACN00706', 'SACN00706', 'SACN', 'Advanced Eyecare', 'Daniel', '', 'Tiller', 'OD', 'Optometry', '', '', NULL, 'O', '901 12th Ave Rd S', 'Nampa', 'Canyon', 'ID', '83651', '2084669251', '2084631714', NULL, NULL, NULL, NULL, NULL, NULL, NULL, 'IDSINCLAIRL', NULL, NULL, '0.00', '15.00', '0.00', 3, '2011-01-01', NULL, NULL, 0, 1, '', '', '', '', 'HCFA|UB|', '1154314268', 0, 'N', 0, '2013-02-28', NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W12001770', 'W12001770', 'UTIHC04', 'Safe and Healthy Families', 'Brian', 'L', 'Thorn', 'PHD', 'Mental Health', 'Psychology', NULL, NULL, 'O', '675 E 500 S', 'Salt Lake City', 'Salt Lake', 'UT', '84102', '8016623600', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '', '', '', '0.00', '10.00', '0.00', 8, '2008-08-01', NULL, NULL, 0, NULL, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1417965518', 0, 'N', 0, '2013-02-28', NULL, NULL, 40.7585, -111.872, NULL, NULL),
('820200895', 'SACN00697', 'SACN00697', 'SACN', 'Saint Alphonsus Medical Group Elm Family Medicine', 'Natasha', '', 'Miller', 'MD', 'Pediatrics', '', '', NULL, 'O', '315 E Elm St Ste 100', 'Caldwell', 'Canyon', 'ID', '83605', '2084597415', '2084533307', '315 E Elm St Ste 100', 'Caldwell', 'Canyon', 'ID', '83605', '2084597415', '2084533307', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', NULL, 0, 0, 0, 'West Valley Medical Center', '', '', '', 'HCFA|', '1144299678', 0, 'N', 0, '2014-06-20', NULL, NULL, 43.6539, -116.695, NULL, NULL),
('820477852', 'SACN00698', 'SACN00698', 'SACN', 'Saint Alphonsus Medical Group Elm Family Medicine', 'Natasha', '', 'Miller', 'MD', 'Pediatrics', '', '', NULL, 'O', '315 E Elm St Ste 100', 'Caldwell', 'Canyon', 'ID', '83605', '2084597415', '2084533307', '315 E Elm St Ste 100', 'Caldwell', 'Canyon', 'ID', '83605', '2084597415', '2084533307', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', NULL, 0, 0, 0, 'West Valley Medical Center', '', '', '', 'HCFA|UB|', '1144299678', 0, 'N', 0, '2014-06-20', NULL, NULL, 43.6539, -116.695, NULL, NULL),
('201300128', 'SACN00714', 'SACN00714', 'SACN', 'Idaho Urologic Institute', 'Stephen', 'J', 'Miller', 'MD', 'Urology', '', '', NULL, 'O', '2855 E Magic View Dr', 'Meridian', 'Ada', 'ID', '83642', '2086394900', NULL, '2855 E Magic View Dr', 'Meridian', 'Ada', 'ID', '83642', '2086394900', '', 'IDSINCLAIRL', 'WUSTDHCPC5', NULL, '0.00', '15.00', '0.00', 3, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Medical Center Nampa', NULL, NULL, NULL, 'HCFA|UB|', '1164474664', 0, 'n', 0, '2013-07-31', NULL, NULL, 43.599, -116.36, NULL, NULL),
('201300128', 'SACN00715', 'SACN00715', 'SACN', 'Idaho Urologic Institute', 'Stephen', 'J', 'Miller', 'MD', 'Urology', '', '', NULL, 'O', '333 N 1st Ste 100', 'Boise', 'Ada', 'ID', '83702', '2086394900', NULL, '333 N 1st Ste 100', 'Boise', 'Ada', 'ID', '83702', '2086394900', '          ', 'IDSINCLAIRL', 'WUSTDHCPC5', '', '0.00', '15.00', '0.00', 3, '2011-01-01', '2012-02-24', 0, 0, 0, 'Saint Alphonsus Medical Center Nampa', NULL, NULL, NULL, 'HCFA|UB|', '1164474664', 0, 'N', 0, '2013-07-31', NULL, NULL, 43.6135, -116.194, NULL, NULL),
('841636078', 'SACN00329', 'SACN00329', 'SACN', 'River Medical Family Practice', 'Michael', 'R', 'Minas', 'MD', 'Family Practice', '', '', NULL, 'O', '100 Cottonwood Ct Ste 150', 'Eagle', 'Ada', 'ID', '83616', '2089393314', NULL, '100 Cottonwood Ct Ste 150', 'Eagle', 'Ada', 'ID', '83616', '2089393314', '', 'IDSINCLAIRL', 'WUSTDHCPC5', '', '0.00', '15.00', '0.00', 3, '2011-01-01', '2011-10-23', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1528178977', 0, 'N', 0, '2014-07-08', NULL, NULL, 0, 0, NULL, NULL),
('841636078', 'SACN00330', 'SACN00330', 'SACN', 'River Medical Family Practice', 'Michael', 'R', 'Minas', 'MD', 'Family Practice', '', '', NULL, 'B', '3210 E Chinden Blvd Ste 115', 'Eagle', 'Ada', 'ID', '83616', '2089393314', '          ', '3210 E Chinden Blvd Ste 115', 'Eagle', 'Ada', 'ID', '83616', '2089393314', '          ', 'IDSINCLAIRL', 'WUSTDHCPC5', '', '0.00', '15.00', '0.00', 3, '2011-01-01', '2014-04-04', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1528178977', 0, 'Y', 0, '2014-07-08', NULL, NULL, 0, 0, NULL, NULL),
('820200895', 'SACN01019', 'SACN01019', 'SACN', 'Saint Alphonsus Boise OB-Gyn', 'Lisa', 'M', 'Minge', 'MD', 'Obstetrics and Gynecology', '', '', NULL, 'O', '5966 Curtisian', 'Boise', 'Ada', 'ID', '83704', '2083758100', '2083778163', '5966 Curtisian', 'Boise', 'Ada', 'ID', '83704', '2083758100', '2083778163', 'IDSINCLAIRL', NULL, NULL, '0.00', '15.00', '0.00', 6, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Regional Medical Center', NULL, NULL, NULL, 'HCFA|', '1467405787', 0, 'N', 0, '2013-07-03', NULL, NULL, 43.6149, -116.256, NULL, NULL),
('820477852', 'SACN01020', 'SACN01020', 'SACN', 'SAMG Boise OB/GYN', 'Lisa', 'M', 'Minge', 'MD', 'Obstetrics and Gynecology', '', '', NULL, 'O', '520 S Eagle Rd Ste 1233', 'Meridian', 'Ada', 'ID', '83642', '2083758100', NULL, '520 S Eagle Rd Ste 1233', 'Meridian', 'Ada', 'ID', '83642', '2083758100', '          ', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', '2011-12-01', 0, 0, 0, 'Saint Alphonsus Regional Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1467405787', 0, 'N', 0, '2013-07-03', NULL, NULL, 43.5995, -116.352, NULL, NULL),
('820477852', 'SACN01021', 'SACN01021', 'SACN', 'SAMG Boise OB/GYN', 'Lisa', 'M', 'Minge', 'MD', 'Obstetrics and Gynecology', '', '', NULL, 'O', '5966 Curtisian', 'Boise', 'Ada', 'ID', '83704', '2083758100', NULL, '5966 Curtisian', 'Boise', 'Ada', 'ID', '83704', '2083758100', '          ', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', '2012-04-03', 0, 0, 0, 'Saint Alphonsus Regional Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1467405787', 0, 'N', 0, '2013-07-03', NULL, NULL, 43.6149, -116.256, NULL, NULL),
('264260933', 'ELHCA0230', 'ELHCA0230', 'TXHOUSTD', 'HWCA ', 'Rachel', NULL, 'Thompson', 'MD', 'Obstetrics and Gynecology', '', '', NULL, 'B', 'PO Box 281928', 'Atlanta', 'Fulton', 'GA', '30384', NULL, NULL, 'PO Box 281928', 'Atlanta', 'Fulton', 'GA', '30384', '', '', 'HCA', 'TXHCPC13', NULL, '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'The Womans Hospital of Texas', NULL, NULL, NULL, 'HCFA|UB|', '1760475065', 0, 'Y', 0, '2013-05-01', NULL, NULL, 0, 0, NULL, NULL),
('202523793', 'SACN00179', 'SACN00179', 'SACN', 'Ada Orthopaedic Clinic ', 'John', 'J', 'Mohr', 'MD', 'Orthopedic Surgery', 'Family Practice', '', NULL, 'O', '1055 N Curtis Rd', 'Boise', 'Ada', 'ID', '83704', '2083672121', NULL, '1055 N Curtis Rd', 'Boise', 'Ada', 'ID', '83704', '2083672121', '          ', 'IDSINCLAIRL', 'WUSTDHCPC5', '', '0.00', '15.00', '0.00', 3, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Medical Center Nampa', '', '', '', 'HCFA|UB|', '1124073077', 0, 'Y', 0, '2013-11-15', NULL, NULL, 43.6136, -116.256, NULL, NULL),
('820415207', 'SACN00180', 'SACN00180', 'SACN', '', 'John', 'J', 'Mohr', 'MD', 'Orthopedic Surgery', 'Family Practice', '', NULL, 'B', '3301 Terra Dr', 'Boise', 'Ada', 'ID', '83709', '2083623740', NULL, '3301 Terra Dr', 'Boise', 'Ada', 'ID', '83709', '2083623740', '          ', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 3, '2011-01-01', '2013-10-08', 0, 0, 1, 'Saint Alphonsus Medical Center Nampa', '', '', '', 'HCFA|UB|', '1124073077', 0, 'Y', 0, '2013-11-15', NULL, NULL, 0, 0, NULL, NULL),
('264260933', 'ELHCA0229', 'ELHCA0229', 'TXHOUSTD', 'HWCA ', 'Rachel', NULL, 'Thompson', 'MD', 'Obstetrics and Gynecology', '', '', NULL, 'O', '7400 Fannin St Ste 1050', 'Houston', 'Harris', 'TX', '77054', '7137951000', '7137961087', '7400 Fannin St Ste 1050', 'Houston', 'Harris', 'TX', '77054', '7137951000', '7137961087', 'HCA', 'TXHCPC13', NULL, '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'The Womans Hospital of Texas', NULL, NULL, NULL, 'HCFA|UB|', '1760475065', 0, 'N', 0, '2013-05-01', NULL, NULL, 29.6956, -95.4009, NULL, NULL),
('942938348', 'W40022578', 'W40022578', 'UTMH1', 'Valley Mental Health  Inc', 'Janet', NULL, 'Tennison', 'LCSW', 'Mental Health', 'Social Worker', '', NULL, 'B', '5965 S 900 E Ste 430', 'Salt Lake City', 'Salt Lake', 'UT', '84121', '8012637100', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, 'UTVMHMA', NULL, NULL, '0.00', '40.00', '0.00', 6, '2013-02-15', NULL, NULL, 0, NULL, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1932437944', 0, 'Y', 0, '2013-02-28', NULL, NULL, 0, 0, NULL, NULL),
('201180479', 'SACN00821', 'SACN00821', 'SACN', '', 'Richard', 'A', 'Montgomery', 'MD', 'Mental Health', 'Psychiatry', '', NULL, 'O', '413 N Allumbaugh Ste 101', 'Boise', 'Ada', 'ID', '83704', '2083231125', NULL, '413 N Allumbaugh Ste 101', 'Boise', 'Ada', 'ID', '83704', '2083231125', '          ', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 3, '2011-01-01', '2013-05-31', 0, 0, 0, 'Saint Alphonsus Medical Center Nampa', '', '', '', 'HCFA|UB|', '1275567638', 0, 'N', 0, '2013-06-06', NULL, NULL, 0, 0, NULL, NULL),
('820200895', 'SACN01678', 'SACN01678', 'SACN', 'Saint Alphonsus Medical Group Eagle Health Plaza', 'Alanna', 'C', 'Moore', 'PA-C', 'Pediatrics', 'Physician Assistant', '', NULL, 'O', '323 E Riverside Dr Ste 224', 'Eagle', 'Ada', 'ID', '83616', '2083675750', '2083674252', '323 E Riverside Dr Ste 224', 'Eagle', 'Ada', 'ID', '83616', '2083675750', '2083674252', 'IDSINCLAIRL', NULL, '', '0.00', '15.00', '0.00', 6, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Regional Medical Center', '', '', '', 'HCFA|', '1982864278', 0, 'Y', 0, '2014-06-20', NULL, NULL, 43.6892, -116.351, NULL, NULL),
('820200895', 'SACN01679', 'SACN01679', 'SACN', 'Saint Alphonsus Medical GroupBoise Pediatrics', 'Alanna', 'C', 'Moore', 'PA-C', 'Pediatrics', 'Physician Assistant', '', NULL, 'O', '999 N Curtis Rd Ste 407', 'Boise', 'Ada', 'ID', '83706', '2083674321', '2083674252', '999 N Curtis Rd Ste 407', 'Boise', 'Ada', 'ID', '83706', '2083674321', '2083674252', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Regional Medical Center', '', '', '', 'HCFA|', '1982864278', 0, 'N', 0, '2014-06-20', NULL, NULL, 43.6132, -116.255, NULL, NULL),
('820477852', 'SACN01680', 'SACN01680', 'SACN', 'Saint Alphonsus Medical Group Pediatrics', 'Alanna', 'C', 'Moore', 'PA-C', 'Pediatrics', 'Physician Assistant', '', NULL, 'O', '999 N Curtis Rd Ste 407', 'Boise', 'Ada', 'ID', '83706', '2083674321', '2083674525', '999 N Curtis Rd Ste 407', 'Boise', 'Ada', 'ID', '83706', '2083674321', '2083674525', 'IDSINCLAIRL', NULL, '', '0.00', '15.00', '0.00', 6, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Regional Medical Center', '', '', '', 'HCFA|UB|', '1982864278', 0, 'Y', 0, '2014-06-20', NULL, NULL, 43.6132, -116.255, NULL, NULL),
('820200895', 'SACN00918', 'SACN00918', 'SACN', 'Saint Alphonsus Medical Group Family Medicine Dominican', 'Ryan', 'A', 'Moore', 'MD', 'Family Practice', '', '', NULL, 'O', '1118 NW 16th St Ste A', 'Fruitland', 'Payette', 'ID', '83619', '2084526851', '2083676170', '1118 NW 16th St Ste A', 'Fruitland', 'Payette', 'ID', '83619', '2084526851', '2083676170', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', NULL, 0, 0, 0, 'West Valley Medical Center', NULL, NULL, NULL, 'HCFA|', '1386664654', 0, 'N', 0, '2012-11-15', NULL, NULL, 44.025, -116.928, NULL, NULL),
('820200895', 'SACN00919', 'SACN00919', 'SACN', 'Saint Alphonsus Medical Group Elm Family Medicine', 'Ryan', 'A', 'Moore', 'MD', 'Family Practice', '', '', NULL, 'O', '315 E Elm St Ste 100', 'Caldwell', 'Canyon', 'ID', '83605', '2084597415', '2084533307', '315 E Elm Ste 100', 'Caldwell', 'Canyon', 'ID', '83605', '2084597415', '2084533307', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', NULL, 0, 0, 0, 'West Valley Medical Center', NULL, NULL, NULL, 'HCFA|', '1386664654', 0, 'N', 0, '2012-11-15', NULL, NULL, 43.6539, -116.695, NULL, NULL),
('760725874', 'SACN01691', 'SACN01691', 'SACN', 'Moore Chiropractic', 'Warren', 'M', 'Moore', 'DC', 'Chiropractic', '', '', NULL, 'O', '376 S Latah', 'Boise', 'Ada', 'ID', '83705', '2083389111', NULL, '376 S Latah', 'Boise', 'Ada', 'ID', '83705', '2083389111', '          ', 'IDSINCLAIRM', '', '', '0.00', '10.00', '0.00', 3, '2011-01-01', '2012-02-01', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1225123573', 0, 'N', 0, '2012-02-02', NULL, NULL, 0, 0, NULL, NULL),
('460500210', 'SACN01598', 'SACN01598', 'SACN', 'Saint Alphonsus Trauma Physician Services', 'Billy', 'R', 'Morgan', 'MD', 'General Surgery', '', '', NULL, 'B', '1055 N Curtis', 'Boise', 'Ada', 'ID', '83706', '0', '0', '1055 N Curtis', 'Boise', 'Ada', 'ID', '83706', '0', '0', 'IDSINCLAIRL', NULL, '', '0.00', '15.00', '0.00', 6, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Regional Medical Center', '', '', '', 'HCFA|UB|', '1891747663', 0, 'Y', 0, '2014-07-09', NULL, NULL, 43.6127, -116.254, NULL, NULL),
('460500210', 'SACN01599', 'SACN01599', 'SACN', 'Saint Alphonsus Outpatient Trauma Services', 'Billy', 'R', 'Morgan', 'MD', 'General Surgery', '', '', NULL, 'O', '901 N Curtis Rd Ste 401', 'Boise', 'Ada', 'ID', '83706', '2083677676', '2083676849', '901 N Curtis Rd Ste 401', 'Boise', 'Ada', 'ID', '83706', '2083677676', '2083676849', 'IDSINCLAIRL', NULL, '', '0.00', '15.00', '0.00', 6, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Regional Medical Center', '', '', '', 'HCFA|UB|', '1891747663', 0, 'N', 0, '2014-07-09', NULL, NULL, 43.6126, -116.255, NULL, NULL),
('820200895', 'SACN00988', 'SACN00988', 'SACN', 'Saint Alphonsus Medical Group Family Medicine Dominican Health ', 'Mary', '', 'Morgan', 'NP-C', 'Family Practice', 'Nurse Practitioner', '', NULL, 'O', '1118 Nw 16th St Ste A', 'Fruitland', 'Payette', 'ID', '83619', '2084526851', '2084522140', '1118 Nw 16th St Ste A', 'Fruitland', 'Payette', 'ID', '83619', '2084526851', '2084522140', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Medical Center Nampa', '', '', '', 'HCFA|', '1437381209', 0, 'Y', 0, '2014-02-10', NULL, NULL, 44.025, -116.928, NULL, NULL),
('820200895', 'SACN00989', 'SACN00989', 'SACN', 'Saint Alphonsus Medical Group Garrity Family Medicine', 'Mary', '', 'Morgan', 'NP-C', 'Family Practice', 'Nurse Practitioner', '', NULL, 'O', '1200 Garrity Blvd', 'Nampa', 'Canyon', 'ID', '83687', '2084669092', '2084665322', '1200 Garrity Blvd', 'Nampa', 'Canyon', 'ID', '83687', '2084669092', '2084665322', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Medical Center Nampa', '', '', '', 'HCFA|', '1437381209', 0, 'Y', 0, '2014-02-10', NULL, NULL, 43.587, -116.549, NULL, NULL),
('820200895', 'SACN00990', 'SACN00990', 'SACN', 'Saint Alphonsus Express Care Inc', 'Mary', '', 'Morgan', 'NP-C', 'Family Practice', 'Nurse Practitioner', '', NULL, 'O', '1515 W State St', 'Boise', 'Ada', 'ID', '83702', '2083456768', '2084522140', '1515 W State St', 'Boise', 'Ada', 'ID', '83702', '2083456768', '2084522140', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Medical Center Nampa', '', '', '', 'HCFA|', '1437381209', 0, 'Y', 0, '2014-02-10', NULL, NULL, 43.6228, -116.21, NULL, NULL),
('820200895', 'SACN00991', 'SACN00991', 'SACN', 'Saint Alphonsus Medical GroupMHP Family Medicine', 'Mary', '', 'Morgan', 'NP-C', 'Family Practice', 'Nurse Practitioner', '', NULL, 'O', '3025 W Cherry Ln Ste B', 'Meridian', 'Ada', 'ID', '83642', '2083678550', '2083678555', '3025 W Cherry Ln Ste B', 'Meridian', 'Ada', 'ID', '83642', '2083678550', '2083678555', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Medical Center Nampa', '', '', '', 'HCFA|', '1437381209', 0, 'Y', 0, '2014-02-10', NULL, NULL, 43.6188, -116.431, NULL, NULL),
('820200895', 'SACN00992', 'SACN00992', 'SACN', 'Saint Alphonsus Medical Group Elm Family Medicine', 'Mary', '', 'Morgan', 'NP-C', 'Family Practice', 'Nurse Practitioner', '', NULL, 'O', '315 E Elm St Ste 100', 'Caldwell', 'Canyon', 'ID', '83605', '2084597415', '2084533307', '315 E Elm St Ste 100', 'Caldwell', 'Canyon', 'ID', '83605', '2084597415', '2084533307', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Medical Center Nampa', '', '', '', 'HCFA|', '1437381209', 0, 'Y', 0, '2014-02-10', NULL, NULL, 43.6539, -116.695, NULL, NULL),
('820200895', 'SACN00993', 'SACN00993', 'SACN', 'Saint Alphonsus Regional Medical Center', 'Mary', '', 'Morgan', 'NP-C', 'Family Practice', 'Nurse Practitioner', '', NULL, 'B', '3340 E Goldstone', 'Meridian', 'Ada', 'ID', '83642', '2084526851', '2084522140', '3340 E Goldstone', 'Meridian', 'Ada', 'ID', '83642', '2084526851', '2084522140', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Medical Center Nampa', '', '', '', 'HCFA|', '1437381209', 0, 'N', 0, '2014-02-10', NULL, NULL, 0, 0, NULL, NULL),
('820200895', 'SACN00994', 'SACN00994', 'SACN', 'Saint Alphonsus Express Care Inc', 'Mary', '', 'Morgan', 'NP-C', 'Family Practice', 'Nurse Practitioner', '', NULL, 'O', '4700 N Eagle Rd', 'Boise', 'Ada', 'ID', '83713', '2089384797', '2084522140', '4700 N Eagle Rd', 'Boise', 'Ada', 'ID', '83713', '2089384797', '2084522140', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Medical Center Nampa', '', '', '', 'HCFA|', '1437381209', 0, 'Y', 0, '2014-02-10', NULL, NULL, 43.6474, -116.352, NULL, NULL),
('820200895', 'SACN00995', 'SACN00995', 'SACN', 'Saint Alphonsus Medical Group Emerald Family Medicine', 'Mary', '', 'Morgan', 'NP-C', 'Family Practice', 'Nurse Practitioner', '', NULL, 'O', '6533 Emerald St', 'Boise', 'Ada', 'ID', '83704', '2083674170', '2083678135', '6533 Emerald St', 'Boise', 'Ada', 'ID', '83704', '2083674170', '2083678135', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Medical Center Nampa', '', '', '', 'HCFA|', '1437381209', 0, 'Y', 0, '2014-02-10', NULL, NULL, 43.6119, -116.268, NULL, NULL),
('263329351', 'TX0103593', 'TX0103593', 'TXSATSTD', 'San Antonio Internal Medicine Physicians', 'G', 'R', 'Taylor', 'MD', 'Internal Medicine', '', '', NULL, 'B', 'PO Box 741181', 'Atlanta', 'Fulton', 'GA', '30374', '2102239617', '2102236115', 'PO Box 741181', 'Atlanta', 'Fulton', 'GA', '30374', '2102239617', '2102236115', 'TXINT', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2012-08-20', '2014-07-15', 0, 0, 0, 'Baptist Medical Center', '', '', '', 'HCFA|UB|', '1548255763', 0, 'Y', 0, '2014-07-14', NULL, NULL, 0, 0, NULL, NULL),
('820200895', 'SACN01208', 'SACN01208', 'SACN', 'Saint Alphonsus Inpatient Medicine', 'Nancy', 'N', 'Taylor', 'NP-C', 'Cardiology', '', '', NULL, 'O', '1055 N Curtis Rd', 'Boise', 'Ada', 'ID', '83706', '2083676279', '2083675180', '1055 N Curtis Rd', 'Boise', 'Ada', 'ID', '83706', '2083676279', '2083675180', 'IDSINCLAIRL', NULL, '', '0.00', '15.00', '0.00', 6, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Medical Center Nampa', '', '', '', 'HCFA|', '1609808328', 0, 'N', 0, '2014-06-13', NULL, NULL, 43.6127, -116.254, NULL, NULL),
('260553931', 'SACN01024', 'SACN01024', 'SACN', 'Saint Alphonsus Medical Group Heart Care Garrity', 'Laura', 'A', 'Morton', 'NP-C', 'Cardiology', 'Nurse Practitioner', '', NULL, 'O', '1200 Garrity Blvd', 'Nampa', 'Canyon', 'ID', '83687', '2083674278', '2083675200', '1200 Garrity Blvd', 'Nampa', 'Canyon', 'ID', '83687', '2083674278', '2083675200', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Medical Center Nampa', '', '', '', 'HCFA|UB|', '1477597573', 0, 'Y', 0, '2014-07-09', NULL, NULL, 43.587, -116.549, NULL, NULL),
('260553931', 'SACN01025', 'SACN01025', 'SACN', 'Saint Alphonsus Medical Group Heart Care Meridian', 'Laura', 'A', 'Morton', 'NP-C', 'Cardiology', 'Nurse Practitioner', '', NULL, 'O', '3025 W Cherry Ln Ste 205', 'Meridian', 'Ada', 'ID', '83642', '2083678484', '2083678456', '3025 W Cherry Ln Ste 205', 'Meridian', 'Ada', 'ID', '83642', '2083678484', '2083678456', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Medical Center Nampa', '', '', '', 'HCFA|UB|', '1477597573', 0, 'Y', 0, '2014-07-09', NULL, NULL, 43.6188, -116.431, NULL, NULL),
('260553931', 'SACN01026', 'SACN01026', 'SACN', 'Saint Alphonsu Medical Group Heart Care Elm  provides coverage as needed do not post on website', 'Laura', 'A', 'Morton', 'NP-C', 'Cardiology', 'Nurse Practitioner', '', NULL, 'O', '315 E Elm St 100 Ste 100', 'Caldwell', 'Canyon', 'ID', '83605', '2084597415', '2083675200', '315 E Elm St 100 Ste 100', 'Caldwell', 'Canyon', 'ID', '83605', '2084597415', '2083675200', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Medical Center Nampa', '', '', '', 'HCFA|UB|', '1477597573', 0, 'Y', 0, '2014-07-09', NULL, NULL, 0, 0, NULL, NULL),
('260553931', 'SACN01027', 'SACN01027', 'SACN', 'Saint Alphonsus Medical Group Heart Care Eagle', 'Laura', 'A', 'Morton', 'NP-C', 'Cardiology', 'Nurse Practitioner', '', NULL, 'O', '323 E Riverside Dr Ste 224', 'Eagle', 'Ada', 'ID', '83616', '2083674278', '2083675765', '323 E Riverside Dr Ste 224', 'Eagle', 'Ada', 'ID', '83616', '2083674278', '2083675765', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Medical Center Nampa', '', '', '', 'HCFA|UB|', '1477597573', 0, 'Y', 0, '2014-07-09', NULL, NULL, 43.6892, -116.351, NULL, NULL),
('260553931', 'SACN01028', 'SACN01028', 'SACN', 'Saint Alphonsus Medical Group Heart Care Boise ', 'Laura', 'A', 'Morton', 'NP-C', 'Cardiology', 'Nurse Practitioner', '', NULL, 'O', '6140 W Curtisian Ste 200', 'Boise', 'Ada', 'ID', '83704', '2083674278', '2083675200', '6140 W Curtisian Ste 200', 'Boise', 'Ada', 'ID', '83704', '2083674278', '2083675200', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Medical Center Nampa', '', '', '', 'HCFA|UB|', '1477597573', 0, 'N', 0, '2014-07-09', NULL, NULL, 43.6151, -116.256, NULL, NULL),
('331078261', 'SACN01029', 'SACN01029', 'SACN', 'Saint Alphonsus Physicians PA', 'Laura', 'A', 'Morton', 'NP-C', 'Cardiology', 'Nurse Practitioner', '', NULL, 'B', '1200 Garrity Blvd', 'Nampa', 'Canyon', 'ID', '83687', '2083674278', '2083675200', '1200 Garrity Blvd', 'Nampa', 'Canyon', 'ID', '83687', '2083674278', '2083675200', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 3, '2011-01-01', '2013-07-02', 0, 0, 0, 'Saint Alphonsus Medical Center Nampa', '', '', '', 'HCFA|UB|', '1477597573', 0, 'Y', 0, '2014-07-09', NULL, NULL, 43.587, -116.549, NULL, NULL),
('331078261', 'SACN01030', 'SACN01030', 'SACN', 'Saint Alphonsus Physicians PA', 'Laura', 'A', 'Morton', 'NP-C', 'Cardiology', 'Nurse Practitioner', '', NULL, 'B', '3025 W Cherry Ln Ste 205', 'Meridian', 'Ada', 'ID', '83642', '2083678484', NULL, '3025 W Cherry Ln Ste 205', 'Meridian', 'Ada', 'ID', '83642', '2083678484', '', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 3, '2011-01-01', '2013-07-02', 0, 0, 0, 'Saint Alphonsus Medical Center Nampa', '', '', '', 'HCFA|UB|', '1477597573', 0, 'Y', 0, '2014-07-09', NULL, NULL, 43.6188, -116.431, NULL, NULL),
('331078261', 'SACN01031', 'SACN01031', 'SACN', 'Saint Alphonsus Physicians PA', 'Laura', 'A', 'Morton', 'NP-C', 'Cardiology', 'Nurse Practitioner', '', NULL, 'O', '315 E Elm St Ste 100', 'Caldwell', 'Canyon', 'ID', '83605', '2083674278', '2083675200', '315 E Elm St Ste 100', 'Caldwell', 'Canyon', 'ID', '83605', '2083674278', '2083675200', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 3, '2011-01-01', '2013-07-02', 0, 0, 0, 'Saint Alphonsus Medical Center Nampa', '', '', '', 'HCFA|UB|', '1477597573', 0, 'N', 0, '2014-07-09', NULL, NULL, 43.6539, -116.695, NULL, NULL),
('331078261', 'SACN01032', 'SACN01032', 'SACN', 'Saint Alphonsus Physicians PA', 'Laura', 'A', 'Morton', 'NP-C', 'Cardiology', 'Nurse Practitioner', '', NULL, 'B', '323 E Riverside Dr Ste 224', 'Eagle', 'Ada', 'ID', '83616', '2083675750', NULL, '323 E Riverside Dr Ste 224', 'Eagle', 'Ada', 'ID', '83616', '2083675750', '', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 3, '2011-01-01', '2013-07-02', 0, 0, 0, 'Saint Alphonsus Medical Center Nampa', '', '', '', 'HCFA|UB|', '1477597573', 0, 'N', 0, '2014-07-09', NULL, NULL, 43.6892, -116.351, NULL, NULL),
('331078261', 'SACN01033', 'SACN01033', 'SACN', 'Saint Alphonsus Physicians PA', 'Laura', 'A', 'Morton', 'NP-C', 'Cardiology', 'Nurse Practitioner', '', NULL, 'B', '6140 W Curtisian Ste 200', 'Boise', 'Ada', 'ID', '83704', '2083674278', '2083675200', '6140 W Curtisian Ste 200', 'Boise', 'Ada', 'ID', '83704', '2083674278', '2083675200', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 3, '2011-01-01', '2013-07-02', 0, 0, 0, 'Saint Alphonsus Medical Center Nampa', '', '', '', 'HCFA|UB|', '1477597573', 0, 'Y', 0, '2014-07-09', NULL, NULL, 43.6151, -116.256, NULL, NULL),
('820312175', 'SACN00534', 'SACN00534', 'SACN', 'Idaho Emergency Physicians PA', 'Brian', 'W', 'Moss', 'MD', 'Emergency Medicine', '', '', NULL, 'O', '1055 N Curtis Rd', 'Boise', 'Ada', 'ID', '83704', '2083221730', '2083221731', '1055 N Curtis Rd', 'Boise', 'Ada', 'ID', '83704', '2083221730', '2083221731', 'IDSINCLAIRL', NULL, NULL, '0.00', '15.00', '0.00', 3, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Medical Center Nampa', 'West Valley Medical Center', '', '', 'HCFA|UB|', '1033384201', 0, 'N', 0, '2012-01-31', NULL, NULL, 43.6136, -116.256, NULL, NULL),
('820312175', 'SACN00535', 'SACN00535', 'SACN', 'Idaho Emergency Physicians PA', 'Brian', 'W', 'Moss', 'MD', 'Emergency Medicine', '', '', NULL, 'O', '1717 Arlington', 'Caldwell', 'Canyon', 'ID', '83605', '2083221730', '2083221731', '1717 Arlington', 'Caldwell', 'Canyon', 'ID', '83605', '2083221730', '2083221731', 'IDSINCLAIRL', NULL, NULL, '0.00', '15.00', '0.00', 3, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Medical Center Nampa', 'West Valley Medical Center', '', '', 'HCFA|UB|', '1033384201', 0, 'N', 0, '2012-01-31', NULL, NULL, 0, 0, NULL, NULL),
('820312175', 'SACN00536', 'SACN00536', 'SACN', 'Idaho Emergency Physicians PA', 'Brian', 'W', 'Moss', 'MD', 'Emergency Medicine', '', '', NULL, 'B', '2963 E Copper Point Dr', 'Meridian', 'Ada', 'ID', '83642', '2083221730', NULL, '2963 E Copper Point Dr', 'Meridian', 'Ada', 'ID', '83642', '2083221730', '          ', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 3, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Medical Center Nampa', 'West Valley Medical Center', '', '', 'HCFA|UB|', '1033384201', 0, 'Y', 0, '2012-01-31', NULL, NULL, 0, 0, NULL, NULL),
('820312175', 'SACN00537', 'SACN00537', 'SACN', 'Idaho Emergency Physicians PA', 'Brian', 'W', 'Moss', 'MD', 'Emergency Medicine', '', '', NULL, 'O', '323 E Riverside Dr', 'Eagle', 'Ada', 'ID', '83616', '2083221730', '2083221731', '323 E Riverside Dr', 'Eagle', 'Ada', 'ID', '83616', '2083221730', '2083221731', 'IDSINCLAIRL', NULL, NULL, '0.00', '15.00', '0.00', 3, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Medical Center Nampa', 'West Valley Medical Center', '', '', 'HCFA|UB|', '1033384201', 0, 'N', 0, '2012-01-31', NULL, NULL, 43.6892, -116.351, NULL, NULL),
('820381882', 'SACN01541', 'SACN01541', 'SACN', 'St Lukes Clinic Orthopedic Surgery', 'Stanley', 'W', 'Moss', 'MD', 'Orthopedic Surgery', '', '', NULL, 'O', '520 S Eagle Rd Ste 1201', 'Meridian', 'Ada', 'ID', '83642', '2088559600', NULL, '520 S Eagle Rd Ste 1201', 'Meridian', 'Ada', 'ID', '83642', '2088559600', '          ', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 3, '2011-01-01', '2011-11-30', 0, 0, 1, '', '', '', '', 'HCFA|UB|', '1831138692', 0, 'N', 0, '2013-11-15', NULL, NULL, 43.5995, -116.352, NULL, NULL),
('460500210', 'SACN00546', 'SACN00546', 'SACN', 'Saint Alphonsus Trauma Physician Services', 'Aziz', 'G', 'Munayirji', 'MD', 'General Surgery', '', '', NULL, 'B', '1055 N Curtis', 'Boise', 'Ada', 'ID', '83706', '0', '0', '1055 N Curtis', 'Boise', 'Ada', 'ID', '83706', '0', '0', 'IDSINCLAIRL', NULL, NULL, '0.00', '15.00', '0.00', 6, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Regional Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1003869629', 0, 'Y', 0, '2013-11-22', NULL, NULL, 43.6127, -116.254, NULL, NULL),
('460500210', 'SACN00547', 'SACN00547', 'SACN', 'Saint Alphonsus Outpatient Trauma Services', 'Aziz', 'G', 'Munayirji', 'MD', 'General Surgery', '', '', NULL, 'O', '901 N Curtis Rd Ste 401', 'Boise', 'Ada', 'ID', '83706', '2083677676', '2083676849', '901 N Curtis Rd Ste 401', 'Boise', 'Ada', 'ID', '83706', '2083677676', '2083676849', 'IDSINCLAIRL', NULL, NULL, '0.00', '15.00', '0.00', 6, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Regional Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1003869629', 0, 'N', 0, '2013-11-22', NULL, NULL, 43.6126, -116.255, NULL, NULL),
('263329351', 'TX0103592', 'TX0103592', 'TXSATSTD', 'San Antonio Internal Medicine Physicians', 'G', 'R', 'Taylor', 'MD', 'Internal Medicine', '', '', NULL, 'O', '1303 McCullough Ave Ste 560', 'San Antonio', 'Bexar', 'TX', '78212', '2102239617', '2102236115', '1303 McCullough Ave Ste 560', 'San Antonio', 'Bexar', 'TX', '78212', '2102239617', '2102236115', 'TXINT', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2012-08-20', '2014-07-15', 0, 0, 0, 'Baptist Medical Center', '', '', '', 'HCFA|UB|', '1548255763', 0, 'N', 0, '2014-07-14', NULL, NULL, 29.4407, -98.4918, NULL, NULL),
('263329351', 'W12003593', 'W12003593', 'TX01', 'San Antonio Internal Medicine Physicians', 'G', 'R', 'Taylor', 'MD', 'Internal Medicine', '', '', NULL, 'B', 'PO Box 741181', 'Atlanta', 'Fulton', 'GA', '30374', '2102239617', '2102236115', 'PO Box 741181', 'Atlanta', 'Fulton', 'GA', '30374', '2102239617', '2102236115', 'TXINT', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2010-08-01', '2012-08-19', 0, 0, 0, 'Baptist Medical Center', '', '', '', 'HCFA|UB|', '1548255763', 0, 'N', 0, '2014-07-14', 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
('820200895', 'SACN01595', 'SACN01595', 'SACN', 'Saint Alphonsus Medical Group Polumnary & Sleep Boise ', 'Nancy', '', 'Nadolski', 'NP-C', 'Nurse Practitioner', '', '', NULL, 'O', '1075 N Curtis Ste 201', 'Boise', 'Ada', 'ID', '83706', '2083678333', '2083672003', '1075 N Curtis Ste 201', 'Boise', 'Ada', 'ID', '83706', '2083678333', '2083672003', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Medical Center Nampa', '', '', '', 'HCFA|', '1881755023', 0, 'N', 0, '2011-09-19', NULL, NULL, 43.6143, -116.258, NULL, NULL),
('820200895', 'SACN01596', 'SACN01596', 'SACN', 'Saint Alphonsus Regional Medical Center', 'Nancy', '', 'Nadolski', 'NP-C', 'Nurse Practitioner', '', '', NULL, 'B', '3340 E Goldstone', 'Meridian', 'Ada', 'ID', '83642', '2083675170', '2083672003', '3340 E Goldstone', 'Meridian', 'Ada', 'ID', '83642', '2083675170', '2083672003', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Medical Center Nampa', '', '', '', 'HCFA|', '1881755023', 0, 'N', 0, '2011-09-19', NULL, NULL, 0, 0, NULL, NULL),
('820200895', 'SACN01597', 'SACN01597', 'SACN', 'Saint Alphonsus Medical Group Polumnary & Sleep Boise ', 'Nancy', '', 'Nadolski', 'NP-C', 'Nurse Practitioner', '', '', NULL, 'O', '6140 W Curtisian Ste B10', 'Boise', 'Ada', 'ID', '83704', '2083678333', '2083672003', '6140 W Curtisian Ste B10', 'Boise', 'Ada', 'ID', '83704', '2083678333', '2083672003', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Medical Center Nampa', '', '', '', 'HCFA|', '1881755023', 0, 'N', 0, '2011-09-19', NULL, NULL, 43.6151, -116.256, NULL, NULL),
('820535616', 'SACN00843', 'SACN00843', 'SACN', '', 'Lindsay', '', 'Nagelmann', 'PA-C', 'Physician Assistant', '', '', NULL, 'O', '2536 N Stokesberry Pl', 'Meridian', 'Ada', 'ID', '83646', '2088550880', '2088550889', '2536 N Stokesberry Pl', 'Meridian', 'Ada', 'ID', '83646', '2088550880', '2088550889', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 3, '2011-01-01', NULL, 0, 0, 1, '', '', '', '', 'HCFA|UB|', '1306168018', 0, 'N', 0, '2012-02-02', NULL, NULL, 0, 0, NULL, NULL),
('263329351', 'W12003592', 'W12003592', 'TX01', 'San Antonio Internal Medicine Physicians', 'G', 'R', 'Taylor', 'MD', 'Internal Medicine', '', '', NULL, 'O', '1303 McCullough Ave Ste 560', 'San Antonio', 'Bexar', 'TX', '78212', '2102239617', '2102236115', '1303 McCullough Ave Ste 560', 'San Antonio', 'Bexar', 'TX', '78212', '2102239617', '2102236115', 'TXINT', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2010-08-01', '2012-08-19', 0, 0, 0, 'Baptist Medical Center', '', '', '', 'HCFA|UB|', '1548255763', 0, 'N', 0, '2014-07-14', NULL, NULL, 29.4412, -98.4924, NULL, NULL),
('820526341', 'SACN01637', 'SACN01637', 'SACN', NULL, 'Roberto', '', 'Negron', 'MD', 'Mental Health', 'Psychiatry', '', NULL, 'O', '413 N Allumbaugh St Ste 101', 'Boise', 'Ada', 'ID', '83704', '2083231125', NULL, '413 N Allumbaugh St Ste 101', 'Boise', 'Ada', 'ID', '83704', '2083231125', '', 'IDSINCLAIRL', NULL, NULL, '0.00', '15.00', '0.00', 3, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Regional Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1932139961', 0, 'n', 0, '2013-03-20', NULL, NULL, 43.6086, -116.268, NULL, NULL),
('203276415', 'SACN01003', 'SACN01003', 'SACN', 'Ada West Dermatology', 'Janice', '', 'Neilson', 'FNP-C', 'Dermatology', '', '', NULL, 'O', '1618 S Millennium Way Ste 100', 'Meridian', 'Ada', 'ID', '83642', '2088843376', NULL, '1618 S Millennium Way Ste 100', 'Meridian', 'Ada', 'ID', '83642', '2088843376', '', 'IDSINCLAIRL', 'WUSTDHCPC5', NULL, '0.00', '15.00', '0.00', 3, '2011-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1447289681', 0, 'n', 0, '2013-03-20', NULL, NULL, 43.5903, -116.368, NULL, NULL),
('820312175', 'SACN01557', 'SACN01557', 'SACN', 'Idaho Emergency Physicians PA', 'Andrew', '', 'Nelson', 'MD', 'Emergency Medicine', '', '', NULL, 'O', '1055 N Curtis Rd', 'Boise', 'Ada', 'ID', '83704', '2083221730', '2083221731', '1055 N Curtis Rd', 'Boise', 'Ada', 'ID', '83704', '2083221730', '2083221731', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 3, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Regional Medical Center', 'West Valley Medical Center', NULL, NULL, 'HCFA|UB|', '1841493665', 0, 'N', 0, '2012-08-13', NULL, NULL, 43.6136, -116.256, NULL, NULL),
('820312175', 'SACN01558', 'SACN01558', 'SACN', 'Idaho Emergency Physicians PA', 'Andrew', '', 'Nelson', 'MD', 'Emergency Medicine', '', '', NULL, 'O', '1717 Arlington', 'Caldwell', 'Canyon', 'ID', '83605', '2083221730', '2083221731', '1717 Arlington', 'Caldwell', 'Canyon', 'ID', '83605', '2083221730', '2083221731', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 3, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Regional Medical Center', 'West Valley Medical Center', NULL, NULL, 'HCFA|UB|', '1841493665', 0, 'N', 0, '2012-08-13', NULL, NULL, 0, 0, NULL, NULL),
('820312175', 'SACN01559', 'SACN01559', 'SACN', 'Idaho Emergency Physicians PA', 'Andrew', '', 'Nelson', 'MD', 'Emergency Medicine', '', '', NULL, 'B', '2963 E Copper Point Dr', 'Meridian', 'Ada', 'ID', '83642', '2083221730', NULL, '2963 E Copper Point Dr', 'Meridian', 'Ada', 'ID', '83642', '2083221730', '          ', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 3, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Regional Medical Center', 'West Valley Medical Center', NULL, NULL, 'HCFA|UB|', '1841493665', 0, 'N', 0, '2012-08-13', NULL, NULL, 0, 0, NULL, NULL),
('820312175', 'SACN01560', 'SACN01560', 'SACN', 'Idaho Emergency Physicians PA', 'Andrew', '', 'Nelson', 'MD', 'Emergency Medicine', '', '', NULL, 'O', '323 E Riverside Dr', 'Eagle', 'Ada', 'ID', '83616', '2083221730', '2083221731', '323 E Riverside Dr', 'Eagle', 'Ada', 'ID', '83616', '2083221730', '2083221731', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 3, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Regional Medical Center', 'West Valley Medical Center', NULL, NULL, 'HCFA|UB|', '1841493665', 0, 'N', 0, '2012-08-13', NULL, NULL, 43.6892, -116.351, NULL, NULL),
('820200895', 'SACN00732', 'SACN00732', 'SACN', 'Saint Alphonsus Inpatient Medicine', 'Lisa', 'M', 'Nelson', 'MD', 'Hospitalist', '', '', NULL, 'O', '1055 N Curtis Rd', 'Boise', 'Ada', 'ID', '83706', '2083672121', '2083675180', '1055 N Curtis Rd', 'Boise', 'Ada', 'ID', '83706', '2083672121', '2083675180', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Regional Medical Center', '', '', '', 'HCFA|', '1194840397', 0, 'Y', 0, '2014-06-20', NULL, NULL, 43.6127, -116.254, NULL, NULL),
('820425454', 'SACN00114', 'SACN00114', 'SACN', 'Boise Anesthesia, PA', 'Taylor', '', 'Nelson', 'CRNA', 'Anesthesiology', '', '', NULL, 'o', '1055 N Curtis Rd', 'Boise', 'Ada', 'ID', '83706', '2083676416', NULL, '1055 N Curtis Rd', 'Boise', 'Ada', 'ID', '83706', '2083676416', '          ', '', '', '', '58.45', '10.00', '0.00', 3, '2011-01-01', '2012-03-01', 1, 15, 0, '', '', '', '', 'HCFA|UB|', '1184863219', 0, 'N', 0, '2012-02-23', NULL, NULL, 43.6127, -116.254, NULL, NULL),
('820425454', 'SACN00115', 'SACN00115', 'SACN', 'Boise Anesthesia, PA', 'Taylor', '', 'Nelson', 'CRNA', 'Anesthesiology', '', '', NULL, 'o', '1717 Arlington Ave', 'Caldwell', 'Canyon', 'ID', '83605', '2084554009', NULL, '1717 Arlington Ave', 'Caldwell', 'Canyon', 'ID', '83605', '2084554009', '          ', '', '', '', '58.45', '10.00', '0.00', 3, '2011-01-01', '2012-03-01', 1, 15, 0, '', '', '', '', 'HCFA|UB|', '1184863219', 0, 'N', 0, '2012-02-23', NULL, NULL, 0, 0, NULL, NULL),
('820425454', 'SACN00116', 'SACN00116', 'SACN', 'Boise Anesthesia, PA', 'Taylor', '', 'Nelson', 'CRNA', 'Anesthesiology', '', '', NULL, 'o', '900 N Liberty St Ste 450', 'Boise', 'Ada', 'ID', '83704', '2053677431', NULL, '900 N Liberty St Ste 450', 'Boise', 'Ada', 'ID', '83704', '2053677431', '          ', '', '', '', '58.45', '10.00', '0.00', 3, '2011-01-01', '2012-03-01', 1, 15, 0, '', '', '', '', 'HCFA|UB|', '1184863219', 0, 'N', 0, '2012-02-23', NULL, NULL, 43.6133, -116.259, NULL, NULL),
('261736078', 'ELHCA0228', 'ELHCA0228', 'TXHOUSTD', 'Womens Associates', 'Bassem', NULL, 'Tawadrous', 'MD', 'Obstetrics and Gynecology', '', '', NULL, 'B', 'PO Box 281181      ', 'Atlanta', 'Fulton', 'GA', '30384', '          ', NULL, 'PO Box 281181      ', 'Atlanta', 'Fulton', 'GA', '30384', '          ', '          ', 'HCA', 'TXHCPC13', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Bayshore Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1730105925', 0, 'Y', 0, '2013-05-01', NULL, NULL, 0, 0, NULL, NULL),
('261736078', 'ELHCA0227', 'ELHCA0227', 'TXHOUSTD', 'Womens Associates', 'Bassem', NULL, 'Tawadrous', 'MD', 'Obstetrics and Gynecology', '', '', NULL, 'O', '4600 Fairmont Pkwy                                 Ste 200', 'Pasadena', 'Harris', 'TX', '77504', '2814872371', '2814873689', '4600 Fairmont Pkwy                                 Ste 200', 'Pasadena', 'Harris', 'TX', '77504', '2814872371', '2814873689', 'HCA', 'TXHCPC13', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Bayshore Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1730105925', 0, 'N', 0, '2013-05-01', NULL, NULL, 29.6495, -95.1736, NULL, NULL),
('942854057', 'W12001768', 'W12001768', 'UTIHC04', 'Safe and Healthy Families', 'Anne', 'F', 'Taverne', 'PHD', 'Mental Health', 'Psychology', NULL, NULL, 'O', '675 E 500 S', 'Salt Lake City', 'Salt Lake', 'UT', '84102', '8016623600', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '', '', '', '0.00', '10.00', '0.00', 8, '2008-10-31', '2010-04-30', NULL, 0, NULL, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1780858662', 0, 'N', 0, '2013-02-28', NULL, NULL, 0, 0, NULL, NULL),
('562749551', 'SACN00228', 'SACN00228', 'SACN', 'Counseling Solutions', 'Phyllis', 'R', 'Nodler', 'LCPC', 'Mental Health', 'Counseling', '', NULL, 'B', '12560 W Freedom Dr', 'Boise', 'Ada', 'ID', '83713', '2085777634', '2083788389', '12560 W Freedom Dr', 'Boise', 'Ada', 'ID', '83713', '2085777634', '2083788389', 'IDSINCLAIRL', 'WUSTDHCPC5', '', '0.00', '15.00', '0.00', 3, '2011-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1295983443', 0, 'N', 0, '2013-02-27', NULL, NULL, 0, 0, NULL, NULL),
('562749551', 'SACN00229', 'SACN00229', 'SACN', 'Counseling Solutions', 'Phyllis', 'R', 'Nodler', 'LCPC', 'Mental Health', 'Counseling', '', NULL, 'O', '3709 N Locust Grove Rd', 'Meridian', 'Ada', 'ID', '83646', '2085777634', '2083788389', '3709 N Locust Grove Rd', 'Meridian', 'Ada', 'ID', '83646', '2085777634', '2083788389', 'IDSINCLAIRL', 'WUSTDHCPC5', '', '0.00', '15.00', '0.00', 3, '2011-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1295983443', 0, 'N', 0, '2013-02-27', NULL, NULL, 0, 0, NULL, NULL),
('200192377', 'SACN00996', 'SACN00996', 'SACN', 'Meridian Family Medicine', 'Jennifer', '', 'Nordquist', 'NP-C', 'Family Practice', '', '', NULL, 'O', '1525 E Leigh Field Dr Ste 150', 'Meridian', 'Ada', 'ID', '83646', '2088881199', '2088887975', '1525 E Leigh Field Dr Ste 150', 'Meridian', 'Ada', 'ID', '83646', '2088881199', '2088887975', 'IDSINCLAIRL', NULL, NULL, '0.00', '15.00', '0.00', 3, '2011-01-01', NULL, 0, 0, 1, 'Saint Alphonsus Regional Medical Center', NULL, '', '', 'HCFA|UB|', '1437489895', 0, 'N', 0, '2013-12-11', NULL, NULL, 0, 0, NULL, NULL),
('200192377', 'SACN00997', 'SACN00997', 'SACN', 'Meridian Family Medicine', 'Jennifer', '', 'Nordquist', 'NP-C', 'Family Practice', '', '', NULL, 'B', 'PO Box 44440', 'Boise', 'Ada', 'ID', '83711', '2088881199', NULL, 'PO Box 44440', 'Boise', 'Ada', 'ID', '83711', '2088881199', '', 'IDSINCLAIRL', NULL, NULL, '0.00', '15.00', '0.00', 3, '2011-01-01', NULL, 0, 0, 1, 'Saint Alphonsus Regional Medical Center', NULL, '', '', 'HCFA|UB|', '1437489895', 0, 'Y', 0, '2013-12-11', NULL, NULL, 0, 0, NULL, NULL),
('820441031', 'SACN01084', 'SACN01084', 'SACN', 'Ada Orthopaedic Clinic', 'Phillip', 'J', 'Norris', 'PA-C', 'Mental Health', '', '', NULL, 'O', '6500 W Emerald St', 'Boise', 'Ada', 'ID', '83704', '2083770777', NULL, '6500 W Emerald St', 'Boise', 'Ada', 'ID', '83704', '2083770777', '', 'IDSINCLAIRL', 'WUSTDHCPC5', '', '0.00', '15.00', '0.00', 3, '2011-01-01', '2012-02-24', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1497790224', 0, 'N', 0, '2014-06-30', NULL, NULL, 43.612, -116.262, NULL, NULL),
('820445140', 'SACN01219', 'SACN01219', 'SACN', 'The Eye Associates', 'Randall', '', 'Norris', 'OD', 'Optometry', '', '', NULL, 'B', '1602 Arlington Ave', 'Caldwell', 'Canyon', 'ID', '83605', '2084590717', NULL, '1602 Arlington Ave', 'Caldwell', 'Canyon', 'ID', '83605', '2084590717', '          ', 'IDSINCLAIRL', 'WUSTDHCPC5', '', '0.00', '15.00', '0.00', 3, '2011-01-01', '2010-01-01', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1619928587', 0, 'Y', 0, '2012-02-22', NULL, NULL, 43.6558, -116.696, NULL, NULL),
('820445140', 'SACN01220', 'SACN01220', 'SACN', 'The Eye Associates', 'Randall', '', 'Norris', 'OD', 'Optometry', '', '', NULL, 'B', '901 N Curtis Rd Ste 302', 'Boise', 'Ada', 'ID', '83706', '2083425151', NULL, '901 N Curtis Rd Ste 302', 'Boise', 'Ada', 'ID', '83706', '2083425151', '          ', 'IDSINCLAIRL', 'WUSTDHCPC5', '', '0.00', '15.00', '0.00', 3, '2011-01-01', '2010-01-01', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1619928587', 0, 'Y', 0, '2012-02-22', NULL, NULL, 43.6126, -116.255, NULL, NULL),
('943022654', 'SACN01451', 'SACN01451', 'SACN', NULL, 'Charles', 'C', 'Novak', 'MD', 'Mental Health', 'Psychiatry', '', NULL, 'O', '413 N Allumbaugh St Ste 101', 'Boise', 'Ada', 'ID', '83704', '2083231125', NULL, '413 N Allumbaugh St Ste 101', 'Boise', 'Ada', 'ID', '83704', '2083231125', '', 'IDSINCLAIRL', NULL, NULL, '0.00', '15.00', '0.00', 3, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Medical Center Nampa', '', '', '', 'HCFA|UB|', '1770511743', 0, 'n', 0, '2013-02-19', NULL, NULL, 43.6086, -116.268, NULL, NULL),
('204843579', 'SACN00980', 'SACN00980', 'SACN', 'Eagle Family Medicine PA', 'Shawn', 'C', 'Nowierski', 'MD', 'Family Practice', NULL, NULL, NULL, 'O', '100 W Cottonwood Ct Ste 100', 'Eagle', 'Ada', 'ID', '83616', '2089393197', '2089393263', '100 W Cottonwood Ct Ste 100', 'Eagle', 'Ada', 'ID', '83616', '2089393197', '2089393263', 'IDSINCLAIRL', NULL, NULL, '0.00', '15.00', '0.00', 3, '2011-01-01', NULL, 0, 0, 1, 'Saint Alphonsus Medical Center Nampa', NULL, '', '', 'HCFA|UB|', '1437109089', 0, 'N', 0, '2012-01-31', NULL, NULL, 0, 0, NULL, NULL),
('260553931', 'SACN00162', 'SACN00162', 'SACN', 'Saint Alphonsus Medical Group Heart Care Boise', 'David', 'F', 'Oakes', 'MD', 'Cardiology', '', '', NULL, 'O', '1070 N Curtis Ste 125', 'Boise', 'Ada', 'ID', '83706', '2083771415', '2083753451', '1070 N Curtis Ste 125', 'Boise', 'Ada', 'ID', '83706', '2083771415', '2083753451', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Regional Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1083642987', 0, 'N', 0, '2014-02-07', NULL, NULL, 43.6141, -116.253, NULL, NULL),
('260553931', 'SACN00163', 'SACN00163', 'SACN', 'Saint Alphonsus Medical Group Heart Care', 'David', 'F', 'Oakes', 'MD', 'Cardiology', '', '', NULL, 'O', '520 S Eagle Rd Ste 2205', 'Meridian', 'Ada', 'ID', '83642', '2088840036', '2088843805', '520 S Eagle Rd Ste 2205', 'Meridian', 'Ada', 'ID', '83642', '2088840036', '2088843805', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', '2012-01-06', 0, 0, 0, 'Saint Alphonsus Regional Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1083642987', 0, 'N', 0, '2014-02-07', NULL, NULL, 43.5995, -116.352, NULL, NULL),
('260553931', 'SACN00164', 'SACN00164', 'SACN', 'Saint Alponsus Medical Group Heart Care Boise ', 'David', 'F', 'Oakes', 'MD', 'Cardiology', '', '', NULL, 'O', '6140 W Curtisian Ste 200', 'Boise', 'Ada', 'ID', '83704', '2083674278', '2083675200', '6140 W Curtisian Ste 200', 'Boise', 'Ada', 'ID', '83704', '2083674278', '2083675200', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Regional Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1083642987', 0, 'N', 0, '2014-02-07', NULL, NULL, 43.6151, -116.256, NULL, NULL),
('820200895', 'SACN00560', 'SACN00560', 'SACN', 'Saint Alphonsus Regional Medical Center (this is a reading p', 'Janat', 'E', 'ODonnell', 'MD', 'Pulmonary', 'Sleep Medicine', 'Sleep Disorders', NULL, 'B', '1055 N Curtis', 'Boise', 'Ada', 'ID', '83706', '2083673722', NULL, '1055 N Curtis', 'Boise', 'Ada', 'ID', '83706', '2083673722', '0         ', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', '2013-03-27', 0, 0, 0, 'Saint Alphonsus Regional Medical Center', NULL, NULL, NULL, 'HCFA|', '1013946391', 0, 'N', 0, '2014-03-20', NULL, NULL, 43.6127, -116.254, NULL, NULL),
('820200895', 'SACN00561', 'SACN00561', 'SACN', 'Saint Alphonsus Regional Medical Group Pulmonary & Sleep Boise', 'Janat', 'E', 'ODonnell', 'MD', 'Pulmonary', 'Sleep Medicine', 'Sleep Disorders', NULL, 'O', '1075 N Curtis Ste 201', 'Boise', 'Ada', 'ID', '83706', '2083678333', '2083672003', '1075 N Curtis Ste 201', 'Boise', 'Ada', 'ID', '83706', '2083678333', '2083672003', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Regional Medical Center', NULL, NULL, NULL, 'HCFA|', '1013946391', 0, 'N', 0, '2014-03-20', NULL, NULL, 43.6143, -116.258, NULL, NULL),
('820200895', 'SACN00562', 'SACN00562', 'SACN', 'Saint Alphonsus Regional Medical Group Pulmonary & Sleep Boise', 'Janat', 'E', 'ODonnell', 'MD', 'Pulmonary', 'Sleep Medicine', 'Sleep Disorders', NULL, 'O', '6140 W Curtisian Ste B10', 'Boise', 'Ada', 'ID', '83704', '2083678333', '2083672003', '6140 W Curtisian Ste B10', 'Boise', 'Ada', 'ID', '83704', '2083678333', '2083672003', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Regional Medical Center', NULL, NULL, NULL, 'HCFA|', '1013946391', 0, 'N', 0, '2014-03-20', NULL, NULL, 43.6151, -116.256, NULL, NULL),
('820200896', 'SACN00563', 'SACN00563', 'SACN', 'Saint Alphonsus Medical Center  Nampa Read Only', 'Janat', 'E', 'ODonnell', 'MD', 'Pulmonary', 'Sleep Medicine', 'Sleep Disorders', NULL, 'O', '1512 12th Ave Rd', 'Nampa', 'Canyon', 'ID', '83686', '2084671171', '2084635050', '1512 12th Ave Rd', 'Nampa', 'Canyon', 'ID', '83686', '2084671171', '2084635050', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Regional Medical Center', NULL, NULL, NULL, 'HCFA|', '1013946391', 0, 'Y', 0, '2014-03-20', NULL, NULL, 43.5537, -116.573, NULL, NULL),
('820200895', 'SACN01280', 'SACN01280', 'SACN', 'Saint Alphonsus Regional Medical Center', 'Amy', '', 'Olson', 'LCSW', 'Mental Health', 'Counseling', '', NULL, 'o', '1055 N Curtis', 'Boise', 'Ada', 'ID', '83706', '2083676238', '2083670285', '1055 N Curtis', 'Boise', 'Ada', 'ID', '83706', '2083676238', '2083670285', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|', '1659390102', 0, 'Y', 0, '2014-06-20', NULL, NULL, 43.6127, -116.254, NULL, NULL),
('680569751', 'SACN01328', 'SACN01328', 'SACN', 'Davis Family Medicine', 'A', 'Marie', 'Osborn', 'FNP', 'Family Practice', '', '', NULL, 'O', '222 N 2nd St Ste 204', 'Boise', 'Ada', 'ID', '83702', '2084299100', NULL, '222 N 2nd St Ste 204', 'Boise', 'Ada', 'ID', '83702', '2084299100', '', 'IDSINCLAIRL', 'WUSTDHCPC5', NULL, '0.00', '15.00', '0.00', 3, '2011-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1679630362', 0, 'n', 0, '2012-01-30', NULL, NULL, 43.6131, -116.195, NULL, NULL),
('680569751', 'SACN01329', 'SACN01329', 'SACN', 'Davis Family Medicine', 'A', 'Marie', 'Osborn', 'FNP', 'Family Practice', '', '', NULL, 'B', 'PO Box 44613', 'Boise', 'Ada', 'ID', '83711', '2084299100', NULL, 'PO Box 44613', 'Boise', 'Ada', 'ID', '83711', '2084299100', '', 'IDSINCLAIRL', 'WUSTDHCPC5', NULL, '0.00', '15.00', '0.00', 3, '2011-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1679630362', 0, 'Y', 0, '2012-01-30', NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W12001767', 'W12001767', 'UTIHC03', 'Safe and Healthy Families', 'Anne', 'F', 'Taverne', 'PHD', 'Mental Health', 'Psychology', NULL, NULL, 'O', '675 E 500 S', 'Salt Lake City', 'Salt Lake', 'UT', '84102', '8016623600', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '', '', '', '0.00', '10.00', '0.00', 8, '2008-10-31', '2010-04-30', NULL, 0, NULL, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1780858662', 0, 'N', 0, '2013-02-28', NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W12001766', 'W12001766', 'UTIHC02', 'Safe and Healthy Families', 'Anne', 'F', 'Taverne', 'PHD', 'Mental Health', 'Psychology', NULL, NULL, 'O', '675 E 500 S', 'Salt Lake City', 'Salt Lake', 'UT', '84102', '8016623600', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '', '', '', '0.00', '10.00', '0.00', 8, '2008-10-31', '2010-04-30', NULL, 0, NULL, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1780858662', 0, 'N', 0, '2013-02-28', NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W12001765', 'W12001765', 'UTIHC01', 'Safe and Healthy Families', 'Anne', 'F', 'Taverne', 'PHD', 'Mental Health', 'Psychology', NULL, NULL, 'O', '675 E 500 S', 'Salt Lake City', 'Salt Lake', 'UT', '84102', '8016623600', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '', '', '', '0.00', '10.00', '0.00', 8, '2008-10-31', '2010-04-30', NULL, 0, NULL, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1780858662', 0, 'N', 0, '2013-02-28', NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W12001769', 'W12001769', 'ID01', 'Safe and Healthy Families', 'Anne', 'F', 'Taverne', 'PHD', 'Mental Health', 'Psychology', NULL, NULL, 'B', '675 E 500 S', 'Salt Lake City', 'Salt Lake', 'UT', '84102', '8016623600', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '', '', '', '0.00', '0.00', '0.00', 8, '2008-10-31', '2010-04-30', NULL, 0, NULL, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1780858662', 0, 'N', 0, '2013-02-28', NULL, NULL, 0, 0, NULL, NULL),
('820200895', 'SACN00564', 'SACN00564', 'SACN', 'Saint Alphonsus Medical Group Garrity Family Medicine', 'Sis', 'E', 'Ostolasa', 'PA-C', 'Physician Assistant', '', '', NULL, 'O', '1200 Garrity Blvd', 'Nampa', 'Canyon', 'ID', '83687', '2084669092', '2084665322', '1200 Garrity Blvd', 'Nampa', 'Canyon', 'ID', '83687', '2084669092', '2084665322', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', NULL, 0, 0, 0, 'West Valley Medical Center', NULL, NULL, NULL, 'HCFA|', '1013952761', 0, 'Y', 0, '2013-09-05', NULL, NULL, 43.587, -116.549, NULL, NULL),
('820200895', 'SACN00565', 'SACN00565', 'SACN', 'Saint Alphonsus Medical Group Elm Family Medicine', 'Sis', 'E', 'Ostolasa', 'PA-C', 'Physician Assistant', '', '', NULL, 'O', '315 E Elm St Ste 100', 'Caldwell', 'Canyon', 'ID', '83605', '2084597415', '2084533307', '315 E Elm St Ste 100', 'Caldwell', 'Canyon', 'ID', '83605', '2084597415', '2084533307', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', NULL, 0, 0, 0, 'West Valley Medical Center', NULL, NULL, NULL, 'HCFA|', '1013952761', 0, 'N', 0, '2013-09-05', NULL, NULL, 43.6539, -116.695, NULL, NULL),
('820477852', 'SACN00566', 'SACN00566', 'SACN', 'Saint Alphonsus Medical Group Garrity', 'Sis', 'E', 'Ostolasa', 'PA-C', 'Physician Assistant', '', '', NULL, 'O', '1200 Garrity Blvd', 'Nampa', 'Canyon', 'ID', '83687', '2084669092', '2084665322', '1200 Garrity Blvd', 'Nampa', 'Canyon', 'ID', '83687', '2084669092', '2084665322', 'IDSINCLAIRL', NULL, NULL, '0.00', '15.00', '0.00', 6, '2011-01-01', NULL, 0, 0, 0, 'West Valley Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1013952761', 0, 'N', 0, '2013-09-05', NULL, NULL, 43.587, -116.549, NULL, NULL),
('820477852', 'SACN00567', 'SACN00567', 'SACN', 'Saint Alphonsus Medical Group Elm Family Medicine', 'Sis', 'E', 'Ostolasa', 'PA-C', 'Physician Assistant', '', '', NULL, 'O', '315 E Elm St Ste 100', 'Caldwell', 'Canyon', 'ID', '83605', '2084597415', '2084533307', '315 E Elm St Ste 100', 'Caldwell', 'Canyon', 'ID', '83605', '2084597415', '2084533307', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', NULL, 0, 0, 0, 'West Valley Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1013952761', 0, 'N', 0, '2014-01-23', NULL, NULL, 43.6539, -116.695, NULL, NULL),
('841385890', 'SACN01664', 'SACN01664', 'SACN', 'Podiatry Center of Idaho', 'Dana', 'S', 'Owen', 'DPM', 'Podiatry', '', '', NULL, 'O', '900 N Liberty Ste 306', 'Boise', 'Ada', 'ID', '83704', '2083677887', '2083677888', '900 N Liberty Ste 306', 'Boise', 'Ada', 'ID', '83704', '2083677887', '2083677888', 'IDSINCLAIRL', NULL, NULL, '0.00', '15.00', '0.00', 3, '2011-01-01', NULL, 0, 0, 1, '', NULL, '', '', 'HCFA|UB|', '1972595676', 0, 'N', 0, '2012-06-29', NULL, NULL, 43.6133, -116.259, NULL, NULL),
('841385890', 'SACN00848', 'SACN00848', 'SACN', 'Podiatry Center of Idaho', 'James', 'J', 'Owen', 'DPM', 'Podiatry', '', '', NULL, 'O', '900 N Liberty Ste 306', 'Boise', 'Ada', 'ID', '83704', '2083677887', '2083677888', '900 N Liberty Ste 306', 'Boise', 'Ada', 'ID', '83704', '2083677887', '2083677888', 'IDSINCLAIRL', NULL, NULL, '0.00', '15.00', '0.00', 3, '2011-01-01', NULL, 0, 0, 1, '', NULL, '', '', 'HCFA|UB|', '1306838016', 0, 'N', 0, '2012-03-29', NULL, NULL, 43.6133, -116.259, NULL, NULL),
('841394139', 'SACN01230', 'SACN01230', 'SACN', 'Southwest Idaho ENT ', 'Jonathan', 'M', 'Owens', 'MD', 'Ear, Nose and Throat', '', '', NULL, 'O', '900 N Liberty St Ste 400', 'Boise', 'Ada', 'ID', '83704', '2083673320', NULL, '900 N Liberty St Ste 400', 'Boise', 'Ada', 'ID', '83704', '2083673320', '          ', 'IDSINCLAIRL', 'WUSTDHCPC5', '', '0.00', '15.00', '0.00', 3, '2011-01-01', '2011-10-01', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1639110109', 0, 'N', 0, '2014-01-24', NULL, NULL, 43.6133, -116.259, NULL, NULL),
('820425454', 'SACN00052', 'SACN00052', 'SACN', 'Boise Anesthesia, PA', 'Stephen', 'B', 'Packer', 'MD', 'Anesthesiology', '', '', NULL, 'o', '1055 N Curtis Rd', 'Boise', 'Ada', 'ID', '83706', '2083676416', '2083759530', '1055 N Curtis Rd', 'Boise', 'Ada', 'ID', '83706', '2083676416', '2083759530', '', '', '', '58.45', '10.00', '0.00', 3, '2011-01-01', NULL, 1, 15, 0, 'Saint Alphonsus Medical Center Nampa', '', 'West Valley Medical Center', '', 'HCFA|UB|', '1598713349', 0, 'N', 0, '2012-11-01', NULL, NULL, 43.6127, -116.254, NULL, NULL),
('820425454', 'SACN00053', 'SACN00053', 'SACN', 'Boise Anesthesia, PA', 'Stephen', 'B', 'Packer', 'MD', 'Anesthesiology', '', '', NULL, 'o', '1717 Arlington Ave', 'Caldwell', 'Canyon', 'ID', '83605', '2084594641', NULL, '1717 Arlington Ave', 'Caldwell', 'Canyon', 'ID', '83605', '2084594641', '0         ', '', '', '', '58.45', '10.00', '0.00', 3, '2011-01-01', NULL, 1, 15, 0, 'Saint Alphonsus Medical Center Nampa', '', 'West Valley Medical Center', '', 'HCFA|UB|', '1598713349', 0, 'N', 0, '2012-11-01', NULL, NULL, 0, 0, NULL, NULL),
('820425454', 'SACN00054', 'SACN00054', 'SACN', 'Boise Anesthesia, PA', 'Stephen', 'B', 'Packer', 'MD', 'Anesthesiology', '', '', NULL, 'o', '3025 W Cherry Ln', 'Meridian', 'Ada', 'ID', '83642', '2083678500', NULL, '3025 W Cherry Ln', 'Meridian', 'Ada', 'ID', '83642', '2083678500', '0         ', '', '', '', '58.45', '10.00', '0.00', 3, '2011-01-01', NULL, 1, 15, 0, 'Saint Alphonsus Medical Center Nampa', '', 'West Valley Medical Center', '', 'HCFA|UB|', '1598713349', 0, 'N', 0, '2012-11-01', NULL, NULL, 43.6188, -116.431, NULL, NULL),
('200324983', 'SACN01233', 'SACN01233', 'SACN', 'Idaho Sports Medicine Institute', 'Bradford', 'R', 'Page', 'PT', 'Physical Therapy', '', '', NULL, 'O', '1188 University Dr', 'Boise', 'Ada', 'ID', '83706', '2083368250', '2083459514', '1188 University Dr', 'Boise', 'Ada', 'ID', '83706', '2083368250', '2083459514', 'IDSINCLAIRL', NULL, NULL, '0.00', '15.00', '0.00', 3, '2011-01-01', NULL, 0, 0, 1, 'Saint Alphonsus Regional Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1639175276', 0, 'N', 0, '2012-07-26', NULL, NULL, 43.601, -116.196, NULL, NULL),
('260553931', 'SACN00420', 'SACN00420', 'SACN', 'Saint Alponsus Medical Group Heart Care Garrity', 'Rakesh', 'K', 'Pai', 'MD', 'Cardiology', '', '', NULL, 'O', '1200 Garrity Blvd', 'Nampa', 'Canyon', 'ID', '83687', '2083674278', '2083675200', '1200 Garrity Blvd', 'Nampa', 'Canyon', 'ID', '83687', '2083674278', '2083675200', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', '2014-01-17', 0, 0, 0, 'Saint Alphonsus Medical Center Nampa', '', '', '', 'HCFA|UB|', '1710190665', 0, 'Y', 0, '2013-12-11', NULL, NULL, 43.587, -116.549, NULL, NULL),
('260553931', 'SACN00421', 'SACN00421', 'SACN', 'Saint Alphonsus Medical Group Cardiology Nampa', 'Rakesh', 'K', 'Pai', 'MD', 'Cardiology', '', '', NULL, 'O', '1524 12th Ave Rd', 'Nampa', 'Canyon', 'ID', '83686', '2084635050', '2084635040', '1524 12th Ave Rd', 'Nampa', 'Canyon', 'ID', '83686', '2084635050', '2084635040', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', '2014-01-17', 0, 0, 0, 'Saint Alphonsus Medical Center Nampa', '', '', '', 'HCFA|UB|', '1710190665', 0, 'N', 0, '2013-12-11', NULL, NULL, 43.5533, -116.573, NULL, NULL),
('260553931', 'SACN00422', 'SACN00422', 'SACN', 'Saint Alponsus Medical Group Heart Care Caldwell', 'Rakesh', 'K', 'Pai', 'MD', 'Cardiology', '', '', NULL, 'O', '1818 S 10th Ave Ste 200', 'Caldwell', 'Canyon', 'ID', '83605', '2083675734', '2083675744', '1818 S 10th Ave Ste 200', 'Caldwell', 'Canyon', 'ID', '83605', '2083675734', '2083675744', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', '2014-01-17', 0, 0, 0, 'Saint Alphonsus Medical Center Nampa', '', '', '', 'HCFA|UB|', '1710190665', 0, 'N', 0, '2013-12-11', NULL, NULL, 43.6538, -116.693, NULL, NULL),
('260553931', 'SACN00423', 'SACN00423', 'SACN', 'Saint Alponsus Medical Group Heart Care Meridian', 'Rakesh', 'K', 'Pai', 'MD', 'Cardiology', '', '', NULL, 'O', '3025 W Cherry Ln Ste 205', 'Meridian', 'Ada', 'ID', '83642', '2083678484', '2083678456', '3025 W Cherry Ln Ste 205', 'Meridian', 'Ada', 'ID', '83642', '2083678484', '2083678456', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', '2014-01-17', 0, 0, 0, 'Saint Alphonsus Medical Center Nampa', '', '', '', 'HCFA|UB|', '1710190665', 0, 'Y', 0, '2013-12-11', NULL, NULL, 43.6188, -116.431, NULL, NULL),
('260553931', 'SACN00424', 'SACN00424', 'SACN', 'Saint Alponsus Medical Group Heart Care Elm', 'Rakesh', 'K', 'Pai', 'MD', 'Cardiology', '', '', NULL, 'O', '315 E Elm St Ste 100', 'Caldwell', 'Canyon', 'ID', '83605', '2083674278', '2083675200', '315 E Elm St Ste 100', 'Caldwell', 'Canyon', 'ID', '83605', '2083674278', '2083675200', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', '2014-01-17', 0, 0, 0, 'Saint Alphonsus Medical Center Nampa', '', '', '', 'HCFA|UB|', '1710190665', 0, 'Y', 0, '2013-12-11', NULL, NULL, 43.6539, -116.695, NULL, NULL),
('260553931', 'SACN00425', 'SACN00425', 'SACN', 'Saint Alponsus Medical Group Heart Care Eagle', 'Rakesh', 'K', 'Pai', 'MD', 'Cardiology', '', '', NULL, 'O', '323 E Riverside Dr Ste 224', 'Eagle', 'Ada', 'ID', '83616', '2083674278', '2083675200', '323 E Riverside Dr Ste 224', 'Eagle', 'Ada', 'ID', '83616', '2083674278', '2083675200', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', '2014-01-17', 0, 0, 0, 'Saint Alphonsus Medical Center Nampa', '', '', '', 'HCFA|UB|', '1710190665', 0, 'Y', 0, '2013-12-11', NULL, NULL, 43.6892, -116.351, NULL, NULL),
('260553931', 'SACN00426', 'SACN00426', 'SACN', 'Saint Alponsus Medical Group Heart Care Boise Moreau Bldg', 'Rakesh', 'K', 'Pai', 'MD', 'Cardiology', '', '', NULL, 'O', '6140 W Curtisian Ste 200', 'Boise', 'Ada', 'ID', '83704', '2083674278', '2083675200', '6140 W Curtisian Ste 200', 'Boise', 'Ada', 'ID', '83704', '2083674278', '2083675200', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', '2014-01-17', 0, 0, 0, 'Saint Alphonsus Medical Center Nampa', '', '', '', 'HCFA|UB|', '1710190665', 0, 'N', 0, '2013-12-11', NULL, NULL, 43.6151, -116.256, NULL, NULL),
('820200895', 'SACN00427', 'SACN00427', 'SACN', 'Saint Alphonsus Regional Medical Center', 'Rakesh', 'K', 'Pai', 'MD', 'Cardiology', '', '', NULL, 'O', '1055 N Curtis', 'Boise', 'Ada', 'ID', '83706', '2083672121', NULL, '1055 N Curtis', 'Boise', 'Ada', 'ID', '83706', '2083672121', '          ', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', '2014-01-17', 0, 0, 0, 'Saint Alphonsus Medical Center Nampa', '', '', '', 'HCFA|', '1710190665', 0, 'Y', 0, '2013-12-11', NULL, NULL, 43.6127, -116.254, NULL, NULL),
('820200895', 'SACN00428', 'SACN00428', 'SACN', '', 'Rakesh', 'K', 'Pai', 'MD', 'Cardiology', '', '', NULL, 'B', 'PO Box 190930', 'Boise', 'Ada', 'ID', '83719', '2083672130', NULL, 'PO Box 190930', 'Boise', 'Ada', 'ID', '83719', '2083672130', '          ', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', '2014-01-17', 0, 0, 0, 'Saint Alphonsus Medical Center Nampa', '', '', '', 'HCFA|', '1710190665', 0, 'Y', 0, '2013-12-11', NULL, NULL, 0, 0, NULL, NULL),
('820312070', 'SACN00153', 'SACN00153', 'SACN', 'Boise Valley Asthma and Allergy Clinic', 'George', 'W', 'Palmer', 'MD', 'Allergy and Immunology', '', '', NULL, 'O', '16060 Idaho Ctr Blvd', 'Nampa', 'Canyon', 'ID', '83687', '2083780080', NULL, '16060 Idaho Ctr Blvd', 'Nampa', 'Canyon', 'ID', '83687', '2083780080', '', 'IDSINCLAIRL', 'WUSTDHCPC5', NULL, '0.00', '15.00', '0.00', 3, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Regional Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1033105259', 0, 'n', 0, '2013-06-11', NULL, NULL, 43.606, -116.513, NULL, NULL),
('820312070', 'SACN00154', 'SACN00154', 'SACN', 'Boise Valley Asthma and Allergy Clinic', 'George', 'W', 'Palmer', 'MD', 'Allergy and Immunology', '', '', NULL, 'O', '2320 E Gala Ste 500', 'Meridian', 'Ada', 'ID', '83642', '2083780080', NULL, '2320 E Gala Ste 500', 'Meridian', 'Ada', 'ID', '83642', '2083780080', '', 'IDSINCLAIRL', 'WUSTDHCPC5', NULL, '0.00', '15.00', '0.00', 3, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Regional Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1033105259', 0, 'n', 0, '2013-06-11', NULL, NULL, 43.59, -116.365, NULL, NULL),
('820312070', 'SACN00155', 'SACN00155', 'SACN', 'Boise Valley Asthma and Allergy Clinic', 'George', 'W', 'Palmer', 'MD', 'Allergy and Immunology', '', '', NULL, 'O', '323 E Riverside Dr Ste 204', 'Eagle', 'Ada', 'ID', '83616', '2083780080', NULL, '323 E Riverside Dr Ste 204', 'Eagle', 'Ada', 'ID', '83616', '2083780080', '', 'IDSINCLAIRL', 'WUSTDHCPC5', NULL, '0.00', '15.00', '0.00', 3, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Regional Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1033105259', 0, 'n', 0, '2013-06-11', NULL, NULL, 43.6892, -116.351, NULL, NULL),
('820312070', 'SACN00156', 'SACN00156', 'SACN', 'Boise Valley Asthma and Allergy Clinic', 'George', 'W', 'Palmer', 'MD', 'Allergy and Immunology', '', '', NULL, 'O', '901 N Curtis Rd Ste 100', 'Boise', 'Ada', 'ID', '83706', '2083780080', NULL, '901 N Curtis Rd Ste 100', 'Boise', 'Ada', 'ID', '83706', '2083780080', '', 'IDSINCLAIRL', 'WUSTDHCPC5', NULL, '0.00', '15.00', '0.00', 3, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Regional Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1033105259', 0, 'n', 0, '2013-06-11', NULL, NULL, 43.6126, -116.255, NULL, NULL),
('260168070', 'SACN01369', 'SACN01369', 'SACN', '', 'Kyle', 'L', 'Palmer', 'MD', 'Orthopedic Surgery', 'Sports Medicine', '', NULL, 'O', '1673 W Shoreline Dr Ste 101', 'Boise', 'Ada', 'ID', '83702', '2088848300', NULL, '1673 W Shoreline Dr Ste 101', 'Boise', 'Ada', 'ID', '83702', '2088848300', '          ', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 3, '2011-01-01', '2011-07-01', 0, 0, 0, 'Saint Alphonsus Regional Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1720027311', 0, 'N', 0, '2013-06-05', NULL, NULL, 43.6171, -116.222, NULL, NULL),
('260168070', 'SACN01370', 'SACN01370', 'SACN', NULL, 'Kyle', 'L', 'Palmer', 'MD', 'Orthopedic Surgery', 'Sports Medicine', '', NULL, 'O', '3875 E Overland Rd', 'Meridian', 'Ada', 'ID', '83642', '2088848300', NULL, '3875 E Overland Rd', 'Meridian', 'Ada', 'ID', '83642', '2088848300', '', 'IDSINCLAIRL', NULL, NULL, '0.00', '15.00', '0.00', 3, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Regional Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1720027311', 0, 'n', 0, '2013-06-05', NULL, NULL, 43.5898, -116.346, NULL, NULL),
('264260933', 'ELHCA0226', 'ELHCA0226', 'TXHOUSTD', 'HWCA ', 'Tiffany', '', 'Tarrant', 'MD', 'Obstetrics and Gynecology', '', '', NULL, 'B', 'PO Box 281928', 'Atlanta', 'Fulton', 'GA', '30384', '          ', NULL, 'PO Box 281928', 'Atlanta', 'Fulton', 'GA', '30384', '          ', '          ', 'HCA', 'TXHCPC13', '', '0.00', '45.00', '0.00', 3, '2013-01-01', '2013-10-24', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1295882173', 0, 'Y', 0, '2013-10-30', NULL, NULL, 0, 0, NULL, NULL),
('820227163', 'SACN00142', 'SACN00142', 'SACN', 'Jerome Family Clinic', 'Lorraine', 'M', 'Tangen', 'MD', 'Family Practice', '', '', NULL, 'B', '128 5th Ave W', 'Jerome', 'Jerome', 'ID', '83338', '2083241122', '2083246778', NULL, NULL, NULL, NULL, NULL, NULL, NULL, 'IDSINCLAIRL', NULL, NULL, '0.00', '15.00', '0.00', 3, '2011-01-01', NULL, 0, 0, 1, '', '', '', '', 'HCFA|UB|', '0000008997', 0, 'Y', 0, '2013-02-28', NULL, NULL, 0, 0, NULL, NULL),
('264260933', 'ELHCA0225', 'ELHCA0225', 'TXHOUSTD', 'HWCA ', 'Tiffany', '', 'Tarrant', 'MD', 'Obstetrics and Gynecology', '', '', NULL, 'O', '7400 Fannin St Ste 1050', 'Houston', 'Harris', 'TX', '77054', '7137951000', '7137961087', '7400 Fannin St Ste 1050', 'Houston', 'Harris', 'TX', '77054', '7137951000', '7137961087', 'HCA', 'TXHCPC13', '', '0.00', '45.00', '0.00', 3, '2013-01-01', '2013-10-24', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1295882173', 0, 'N', 0, '2013-10-30', NULL, NULL, 29.6946, -95.4012, NULL, NULL),
('830330554', 'W12022257', 'W12022257', 'WYT1', 'Evanston Clinic', 'Eric', 'N', 'Swensen', 'DO', 'Family Practice', '', '', NULL, 'B', 'PO Box 848407', 'Boston', 'Suffolk', 'MA', '02284', '3077838190', '3077838191', 'PO Box 848407', 'Boston', 'Suffolk', 'MA', '02284', '3077838190', '3077838191', 'WYSTD', 'WYHCPCS', '', '0.00', '35.00', '0.00', 3, '2012-11-01', NULL, 0, 0, 0, 'Evanston Regional Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1700013661', 0, 'N', 0, '2013-06-28', NULL, NULL, 0, 0, NULL, NULL),
('830330554', 'W12022256', 'W12022256', 'WYT1', 'Evanston Clinic', 'Eric', 'N', 'Swensen', 'DO', 'Family Practice', '', '', NULL, 'O', '196 Arrowhead Dr Ste 4', 'Evanston', 'Uinta', 'WY', '82930', '3077838190', '3077838191', '196 Arrowhead Dr Ste 4', 'Evanston', 'Uinta', 'WY', '82930', '3077838190', '3077838191', 'WYSTD', 'WYHCPCS', '', '0.00', '35.00', '0.00', 3, '2012-11-01', NULL, 0, 0, 0, 'Evanston Regional Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1700013661', 0, 'N', 0, '2013-06-28', NULL, NULL, 0, 0, NULL, NULL),
('260553931', 'SACN00341', 'SACN00341', 'SACN', 'Saint Alphonsus Medical Group Heart Care Ketchum', 'Mark', 'G', 'Parent', 'MD', 'Cardiology', '', '', NULL, 'O', '100 Hospital Dr', 'Ketchum', 'Blaine', 'ID', '83340', '2083674278', NULL, '100 Hospital Dr', 'Ketchum', 'Blaine', 'ID', '83340', '2083674278', '          ', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Regional Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1558301515', 0, 'Y', 0, '2013-01-10', NULL, NULL, 43.6485, -114.35, NULL, NULL),
('260553931', 'SACN00342', 'SACN00342', 'SACN', 'Saint Alphonsus Specialty Services, Inc', 'Mark', 'G', 'Parent', 'MD', 'Cardiology', '', '', NULL, 'O', '1000 State St', 'McCall', 'Valley', 'ID', '83638', '2086342221', NULL, '1000 State St', 'McCall', 'Valley', 'ID', '83638', '2086342221', '', 'IDSINCLAIRL', NULL, NULL, '0.00', '15.00', '0.00', 6, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Regional Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1558301515', 0, 'Y', 0, '2013-01-10', NULL, NULL, 44.9094, -116.11, NULL, NULL),
('260553931', 'SACN00343', 'SACN00343', 'SACN', 'Idaho Heart Care', 'Mark', 'G', 'Parent', 'MD', 'Cardiology', '', '', NULL, 'O', '1118 NW 16th Ste A', 'Fruitland', 'Payette', 'ID', '83619', '2087278240', '2084522140', '1118 NW 16th Ste A', 'Fruitland', 'Payette', 'ID', '83619', '2087278240', '2084522140', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Regional Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1558301515', 0, 'N', 0, '2013-01-10', NULL, NULL, 0, 0, NULL, NULL),
('260553931', 'SACN00344', 'SACN00344', 'SACN', 'Saint Alphonsus Medical Group Heart Care Hailey', 'Mark', 'G', 'Parent', 'MD', 'Cardiology', '', '', NULL, 'O', '21 E Maple St Ste A', 'Hailey', 'Blaine', 'ID', '83333', '2083674278', NULL, '21 E Maple St Ste A', 'Hailey', 'Blaine', 'ID', '83333', '2083674278', '          ', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Regional Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1558301515', 0, 'Y', 0, '2013-01-10', NULL, NULL, 43.5143, -114.31, NULL, NULL),
('260553931', 'SACN00345', 'SACN00345', 'SACN', 'Saint Alphonsus Specialty Services, Inc', 'Mark', 'G', 'Parent', 'MD', 'Cardiology', '', '', NULL, 'O', '315 E Elm St Ste 100', 'Caldwell', 'Canyon', 'ID', '83605', '2083674278', '2083675200', '315 E Elm Ste 100', 'Caldwell', 'Canyon', 'ID', '83605', '2083674278', '2083675200', 'IDSINCLAIRL', NULL, NULL, '0.00', '15.00', '0.00', 6, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Regional Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1558301515', 0, 'Y', 0, '2013-01-10', NULL, NULL, 43.6539, -116.695, NULL, NULL),
('260553931', 'SACN00346', 'SACN00346', 'SACN', 'Saint Alphonsus Medical Group Heart Care Boise ', 'Mark', 'G', 'Parent', 'MD', 'Cardiology', '', '', NULL, 'O', '6140 W Curtisian Ste 200', 'Boise', 'Ada', 'ID', '83704', '2083674278', '2083675200', '6140 W Curtisian Ste 200', 'Boise', 'Ada', 'ID', '83704', '2083674278', '2083675200', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Regional Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1558301515', 0, 'N', 0, '2014-01-24', NULL, NULL, 43.6151, -116.256, NULL, NULL),
('260553931', 'SACN00347', 'SACN00347', 'SACN', 'Saint Alphonsus Medical Group Heart Care Weiser', 'Mark', 'G', 'Parent', 'MD', 'Cardiology', '', '', NULL, 'O', '645 E 5th St', 'Weiser', 'Washington', 'ID', '83672', '2085493152', NULL, '645 E 5th St', 'Weiser', 'Washington', 'ID', '83672', '2085493152', '          ', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Regional Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1558301515', 0, 'Y', 0, '2013-01-10', NULL, NULL, 44.2487, -116.962, NULL, NULL),
('331078261', 'SACN00348', 'SACN00348', 'SACN', 'St Lukes Medical Center Wood River', 'Mark', 'G', 'Parent', 'MD', 'Cardiology', '', '', NULL, 'B', '100 Hospital Dr', 'Ketchum', 'Blaine', 'ID', '83340', '2087278240', '0', '100 Hospital Dr', 'Ketchum', 'Blaine', 'ID', '83340', '2087278240', '0', 'IDSINCLAIRL', NULL, NULL, '0.00', '15.00', '0.00', 3, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Regional Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1558301515', 0, 'n', 0, '2013-01-10', NULL, NULL, 43.6485, -114.35, NULL, NULL),
('331078261', 'SACN00349', 'SACN00349', 'SACN', 'McCall Memorial Hospital', 'Mark', 'G', 'Parent', 'MD', 'Cardiology', '', '', NULL, 'B', '1000 State St', 'McCall', 'Valley', 'ID', '83638', '2086342221', '0', '1000 State St', 'McCall', 'Valley', 'ID', '83638', '2086342221', '0', 'IDSINCLAIRL', NULL, NULL, '0.00', '15.00', '0.00', 3, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Regional Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1558301515', 0, 'n', 0, '2013-01-10', NULL, NULL, 44.9094, -116.11, NULL, NULL),
('331078261', 'SACN00350', 'SACN00350', 'SACN', 'Family Practice Associates', 'Mark', 'G', 'Parent', 'MD', 'Cardiology', '', '', NULL, 'B', '21 E Maple St Ste  A', 'Hailey', 'Blaine', 'ID', '83333', '2087883200', '0', '21 E Maple St Ste  A', 'Hailey', 'Blaine', 'ID', '83333', '2087883200', '0', 'IDSINCLAIRL', NULL, NULL, '0.00', '15.00', '0.00', 3, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Regional Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1558301515', 0, 'n', 0, '2013-01-10', NULL, NULL, 43.5143, -114.31, NULL, NULL),
('331078261', 'SACN00351', 'SACN00351', 'SACN', 'Saint Alphonsus Physicians PA', 'Mark', 'G', 'Parent', 'MD', 'Cardiology', '', '', NULL, 'O', '315 E Elm St Ste 100', 'Caldwell', 'Canyon', 'ID', '83605', '2083674278', '2083675200', '315 E Elm Ste 100', 'Caldwell', 'Canyon', 'ID', '83605', '2083674278', '2083675200', 'IDSINCLAIRL', NULL, NULL, '0.00', '15.00', '0.00', 3, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Regional Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1558301515', 0, 'y', 0, '2013-01-10', NULL, NULL, 43.6539, -116.695, NULL, NULL),
('331078261', 'SACN00352', 'SACN00352', 'SACN', 'Saint Alphonsus Physicians PA', 'Mark', 'G', 'Parent', 'MD', 'Cardiology', '', '', NULL, 'o', '6140 W Curtisian Ste 200', 'Boise', 'Ada', 'ID', '83704', '2083674278', '2083675200', '6140 W Curtisian Ste 200', 'Boise', 'Ada', 'ID', '83704', '2083674278', '2083675200', 'IDSINCLAIRL', NULL, NULL, '0.00', '15.00', '0.00', 3, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Regional Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1558301515', 0, 'n', 0, '2013-01-10', NULL, NULL, 43.6151, -116.256, NULL, NULL),
('331078261', 'SACN00353', 'SACN00353', 'SACN', 'Weiser Memorial Hospital', 'Mark', 'G', 'Parent', 'MD', 'Cardiology', '', '', NULL, 'B', '645 E 5th St', 'Weiser', 'Washington', 'ID', '83672', '2085493152', '0', '645 E 5th St', 'Weiser', 'Washington', 'ID', '83672', '2085493152', '0', 'IDSINCLAIRL', NULL, NULL, '0.00', '15.00', '0.00', 3, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Regional Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1558301515', 0, 'n', 0, '2013-01-10', NULL, NULL, 44.2487, -116.962, NULL, NULL),
('820200895', 'SACN00354', 'SACN00354', 'SACN', 'Saint Alphonsus Regional Medical Center - Reading Panel', 'Mark', 'G', 'Parent', 'MD', 'Cardiology', '', '', NULL, 'B', '1055 N Curtis', 'Boise', 'Ada', 'ID', '83706', '2083673722', '0', '1055 N Curtis', 'Boise', 'Ada', 'ID', '83706', '2083673722', '0', 'IDSINCLAIRL', NULL, NULL, '0.00', '15.00', '0.00', 6, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Regional Medical Center', NULL, NULL, NULL, 'HCFA|', '1558301515', 0, 'n', 0, '2013-01-10', NULL, NULL, 43.6127, -116.254, NULL, NULL),
('820200895', 'SACN01611', 'SACN01611', 'SACN', 'Saint Alphonsus Medical Group Emerald', 'Susan', '', 'Paytash', 'PA-C', 'Physician Assistant', '', '', NULL, 'O', '6533 Emerald St', 'Boise', NULL, 'ID', '83704', '2083674170', '2083678135', '6533 Emerald St', 'Boise', '', 'ID', '83704', '2083674170', '2083678135', 'IDSINCLAIRL', NULL, NULL, '0.00', '15.00', '0.00', 6, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Regional Medical Center', NULL, NULL, NULL, 'HCFA|', '1912073370', 0, 'N', 0, '2012-10-12', NULL, NULL, 43.6119, -116.268, NULL, NULL),
('203558484', 'SACN00642', 'SACN00642', 'SACN', 'Peine Osteopathic Medicine', 'Christopher', 'C', 'Peine', 'DO', 'Family Practice', '', '', NULL, 'O', '450 W State St Ste 250', 'Eagle', 'Ada', 'ID', '83616', '2089470925', NULL, '450 W State St Ste 250', 'Eagle', 'Ada', 'ID', '83616', '2089470925', '', 'IDSINCLAIRL', 'WUSTDHCPC5', NULL, '0.00', '15.00', '0.00', 3, '2011-01-01', NULL, 0, 0, 1, '', '', '', '', 'HCFA|UB|', '1073529202', 0, 'n', 0, '2012-06-11', NULL, NULL, 0, 0, NULL, NULL),
('202975807', 'SACN01377', 'SACN01377', 'SACN', 'Idaho Gynecology Oncology', 'Gerardo', 'M', 'Perez', 'MD', 'Gynecologic Oncology', '', '', NULL, 'O', '100 E Idaho St', 'Boise', 'Ada', 'ID', '83712', '2083814044', '2083814002', '100 E Idaho St', 'Boise', 'Ada', 'ID', '83712', '2083814044', '2083814002', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 3, '2011-01-01', '2013-02-05', 0, 0, 1, 'Saint Alphonsus Medical Center Nampa', NULL, '', '', 'HCFA|UB|', '1730103995', 0, 'Y', 0, '2013-11-14', NULL, NULL, 43.6123, -116.194, NULL, NULL),
('202975807', 'SACN01378', 'SACN01378', 'SACN', 'Idaho Gynecology Oncology', 'Gerardo', 'M', 'Perez', 'MD', 'Gynecologic Oncology', '', '', NULL, 'O', '1055 N Curtis Rd', 'Boise', 'Ada', 'ID', '83706', '2083814044', '2083814002', '1055 N Curtis Rd', 'Boise', 'Ada', 'ID', '83706', '2083814044', '2083814002', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 3, '2011-01-01', '2013-02-05', 0, 0, 1, 'Saint Alphonsus Medical Center Nampa', NULL, '', '', 'HCFA|UB|', '1730103995', 0, 'Y', 0, '2013-11-14', NULL, NULL, 43.6127, -116.254, 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
('202975807', 'SACN01379', 'SACN01379', 'SACN', 'Idaho Gynecology Oncology', 'Gerardo', 'M', 'Perez', 'MD', 'Gynecologic Oncology', '', '', NULL, 'B', 'PO Box 147', 'Caldwell', 'Canyon', 'ID', '83606', '2083814044', '2083814002', 'PO Box 147', 'Caldwell', 'Canyon', 'ID', '83606', '2083814044', '2083814002', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 3, '2011-01-01', '2013-02-05', 0, 0, 1, 'Saint Alphonsus Medical Center Nampa', NULL, '', '', 'HCFA|UB|', '1730103995', 0, 'Y', 0, '2013-11-14', NULL, NULL, 0, 0, NULL, NULL),
('820200895', 'SACN00609', 'SACN00609', 'SACN', 'Saint Alphonsus Medical Group McMillan Family Medicine', 'Robert', 'K', 'Perko', 'MD', 'Family Practice', '', '', NULL, 'O', '12273 W McMillan Rd', 'Boise', 'Ada', 'ID', '83713', '2083676330', '2083674765', '12273 W McMillan Rd', 'Boise', 'Ada', 'ID', '83713', '2083676330', '2083674765', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Regional Medical Center', '', '', '', 'HCFA|', '1043261803', 0, 'N', 0, '2014-06-20', NULL, NULL, 43.6481, -116.335, NULL, NULL),
('820477852', 'SACN00610', 'SACN00610', 'SACN', 'Saint Alphonsus Medical Group McMillan Family Medicine', 'Robert', 'K', 'Perko', 'MD', 'Family Practice', '', '', NULL, 'o', '12273 W McMillan Rd', 'Boise', 'Ada', 'ID', '83713', '2083676330', '2083674765', '12273 W McMillan Rd', 'Boise', 'Ada', 'ID', '83713', '2083676330', '2083674765', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Regional Medical Center', '', '', '', 'HCFA|UB|', '1043261803', 0, 'N', 0, '2014-06-20', NULL, NULL, 43.6481, -116.335, NULL, NULL),
('621560557', 'SACN01682', 'SACN01682', 'SACN', 'The Clinic at Wilder', 'Kelly', '', 'Pesnell', 'NP', 'Family Practice', '', '', NULL, 'O', '215 3rd St', 'Wilder', 'Canyon', 'ID', '83676', '2084827430', NULL, '215 3rd St', 'Wilder', 'Canyon', 'ID', '83676', '2084827430', '          ', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 3, '2011-01-01', '2012-04-03', 0, 0, 1, '', '', '', '', 'HCFA|UB|', '1992785463', 0, 'N', 0, '2013-11-12', NULL, NULL, 43.6779, -116.91, NULL, NULL),
('820312070', 'SACN00998', 'SACN00998', 'SACN', 'Boise Valley Asthma and Allergy Clinic', 'Heidi', 'S', 'Peters', 'FNP', 'Allergy and Immunology', '', '', NULL, 'O', '16060 Idaho Ctr Blvd', 'Nampa', 'Canyon', 'ID', '83687', '2083780080', NULL, '16060 Idaho Ctr Blvd', 'Nampa', 'Canyon', 'ID', '83687', '2083780080', '', 'IDSINCLAIRL', 'WUSTDHCPC5', NULL, '0.00', '15.00', '0.00', 3, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Regional Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1447246905', 0, 'n', 0, '2012-02-29', NULL, NULL, 43.606, -116.513, NULL, NULL),
('820312070', 'SACN00999', 'SACN00999', 'SACN', 'Boise Valley Asthma and Allergy Clinic', 'Heidi', 'S', 'Peters', 'FNP', 'Allergy and Immunology', '', '', NULL, 'O', '2320 E Gala Ste 500', 'Meridian', 'Ada', 'ID', '83642', '2083780080', NULL, '2320 E Gala Ste 500', 'Meridian', 'Ada', 'ID', '83642', '2083780080', '', 'IDSINCLAIRL', 'WUSTDHCPC5', NULL, '0.00', '15.00', '0.00', 3, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Regional Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1447246905', 0, 'n', 0, '2012-02-29', NULL, NULL, 43.59, -116.365, NULL, NULL),
('820312070', 'SACN01000', 'SACN01000', 'SACN', 'Boise Valley Asthma and Allergy Clinic', 'Heidi', 'S', 'Peters', 'FNP', 'Allergy and Immunology', '', '', NULL, 'O', '323 E Riverside Dr Ste 204', 'Eagle', 'Ada', 'ID', '83616', '2083780080', NULL, '323 E Riverside Dr Ste 204', 'Eagle', 'Ada', 'ID', '83616', '2083780080', '', 'IDSINCLAIRL', 'WUSTDHCPC5', NULL, '0.00', '15.00', '0.00', 3, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Regional Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1447246905', 0, 'n', 0, '2012-02-29', NULL, NULL, 43.6892, -116.351, NULL, NULL),
('820312070', 'SACN01001', 'SACN01001', 'SACN', 'Boise Valley Asthma and Allergy Clinic', 'Heidi', 'S', 'Peters', 'FNP', 'Allergy and Immunology', '', '', NULL, 'O', '901 N Curtis Rd Ste 100', 'Boise', 'Ada', 'ID', '83706', '2083780080', NULL, '901 N Curtis Rd Ste 100', 'Boise', 'Ada', 'ID', '83706', '2083780080', '', 'IDSINCLAIRL', 'WUSTDHCPC5', NULL, '0.00', '15.00', '0.00', 3, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Regional Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1447246905', 0, 'n', 0, '2012-02-29', NULL, NULL, 43.6126, -116.255, NULL, NULL),
('820200895', 'SACN00606', 'SACN00606', 'SACN', 'Saint Alphonsus Medical Group Hosptialist Boise', 'Robert', 'L', 'Petersen', 'MD', 'Hospitalist', '', '', NULL, 'o', '1055 N Curtis Rd', 'Boise', 'Ada', 'ID', '83706', '2083672121', '2083675180', '1055 N Curtis Rd', 'Boise', 'Ada', 'ID', '83706', '2083672121', '2083675180', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Regional Medical Center', NULL, NULL, NULL, 'HCFA|', '1043229685', 0, 'Y', 0, '2013-07-03', NULL, NULL, 43.6127, -116.254, NULL, NULL),
('205934739', 'SACN00497', 'SACN00497', 'SACN', 'Family Medicine Health Center', 'Jennifer', 'L', 'Petrie', 'MD', 'Family Practice', '', '', NULL, 'O', '121 E Fort St', 'Boise', 'Ada', 'ID', '83712', '2083811775', NULL, '121 E Fort St', 'Boise', 'Ada', 'ID', '83712', '2083811775', '          ', 'IDSINCLAIRL', 'WUSTDHCPC5', '', '0.00', '15.00', '0.00', 3, '2011-01-01', '2012-04-05', 0, 0, 1, 'Saint Alphonsus Medical Center Nampa', '', '', '', 'HCFA|UB|', '1891879094', 0, 'N', 0, '2013-12-26', NULL, NULL, 0, 0, NULL, NULL),
('205934739', 'SACN00498', 'SACN00498', 'SACN', 'Family Medicine Health Center', 'Jennifer', 'L', 'Petrie', 'MD', 'Family Practice', '', '', NULL, 'O', '777 N Raymond St', 'Boise', 'Ada', 'ID', '83704', '2085142500', NULL, '777 N Raymond St', 'Boise', 'Ada', 'ID', '83704', '2085142500', '          ', 'IDSINCLAIRL', 'WUSTDHCPC5', '', '0.00', '15.00', '0.00', 3, '2011-01-01', '2012-04-05', 0, 0, 1, 'Saint Alphonsus Medical Center Nampa', '', '', '', 'HCFA|UB|', '1891879094', 0, 'N', 0, '2013-12-26', NULL, NULL, 0, 0, NULL, NULL),
('820200895', 'SACN01540', 'SACN01540', 'SACN', 'Saint Alphonsus Regional Medical Center Behavioral Health', 'Richard', 'J', 'Pines', 'DO', 'Mental Health', 'Pediatric Psychiatry', '', NULL, 'o', '131 N Allumbaugh', 'Boise', 'Ada', 'ID', '83704', '2083676500', '2083670285', '131 N Allumbaugh', 'Boise', 'Ada', 'ID', '83704', '2083676500', '2083670285', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', '2011-07-31', 0, 0, 0, 'Saint Alphonsus Medical Center Nampa', '', '', '', 'HCFA|', '1831129394', 0, 'N', 0, '2013-02-27', NULL, NULL, 43.6059, -116.267, NULL, NULL),
('203276415', 'SACN01275', 'SACN01275', 'SACN', 'Ada West Dermatology', 'Alan', 'J', 'Pitt', 'MD PHD', 'Dermatology', '', '', NULL, 'O', '1618 S Millennium Way Ste 100', 'Meridian', 'Ada', 'ID', '83642', '2088843376', NULL, '1618 S Millennium Way Ste 100', 'Meridian', 'Ada', 'ID', '83642', '2088843376', '', 'IDSINCLAIRL', 'WUSTDHCPC5', NULL, '0.00', '15.00', '0.00', 3, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Medical Center Nampa', '', '', '', 'HCFA|UB|', '1659301950', 0, 'n', 0, '2013-03-20', NULL, NULL, 43.5903, -116.368, NULL, NULL),
('820487790', 'SACN01398', 'SACN01398', 'SACN', 'Selah Medical Center', 'Bryan', 'C', 'Pogue', 'MD', 'Family Practice', '', '', NULL, 'O', '1618 S Millennium Way Ste 220', 'Meridian', 'Ada', 'ID', '83642', '2082881717', NULL, '1618 S Millennium Way Ste 220', 'Meridian', 'Ada', 'ID', '83642', '2082881717', '          ', 'IDSINCLAIRL', 'WUSTDHCPC5', '', '0.00', '15.00', '0.00', 3, '2011-01-01', '2011-12-15', 0, 0, 0, 'Saint Alphonsus Medical Center Nampa', NULL, '', '', 'HCFA|UB|', '1740286723', 0, 'N', 0, '2012-01-04', NULL, NULL, 43.5903, -116.368, NULL, NULL),
('820487790', 'SACN01399', 'SACN01399', 'SACN', 'Selah Medical Center', 'Bryan', 'C', 'Pogue', 'MD', 'Family Practice', '', '', NULL, 'O', '6565 W Emerald St', 'Boise', 'Ada', 'ID', '83704', '2083775055', NULL, '6565 W Emerald St', 'Boise', 'Ada', 'ID', '83704', '2083775055', '', 'IDSINCLAIRL', 'WUSTDHCPC5', NULL, '0.00', '15.00', '0.00', 3, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Medical Center Nampa', NULL, '', '', 'HCFA|UB|', '1740286723', 0, 'n', 0, '2012-01-04', NULL, NULL, 43.6119, -116.268, NULL, NULL),
('820312175', 'SACN00708', 'SACN00708', 'SACN', 'Idaho Emergency Physicians PA', 'Mike', 'W', 'Pool', 'MD', 'Emergency Medicine', '', '', NULL, 'o', '1055 N Curtis Rd', 'Boise', 'Ada', 'ID', '83704', '2083221730', '2083221731', '1055 N Curtis Rd', 'Boise', 'Ada', 'ID', '83704', '2083221730', '2083221731', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 3, '2011-01-01', '2011-12-31', 0, 0, 0, 'Saint Alphonsus Medical Center Nampa', 'West Valley Medical Center', '', '', 'HCFA|UB|', '1154368918', 0, 'N', 0, '2012-02-23', NULL, NULL, 43.6136, -116.256, NULL, NULL),
('820312175', 'SACN00709', 'SACN00709', 'SACN', 'Idaho Emergency Physicians PA', 'Mike', 'W', 'Pool', 'MD', 'Emergency Medicine', '', '', NULL, 'O', '1717 Arlington', 'Caldwell', 'Canyon', 'ID', '83605', '2083221730', '2083221731', '1717 Arlington', 'Caldwell', 'Canyon', 'ID', '83605', '2083221730', '2083221731', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 3, '2011-01-01', '2011-12-31', 0, 0, 0, 'Saint Alphonsus Medical Center Nampa', 'West Valley Medical Center', '', '', 'HCFA|UB|', '1154368918', 0, 'N', 0, '2012-02-23', NULL, NULL, 0, 0, NULL, NULL),
('820312175', 'SACN00710', 'SACN00710', 'SACN', 'Idaho Emergency Physicians PA', 'Mike', 'W', 'Pool', 'MD', 'Emergency Medicine', '', '', NULL, 'B', '2963 E Copper Point Dr', 'Meridian', 'Ada', 'ID', '83642', '2083221730', NULL, '2963 E Copper Point Dr', 'Meridian', 'Ada', 'ID', '83642', '2083221730', '          ', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 3, '2011-01-01', '2011-12-31', 0, 0, 0, 'Saint Alphonsus Medical Center Nampa', 'West Valley Medical Center', '', '', 'HCFA|UB|', '1154368918', 0, 'Y', 0, '2012-02-23', NULL, NULL, 0, 0, NULL, NULL),
('820312175', 'SACN00711', 'SACN00711', 'SACN', 'Idaho Emergency Physicians PA', 'Mike', 'W', 'Pool', 'MD', 'Emergency Medicine', '', '', NULL, 'o', '323 E Riverside Dr', 'Eagle', 'Ada', 'ID', '83616', '2083221730', '2083221731', '323 E Riverside Dr', 'Eagle', 'Ada', 'ID', '83616', '2083221730', '2083221731', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 3, '2011-01-01', '2011-12-31', 0, 0, 0, 'Saint Alphonsus Medical Center Nampa', 'West Valley Medical Center', '', '', 'HCFA|UB|', '1154368918', 0, 'N', 0, '2012-02-23', NULL, NULL, 43.6892, -116.351, NULL, NULL),
('820200895', 'SACN00894', 'SACN00894', 'SACN', 'Saint Alphonsus Medical Group Elm Family Medicine', 'Samantha', 'J', 'Portenier', 'MD', 'Family Practice', '', '', NULL, 'O', '315 E Elm St Ste 100', 'Caldwell', 'Canyon', 'ID', '83605', '2084597415', '2084533307', '315 E Elm St Ste 100', 'Caldwell', 'Canyon', 'ID', '83605', '2084597415', '2084533307', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', NULL, 0, 0, 0, 'West Valley Medical Center', '', '', '', 'HCFA|', '1356385132', 0, 'N', 0, '2014-06-20', NULL, NULL, 43.6539, -116.695, NULL, NULL),
('820477852', 'SACN00895', 'SACN00895', 'SACN', 'Saint Alphonsus Medical Group Elm Family Medicine', 'Samantha', 'J', 'Portenier', 'MD', 'Family Practice', '', '', NULL, 'o', '315 E Elm St Ste 100', 'Caldwell', 'Canyon', 'ID', '83605', '2084597415', '2084545107', '315 E Elm St Ste 100', 'Caldwell', 'Canyon', 'ID', '83605', '2084597415', '2084545107', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', '2013-08-26', 0, 0, 0, 'West Valley Medical Center', '', '', '', 'HCFA|UB|', '1356385132', 0, 'N', 0, '2014-06-20', NULL, NULL, 43.6539, -116.695, NULL, NULL),
('522984976', 'SACN00653', 'SACN00653', 'SACN', '', 'John', 'C', 'Preece', 'LMFT', 'Mental Health', 'Marriage and Family Therapy', '', NULL, 'O', '413 N Allumbaugh St Ste 101', 'Boise', 'Ada', 'ID', '83704', '2083231125', NULL, '413 N Allumbaugh St Ste 101', 'Boise', 'Ada', 'ID', '83704', '2083231125', '          ', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 3, '2011-01-01', '2011-12-31', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1093871436', 0, 'N', 0, '2013-02-27', NULL, NULL, 43.6086, -116.268, NULL, NULL),
('830330554', 'W12022032', 'W12022032', 'WY01', 'Evanston Clinic', 'Eric', 'N', 'Swensen', 'DO', 'Family Practice', '', '', NULL, 'B', 'PO Box 848407', 'Boston', 'Suffolk', 'MA', '02284', '3077838190', '3077838191', 'PO Box 848407', 'Boston', 'Suffolk', 'MA', '02284', '3077838190', '3077838191', 'WYSTD', 'WYHCPCS', '', '0.00', '35.00', '0.00', 3, '2012-11-01', NULL, 0, 0, 0, 'Evanston Regional Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1700013661', 0, 'N', 0, '2013-06-28', NULL, NULL, 0, 0, NULL, NULL),
('820425454', 'SACN00039', 'SACN00039', 'SACN', 'Boise Anesthesia, PA', 'Emily', '', 'Price', 'CRNA', 'Nurse Anesthetist', '', '', NULL, 'O', '1055 N Curtis', 'Boise', 'Ada', 'ID', '83706', '2083676416', '2083759530', '1055 N Curtis', 'Boise', 'Ada', 'ID', '83706', '2083676416', '2083759530', '', '', '', '58.45', '10.00', '0.00', 3, '2011-01-01', NULL, 1, 15, 0, '', '', '', '', 'HCFA|UB|', '1508803255', 0, 'N', 0, '2012-12-27', NULL, NULL, 43.6127, -116.254, NULL, NULL),
('820425454', 'SACN00040', 'SACN00040', 'SACN', 'Boise Anesthesia, PA', 'Emily', '', 'Price', 'CRNA', 'Nurse Anesthetist', '', '', NULL, 'O', '1717 Arlington Ave', 'Caldwell', 'Canyon', 'ID', '83605', '2084594641', NULL, '1717 Arlington Ave', 'Caldwell', 'Canyon', 'ID', '83605', '2084594641', '          ', '', '', '', '58.45', '10.00', '0.00', 3, '2011-01-01', NULL, 1, 15, 0, '', '', '', '', 'HCFA|UB|', '1508803255', 0, 'N', 0, '2012-12-27', NULL, NULL, 0, 0, NULL, NULL),
('820536340', 'SACN00904', 'SACN00904', 'SACN', 'The Clinic at Eagle', 'Marcia', 'D', 'Price-Miller', 'MD', 'Family Practice', '', '', NULL, 'O', '600 E State St Ste 200', 'Eagle', 'Ada', 'ID', '83616', '2089392273', '2089395888', '600 E State St Ste 200', 'Eagle', 'Ada', 'ID', '83616', '2089392273', '2089395888', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 3, '2011-01-01', '2012-03-21', 0, 0, 1, 'Saint Alphonsus Medical Center Nampa', NULL, '', '', 'HCFA|UB|', '1376504498', 0, 'N', 0, '2012-06-30', NULL, NULL, 0, 0, NULL, NULL),
('820536340', 'SACN00905', 'SACN00905', 'SACN', 'The Clinic at Eagle', 'Marcia', 'D', 'Price-Miller', 'MD', 'Family Practice', '', '', NULL, 'B', 'PO Box 9589', 'Boise', 'Ada', 'ID', '83707', '2084728112', '2084728112', 'PO Box 9589', 'Boise', 'Ada', 'ID', '83707', '2084728112', '2084728112', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 3, '2011-01-01', '2012-03-25', 0, 0, 1, 'Saint Alphonsus Medical Center Nampa', NULL, '', '', 'HCFA|UB|', '1376504498', 0, 'N', 0, '2012-06-30', NULL, NULL, 0, 0, NULL, NULL),
('820200895', 'SACN01512', 'SACN01512', 'SACN', 'Saint Alphonsus Medical Group Garrity Family Medicine', 'Erin', '', 'Proctor', 'PA-C', 'Obstetrics and Gynecology', 'Physician Assistant', 'Family Practice', NULL, 'O', '1200 Garrity Blvd', 'Nampa', 'Canyon', 'ID', '83687', '2084669092', '2084665322', '1200 Garrity Blvd', 'Nampa', 'Canyon', 'ID', '83687', '2084669092', '2084665322', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', '2011-12-01', 0, 0, 0, 'West Valley Medical Center', NULL, NULL, NULL, 'HCFA|', '1811987076', 0, 'Y', 0, '2013-08-21', NULL, NULL, 43.587, -116.549, NULL, NULL),
('820200895', 'SACN01513', 'SACN01513', 'SACN', 'Saint Alphonsus Medical Group MHP Family Medicine ', 'Erin', '', 'Proctor', 'PA-C', 'Obstetrics and Gynecology', 'Physician Assistant', 'Family Practice', NULL, 'O', '3025 W Cherry Ln Ste B', 'Meridian', 'Ada', 'ID', '83642', '2083678550', '2083678555', '3025 W Cherry Ln Ste B', 'Meridian', 'Ada', 'ID', '83642', '2083678550', '2083678555', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', NULL, 0, 0, 0, 'West Valley Medical Center', NULL, NULL, NULL, 'HCFA|', '1811987076', 0, 'Y', 0, '2013-08-21', NULL, NULL, 43.6188, -116.431, NULL, NULL),
('820200895', 'SACN01514', 'SACN01514', 'SACN', 'Saint Alphonsus Medical Group Elm Family Medicine', 'Erin', '', 'Proctor', 'PA-C', 'Obstetrics and Gynecology', 'Physician Assistant', 'Family Practice', NULL, 'O', '315 E Elm St Ste 100', 'Caldwell', 'Canyon', 'ID', '83605', '2084597415', '2084533307', '315 E Elm St Ste 100', 'Caldwell', 'Canyon', 'ID', '83605', '2084597415', '2084533307', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', NULL, 0, 0, 0, 'West Valley Medical Center', NULL, NULL, NULL, 'HCFA|', '1811987076', 0, 'N', 0, '2013-08-21', NULL, NULL, 43.6539, -116.695, NULL, NULL),
('820200895', 'SACN01515', 'SACN01515', 'SACN', 'Saint Alphonsus Medical Group OB/GYN Boise Moreau Bldg', 'Erin', '', 'Proctor', 'PA-C', 'Obstetrics and Gynecology', 'Physician Assistant', 'Family Practice', NULL, 'O', '6140 W Curtisian Ste 100', 'Boise', 'Ada', 'ID', '83704', '2083674224', '2083677806', '6140 W Curtisian Ste 100', 'Boise', 'Ada', 'ID', '83704', '2083674224', '2083677806', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', '2013-08-01', 0, 0, 0, 'West Valley Medical Center', NULL, NULL, NULL, 'HCFA|', '1811987076', 0, 'Y', 0, '2013-08-21', NULL, NULL, 43.6151, -116.256, NULL, NULL),
('820200895', 'SACN01516', 'SACN01516', 'SACN', 'Saint Alphonsus Medical Group Emerald Family Medicine', 'Erin', '', 'Proctor', 'PA-C', 'Obstetrics and Gynecology', 'Physician Assistant', 'Family Practice', NULL, 'O', '6533 Emerald St', 'Boise', 'Ada', 'ID', '83704', '2083674197', '2083678135', '6533 Emerald St', 'Boise', 'Ada', 'ID', '83704', '2083674197', '2083678135', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', NULL, 0, 0, 0, 'West Valley Medical Center', NULL, NULL, NULL, 'HCFA|', '1811987076', 0, 'Y', 0, '2013-08-21', NULL, NULL, 43.6119, -116.268, NULL, NULL),
('820477852', 'SACN01517', 'SACN01517', 'SACN', 'Saint Alphonsus Medical Group Garrity', 'Erin', '', 'Proctor', 'PA-C', 'Obstetrics and Gynecology', 'Physician Assistant', 'Family Practice', NULL, 'B', '1200 Garrity Blvd', 'Nampa', 'Canyon', 'ID', '83687', '2084669092', '2084665322', '1200 Garrity Blvd', 'Nampa', 'Canyon', 'ID', '83687', '2084669092', '2084665322', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', '2011-12-01', 0, 0, 0, 'West Valley Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1811987076', 0, 'Y', 0, '2013-08-21', NULL, NULL, 43.587, -116.549, NULL, NULL),
('820477852', 'SACN01518', 'SACN01518', 'SACN', 'Saint Alphonsus Medical Group Cherry Lane', 'Erin', '', 'Proctor', 'PA-C', 'Obstetrics and Gynecology', 'Physician Assistant', 'Family Practice', NULL, 'B', '3025 W Cherry Ln Ste B', 'Meridian', 'Ada', 'ID', '83642', '2083678550', '2083678555', '3025 W Cherry Ln Ste B', 'Meridian', 'Ada', 'ID', '83642', '2083678550', '2083678555', 'IDSINCLAIRL', NULL, NULL, '0.00', '15.00', '0.00', 6, '2011-01-01', NULL, 0, 0, 0, 'West Valley Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1811987076', 0, 'Y', 0, '2013-08-21', NULL, NULL, 43.6188, -116.431, NULL, NULL),
('820477852', 'SACN01519', 'SACN01519', 'SACN', 'Saint Alphonsus Medical Group Elm Family Medicine', 'Erin', '', 'Proctor', 'PA-C', 'Obstetrics and Gynecology', 'Physician Assistant', 'Family Practice', NULL, 'B', '315 E Elm St Ste 100', 'Caldwell', 'Canyon', 'ID', '83605', '2084597415', '2084533307', '315 E Elm St Ste 100', 'Caldwell', 'Canyon', 'ID', '83605', '2084597415', '2084533307', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', NULL, 0, 0, 0, 'West Valley Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1811987076', 0, 'Y', 0, '2014-01-23', NULL, NULL, 43.6539, -116.695, NULL, NULL),
('820477852', 'SACN01520', 'SACN01520', 'SACN', 'Saint Alphonsus Medical Group Womens Health', 'Erin', '', 'Proctor', 'PA-C', 'Obstetrics and Gynecology', 'Physician Assistant', 'Family Practice', NULL, 'o', '6140 W Curtisian Ste 100', 'Boise', 'Ada', 'ID', '83706', '2083674224', '2083677806', '6140 W Curtisian Ste 100', 'Boise', 'Ada', 'ID', '83706', '2083674224', '2083677806', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', '2013-08-01', 0, 0, 0, 'West Valley Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1811987076', 0, 'N', 0, '2013-08-21', NULL, NULL, 43.6151, -116.256, NULL, NULL),
('820477852', 'SACN01521', 'SACN01521', 'SACN', 'Saint Alphonsus Medical Group Emerald Family Medicine', 'Erin', '', 'Proctor', 'PA-C', 'Obstetrics and Gynecology', 'Physician Assistant', 'Family Practice', NULL, 'B', '6533 Emerald St', 'Boise', 'Ada', 'ID', '83704', '2083674170', '2083678135', '6533 Emerald St', 'Boise', 'Ada', 'ID', '83704', '2083674170', '2083678135', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', NULL, 0, 0, 0, 'West Valley Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1811987076', 0, 'Y', 0, '2014-01-23', NULL, NULL, 43.6119, -116.268, NULL, NULL),
('460500210', 'SACN00906', 'SACN00906', 'SACN', 'Saint Alphonsus Oncology Physician Services', 'Kerry', 'P', 'Pulver', 'MD', 'Hematology and Oncology', 'Oncology', '', NULL, 'O', '1055 N Curtis Rd', 'Boise', 'Ada', 'ID', '83706', '2083673627', '2083673174', '1055 N Curtis Rd', 'Boise', 'Ada', 'ID', '83706', '2083673627', '2083673174', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', '2013-04-30', 0, 0, 0, 'Saint Alphonsus Medical Center Nampa', '', 'West Valley Medical Center', 'Saint Alphonsus Medical Center Nampa', 'HCFA|UB|', '1376596247', 0, 'N', 0, '2014-05-28', NULL, NULL, 43.6127, -116.254, NULL, NULL),
('460500210', 'SACN00907', 'SACN00907', 'SACN', 'Saint Alphonsus Oncology Physician Services', 'Kerry', 'P', 'Pulver', 'MD', 'Hematology and Oncology', 'Oncology', '', NULL, 'O', '1202 E Locust', 'Emmett', 'Gem', 'ID', '83617', '2083653561', '0         ', '1202 E Locust', 'Emmett', 'Gem', 'ID', '83617', '2083653561', '0         ', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', '2013-04-30', 0, 0, 0, 'Saint Alphonsus Medical Center Nampa', '', 'West Valley Medical Center', 'Saint Alphonsus Medical Center Nampa', 'HCFA|UB|', '1376596247', 0, 'N', 0, '2014-05-28', NULL, NULL, 43.8791, -116.485, NULL, NULL),
('460500210', 'SACN00908', 'SACN00908', 'SACN', 'Saint Alphonsus Oncology Physician Services', 'Kerry', 'P', 'Pulver', 'MD', 'Hematology and Oncology', 'Oncology', '', NULL, 'O', '3123 Medical Dr', 'Caldwell', 'Canyon', 'ID', '83605', '2083673627', '2083674817', '3123 Medical Dr', 'Caldwell', 'Canyon', 'ID', '83605', '2083673627', '2083674817', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', '2013-04-30', 0, 0, 0, 'Saint Alphonsus Medical Center Nampa', '', 'West Valley Medical Center', 'Saint Alphonsus Medical Center Nampa', 'HCFA|UB|', '1376596247', 0, 'N', 0, '2014-05-28', NULL, NULL, 43.6596, -116.658, NULL, NULL),
('820425454', 'SACN00105', 'SACN00105', 'SACN', 'Boise Anesthesia, PA', 'MaryBeth', '', 'Puzio', 'CRNA', 'Nurse Anesthetist', '', '', NULL, 'o', '1055 N Curtis Rd', 'Boise', 'Ada', 'ID', '83706', '2083676416', '2083759530', '1055 N Curtis Rd', 'Boise', 'Ada', 'ID', '83706', '2083676416', '2083759530', '', '', '', '58.45', '10.00', '0.00', 3, '2011-01-01', NULL, 1, 15, 0, '', '', '', '', 'HCFA|UB|', '1912948464', 0, 'N', 0, '2012-11-01', NULL, NULL, 43.6127, -116.254, NULL, NULL),
('820425454', 'SACN00106', 'SACN00106', 'SACN', 'Boise Anesthesia, PA', 'MaryBeth', '', 'Puzio', 'CRNA', 'Nurse Anesthetist', '', '', NULL, 'o', '1717 Arlington Ave', 'Caldwell', 'Canyon', 'ID', '83605', '2084594641', NULL, '1717 Arlington Ave', 'Caldwell', 'Canyon', 'ID', '83605', '2084594641', '0         ', '', '', '', '58.45', '10.00', '0.00', 3, '2011-01-01', NULL, 1, 15, 0, '', '', '', '', 'HCFA|UB|', '1912948464', 0, 'N', 0, '2012-11-01', NULL, NULL, 0, 0, NULL, NULL),
('820312175', 'SACN01359', 'SACN01359', 'SACN', 'Idaho Emergency Physicians PA', 'Jason', 'M', 'Quinn', 'MD', 'Emergency Medicine', '', '', NULL, 'o', '1055 N Curtis Rd', 'Boise', 'Ada', 'ID', '83704', '2083221730', '2083221731', '1055 N Curtis Rd', 'Boise', 'Ada', 'ID', '83704', '2083221730', '2083221731', 'IDSINCLAIRL', NULL, NULL, '0.00', '15.00', '0.00', 3, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Regional Medical Center', 'West Valley Medical Center', NULL, NULL, 'HCFA|UB|', '1710978036', 0, 'n', 0, '2012-01-31', NULL, NULL, 43.6136, -116.256, NULL, NULL),
('820312175', 'SACN01360', 'SACN01360', 'SACN', 'Idaho Emergency Physicians PA', 'Jason', 'M', 'Quinn', 'MD', 'Emergency Medicine', '', '', NULL, 'O', '1717 Arlington', 'Caldwell', 'Canyon', 'ID', '83605', '2083221730', '2083221731', '1717 Arlington', 'Caldwell', 'Canyon', 'ID', '83605', '2083221730', '2083221731', 'IDSINCLAIRL', NULL, NULL, '0.00', '15.00', '0.00', 3, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Regional Medical Center', 'West Valley Medical Center', NULL, NULL, 'HCFA|UB|', '1710978036', 0, 'N', 0, '2012-01-31', NULL, NULL, 0, 0, NULL, NULL),
('820312175', 'SACN01361', 'SACN01361', 'SACN', 'Idaho Emergency Physicians PA', 'Jason', 'M', 'Quinn', 'MD', 'Emergency Medicine', '', '', NULL, 'B', '2963 E Copper Point Dr', 'Meridian', 'Ada', 'ID', '83642', '2083221730', NULL, '2963 E Copper Point Dr', 'Meridian', 'Ada', 'ID', '83642', '2083221730', '          ', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 3, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Regional Medical Center', 'West Valley Medical Center', NULL, NULL, 'HCFA|UB|', '1710978036', 0, 'Y', 0, '2012-01-31', NULL, NULL, 0, 0, NULL, NULL),
('820312175', 'SACN01362', 'SACN01362', 'SACN', 'Idaho Emergency Physicians PA', 'Jason', 'M', 'Quinn', 'MD', 'Emergency Medicine', '', '', NULL, 'o', '323 E Riverside Dr', 'Eagle', 'Ada', 'ID', '83616', '2083221730', '2083221731', '323 E Riverside Dr', 'Eagle', 'Ada', 'ID', '83616', '2083221730', '2083221731', 'IDSINCLAIRL', NULL, NULL, '0.00', '15.00', '0.00', 3, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Regional Medical Center', 'West Valley Medical Center', NULL, NULL, 'HCFA|UB|', '1710978036', 0, 'n', 0, '2012-01-31', NULL, NULL, 43.6892, -116.351, NULL, NULL),
('820498010', 'SACN01317', 'SACN01317', 'SACN', 'Meridian Pain Center', 'Thomas', '', 'Rambow', 'PA-C', 'Physician Assistant', '', '', NULL, 'O', '3875 E Overland Rd, Ste 200', 'Meridian', 'Ada', 'ID', '83642', '2089557246', '2089557246', '3875 E Overland Rd, Ste 200', 'Meridian', 'Ada', 'ID', '83642', '2089557246', '2089557246', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 3, '2011-01-01', '2012-03-13', 0, 0, 1, '', '', '', '', 'HCFA|UB|', '1679534184', 0, 'N', 0, '2014-04-15', NULL, NULL, 0, 0, NULL, NULL),
('260553931', 'SACN01585', 'SACN01585', 'SACN', 'Saint Alphonsus Medical Group Heart Care Boise', 'Charles', 'M', 'Rasmussen', 'MD', 'Cardiology', '', '', NULL, 'O', '1070 N Curtis Ste 125', 'Boise', 'Ada', 'ID', '83706', '2083771415', '2083753451', '1070 N Curtis Ste 125', 'Boise', 'Ada', 'ID', '83706', '2083771415', '2083753451', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Regional Medical Center', '', '', '', 'HCFA|UB|', '1881611424', 0, 'N', 0, '2014-03-27', NULL, NULL, 43.6141, -116.253, NULL, NULL),
('260553931', 'SACN01586', 'SACN01586', 'SACN', 'Saint Alphonsus Medical Group Heart Care Emmett', 'Charles', 'M', 'Rasmussen', 'MD', 'Cardiology', '', '', NULL, 'O', '1202 E Locust St', 'Emmett', 'Gem', 'ID', '83617', '2083771415', '2083753451', '1202 E Locust St', 'Emmett', 'Gem', 'ID', '83617', '2083771415', '2083753451', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Regional Medical Center', '', '', '', 'HCFA|UB|', '1881611424', 0, 'N', 0, '2014-03-27', NULL, NULL, 43.8791, -116.485, NULL, NULL),
('260553931', 'SACN01587', 'SACN01587', 'SACN', 'Saint Alphonsus Medical Group Heart Care', 'Charles', 'M', 'Rasmussen', 'MD', 'Cardiology', '', '', NULL, 'O', '520 S Eagle Rd Ste 2205', 'Meridian', 'Ada', 'ID', '83642', '2088840036', '2088843805', '520 S Eagle Rd Ste 2205', 'Meridian', 'Ada', 'ID', '83642', '2088840036', '2088843805', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', '2012-01-06', 0, 0, 0, 'Saint Alphonsus Regional Medical Center', '', '', '', 'HCFA|UB|', '1881611424', 0, 'N', 0, '2014-03-27', NULL, NULL, 43.5995, -116.352, NULL, NULL),
('820200895', 'SACN01588', 'SACN01588', 'SACN', 'Saint Alphonsus Regional Medical Center - Reading Panel', 'Charles', 'M', 'Rasmussen', 'MD', 'Cardiology', '', '', NULL, 'B', '1055 N Curtis', 'Boise', 'Ada', 'ID', '83706', '2083673722', '0', '1055 N Curtis', 'Boise', 'Ada', 'ID', '83706', '2083673722', '0', 'IDSINCLAIRL', NULL, NULL, '0.00', '15.00', '0.00', 6, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Regional Medical Center', '', '', '', 'HCFA|', '1881611424', 0, 'n', 0, '2014-03-27', NULL, NULL, 43.6127, -116.254, NULL, NULL),
('820477852', 'SACN00239', 'SACN00239', 'SACN', 'Saint Alphonsus Medical Group Meridian', 'Leck', '', 'Read', 'MD', 'Family Practice', '', '', NULL, 'B', '1001 Meridian St', 'Meridian', 'Ada', 'ID', '83642', '2088885406', '2088884948', '1001 Meridian St', 'Meridian', 'Ada', 'ID', '83642', '2088885406', '2088884948', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', '2012-04-03', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1316965239', 0, 'Y', 0, '2012-04-03', NULL, NULL, 0, 0, NULL, NULL),
('820477852', 'SACN00240', 'SACN00240', 'SACN', 'Saint Alphonsus Medical Group Garrity', 'Leck', '', 'Read', 'MD', 'Family Practice', '', '', NULL, 'B', '1200 Garrity Blvd', 'Nampa', 'Canyon', 'ID', '83687', '2084669092', '2084665322', '1200 Garrity Blvd', 'Nampa', 'Canyon', 'ID', '83687', '2084669092', '2084665322', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', '2012-04-03', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1316965239', 0, 'Y', 0, '2012-04-03', NULL, NULL, 43.587, -116.549, NULL, NULL),
('820477852', 'SACN00241', 'SACN00241', 'SACN', 'Saint Alphonsus Medical Group McMillan Family Medicine', 'Leck', '', 'Read', 'MD', 'Family Practice', '', '', NULL, 'B', '12273 W McMillan Rd', 'Boise', 'Ada', 'ID', '83713', '2083676330', '2083674765', '12273 W McMillan Rd', 'Boise', 'Ada', 'ID', '83713', '2083676330', '2083674765', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', '2012-04-03', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1316965239', 0, 'Y', 0, '2014-01-24', NULL, NULL, 43.6481, -116.335, NULL, NULL),
('820477852', 'SACN00242', 'SACN00242', 'SACN', 'Saint Alphonsus Medical Group Shoreline', 'Leck', '', 'Read', 'MD', 'Family Practice', '', '', NULL, 'B', '1673 W Shoreline Dr Ste 120', 'Boise', 'Ada', 'ID', '83702', '2084298311', '2084298310', '1673 W Shoreline Dr Ste 120', 'Boise', 'Ada', 'ID', '83702', '2084298311', '2084298310', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', '2012-04-03', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1316965239', 0, 'Y', 0, '2012-04-03', NULL, NULL, 43.6171, -116.222, NULL, NULL),
('820477852', 'SACN00243', 'SACN00243', 'SACN', 'Saint Alphonsus Medical Group Federal Way', 'Leck', '', 'Read', 'MD', 'Family Practice', '', '', NULL, 'B', '1880 W Judith Ln', 'Boise', 'Ada', 'ID', '83705', '2083676910', NULL, '1880 W Judith Ln', 'Boise', 'Ada', 'ID', '83705', '2083676910', '          ', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', '2012-04-03', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1316965239', 0, 'Y', 0, '2012-04-03', NULL, NULL, 43.5916, -116.204, NULL, NULL),
('820477852', 'SACN00244', 'SACN00244', 'SACN', 'Saint Alphonsus Medical Group Iowa', 'Leck', '', 'Read', 'MD', 'Family Practice', '', '', NULL, 'B', '211 W Iowa Ave', 'Caldwell', 'Canyon', 'ID', '83686', '2084657377', '2084657397', '211 W Iowa Ave', 'Caldwell', 'Canyon', 'ID', '83686', '2084657377', '2084657397', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', '2012-04-03', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1316965239', 0, 'Y', 0, '2012-04-03', NULL, NULL, 43.554, -116.638, NULL, NULL),
('820477852', 'SACN00245', 'SACN00245', 'SACN', 'Saint Alphonsus Medical Group Cherry Lane', 'Leck', '', 'Read', 'MD', 'Family Practice', '', '', NULL, 'B', '3025 W Cherry Ln Ste  B', 'Meridian', 'Ada', 'ID', '83642', '2083678550', '2083678555', '3025 W Cherry Ln Ste  B', 'Meridian', 'Ada', 'ID', '83642', '2083678550', '2083678555', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', '2012-04-03', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1316965239', 0, 'Y', 0, '2012-04-03', NULL, NULL, 43.6188, -116.431, NULL, NULL),
('820477852', 'SACN00246', 'SACN00246', 'SACN', 'Saint Alphonsus Medical Group Elm Family Medicine', 'Leck', '', 'Read', 'MD', 'Family Practice', '', '', NULL, 'o', '315 E Elm St Ste 100', 'Caldwell', 'Canyon', 'ID', '83605', '2084593621', '2084545107', '315 E Elm St Ste 100', 'Caldwell', 'Canyon', 'ID', '83605', '2084593621', '2084545107', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', '2012-04-03', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1316965239', 0, 'Y', 0, '2014-01-23', NULL, NULL, 43.6539, -116.695, NULL, NULL),
('820477852', 'SACN00247', 'SACN00247', 'SACN', 'Saint Alphonsus Medical Group Eagle Health Plaza', 'Leck', '', 'Read', 'MD', 'Family Practice', '', '', NULL, 'B', '323 E Riverside Dr Ste 224', 'Eagle', 'Ada', 'ID', '83616', '2083675750', '2083675180', '323 E Riverside Dr Ste 224', 'Eagle', 'Ada', 'ID', '83616', '2083675750', '2083675180', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', '2012-04-03', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1316965239', 0, 'Y', 0, '2012-04-03', NULL, NULL, 43.6892, -116.351, NULL, NULL),
('820477852', 'SACN00248', 'SACN00248', 'SACN', 'Saint Alphonsus Medical Group Internal Medicine', 'Leck', '', 'Read', 'MD', 'Family Practice', '', '', NULL, 'B', '6094 Emerald Ste 2', 'Boise', 'Ada', 'ID', '83704', '2083676575', '2083676597', '6094 Emerald Ste 2', 'Boise', 'Ada', 'ID', '83704', '2083676575', '2083676597', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', '2012-04-03', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1316965239', 0, 'Y', 0, '2012-04-03', NULL, NULL, 43.6122, -116.257, NULL, NULL),
('820477852', 'SACN00249', 'SACN00249', 'SACN', 'Saint Alphonsus Medical Group Womens Health', 'Leck', '', 'Read', 'MD', 'Family Practice', '', '', NULL, 'B', '6140 W Curtisian Ste 100', 'Boise', 'Ada', 'ID', '83704', '2083674224', '2083677806', '6140 W Curtisian Ste 100', 'Boise', 'Ada', 'ID', '83704', '2083674224', '2083677806', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', '2012-04-03', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1316965239', 0, 'Y', 0, '2012-04-03', NULL, NULL, 43.6151, -116.256, NULL, NULL),
('820477852', 'SACN00250', 'SACN00250', 'SACN', 'Saint Alphonsus Medical Group Emerald Family Medicine', 'Leck', '', 'Read', 'MD', 'Family Practice', '', '', NULL, 'B', '6533 Emerald St', 'Boise', 'Ada', 'ID', '83704', '2083674170', '2083678135', '6533 Emerald St', 'Boise', 'Ada', 'ID', '83704', '2083674170', '2083678135', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', '2012-04-03', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1316965239', 0, 'Y', 0, '2014-01-23', NULL, NULL, 43.6119, -116.268, NULL, NULL),
('820477852', 'SACN00251', 'SACN00251', 'SACN', 'Saint Alphonsus Medical Group Pediatrics', 'Leck', '', 'Read', 'MD', 'Family Practice', '', '', NULL, 'B', '999 N Curtis Ste 407', 'Boise', 'Ada', 'ID', '83706', '2083674321', '2083674525', '999 N Curtis Ste 407', 'Boise', 'Ada', 'ID', '83706', '2083674321', '2083674525', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', '2012-04-03', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1316965239', 0, 'Y', 0, '2012-04-03', NULL, NULL, 43.6132, -116.255, NULL, NULL),
('519376897', 'SACN01057', 'SACN01057', 'SACN', 'Boise Neurological Consultants', 'James', 'D', 'Redshaw', 'MD', 'Neurology', '', '', NULL, 'O', '999 N Curtis Rd Ste 506', 'Boise', 'Ada', 'ID', '83706', '2083672800', NULL, '999 N Curtis Rd Ste 506', 'Boise', 'Ada', 'ID', '83706', '2083672800', '', 'IDSINCLAIRL', 'WUSTDHCPC5', '', '0.00', '15.00', '0.00', 3, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Regional Medical Center', '', '', '', 'HCFA|UB|', '1487640561', 0, 'n', 0, '2014-05-19', NULL, NULL, 43.6132, -116.255, NULL, NULL),
('205934739', 'SACN00218', 'SACN00218', 'SACN', 'Family Medicine Health Center', 'Alex', 'J', 'Reed', 'PsyD', 'Mental Health', 'Psycology', '', NULL, 'O', '121 E Fort St', 'Boise', 'Ada', 'ID', '83712', '2083811775', NULL, '121 E Fort St', 'Boise', 'Ada', 'ID', '83712', '2083811775', '', 'IDSINCLAIRL', 'WUSTDHCPC5', NULL, '0.00', '15.00', '0.00', 3, '2011-01-01', NULL, 0, 0, 1, 'Saint Alphonsus Medical Center Nampa', '', '', '', 'HCFA|UB|', '1255385159', 0, 'n', 0, '2013-02-27', NULL, NULL, 0, 0, NULL, NULL),
('205934739', 'SACN00219', 'SACN00219', 'SACN', 'Family Medicine Health Center', 'Alex', 'J', 'Reed', 'PsyD', 'Mental Health', 'Psycology', '', NULL, 'O', '777 N Raymond St', 'Boise', 'Ada', 'ID', '83704', '2085142500', NULL, '777 N Raymond St', 'Boise', 'Ada', 'ID', '83704', '2085142500', '', 'IDSINCLAIRL', 'WUSTDHCPC5', NULL, '0.00', '15.00', '0.00', 3, '2011-01-01', NULL, 0, 0, 1, 'Saint Alphonsus Medical Center Nampa', '', '', '', 'HCFA|UB|', '1255385159', 0, 'n', 0, '2013-02-27', NULL, NULL, 0, 0, NULL, NULL),
('820425454', 'SACN00060', 'SACN00060', 'SACN', 'Boise Anesthesia, PA', 'Steven', 'D', 'Reid', 'MD', 'Anesthesiology', '', '', NULL, 'o', '1055 N Curtis Rd', 'Boise', 'Ada', 'ID', '83706', '2083676416', '2083759530', '1055 N Curtis Rd', 'Boise', 'Ada', 'ID', '83706', '2083676416', '2083759530', '', '', '', '58.45', '10.00', '0.00', 3, '2011-01-01', NULL, 1, 15, 0, 'Saint Alphonsus Regional Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1639122385', 0, 'N', 0, '2012-11-01', NULL, NULL, 43.6127, -116.254, NULL, NULL),
('820425454', 'SACN00061', 'SACN00061', 'SACN', 'Boise Anesthesia, PA', 'Steven', 'D', 'Reid', 'MD', 'Anesthesiology', '', '', NULL, 'o', '1717 Arlington Ave', 'Caldwell', 'Canyon', 'ID', '83605', '2084594641', NULL, '1717 Arlington Ave', 'Caldwell', 'Canyon', 'ID', '83605', '2084594641', '0         ', '', '', '', '58.45', '10.00', '0.00', 3, '2011-01-01', NULL, 1, 15, 0, 'Saint Alphonsus Regional Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1639122385', 0, 'N', 0, '2012-11-01', NULL, NULL, 0, 0, NULL, NULL),
('820425454', 'SACN00062', 'SACN00062', 'SACN', 'Boise Anesthesia, PA', 'Steven', 'D', 'Reid', 'MD', 'Anesthesiology', '', '', NULL, 'o', '3025 W Cherry Ln', 'Meridian', 'Ada', 'ID', '83642', '2083678500', NULL, '3025 W Cherry Ln', 'Meridian', 'Ada', 'ID', '83642', '2083678500', '0         ', '', '', '', '58.45', '10.00', '0.00', 3, '2011-01-01', NULL, 1, 15, 0, 'Saint Alphonsus Regional Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1639122385', 0, 'N', 0, '2012-11-01', NULL, NULL, 43.6188, -116.431, NULL, NULL),
('043698413', 'SACN00771', 'SACN00771', 'SACN', 'Scott P Hoopes MD & Associates', 'Joycelyn', 'J', 'Reiland', 'NP', 'Mental Health', '', '', NULL, 'O', '2273 E Gala St Ste 100', 'Meridian', 'Ada', 'ID', '83642', '2088988999', NULL, '2273 E Gala St Ste 100', 'Meridian', 'Ada', 'ID', '83642', '2088988999', '          ', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 3, '2011-01-01', '2012-12-31', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1225101975', 0, 'N', 0, '2013-07-25', NULL, NULL, 0, 0, NULL, NULL),
('820200895', 'SACN01644', 'SACN01644', 'SACN', 'Saint Alphonsus Medical Group Iowa Family Medicine', 'Jeffrey', 'L', 'Reimers', 'PA-C', 'Family Practice', 'Physician Assistant', '', NULL, 'O', '211 W Iowa Ave', 'Nampa', 'Canyon', 'ID', '83686', '2084657377', '2084657397', '211 W Iowa Ave', 'Nampa', 'Canyon', 'ID', '83686', '2084657377', '2084657397', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Medical Center Nampa', NULL, NULL, NULL, 'HCFA|', '1952339434', 0, 'N', 0, '2013-09-05', NULL, NULL, 43.5539, -116.575, NULL, NULL),
('820477852', 'SACN01645', 'SACN01645', 'SACN', 'Saint Alphonsus Medical Group Iowa', 'Jeffrey', 'L', 'Reimers', 'PA-C', 'Family Practice', 'Physician Assistant', '', NULL, 'O', '211 W Iowa', 'Nampa', 'Canyon', 'ID', '83686', '2084657377', '2084657397', '211 W Iowa', 'Nampa', 'Canyon', 'ID', '83686', '2084657377', '2084657397', 'IDSINCLAIRL', NULL, NULL, '0.00', '15.00', '0.00', 6, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Medical Center Nampa', NULL, NULL, NULL, 'HCFA|UB|', '1952339434', 0, 'Y', 0, '2013-09-05', NULL, NULL, 0, 0, NULL, NULL),
('820200895', 'SACN01053', 'SACN01053', 'SACN', 'Saint Alphonsus Regional Medical Center', 'John ', 'R', 'Reusser', 'LCSW', 'Mental Health', 'Counseling', '', NULL, 'O', '1055 N Curtis', 'Boise', 'Ada', 'ID', '83706', '2083676238', '2083670285', '1055 N Curtis', 'Boise', 'Ada', 'ID', '83706', '2083676238', '2083670285', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|', '1477864411', 0, 'Y', 0, '2014-06-20', NULL, NULL, 43.6127, -116.254, NULL, NULL),
('820200895', 'SACN01054', 'SACN01054', 'SACN', 'Saint Alphonsus Regional Medical Center', 'John ', 'R', 'Reusser', 'LCSW', 'Mental Health', 'Counseling', '', NULL, 'B', 'PO Box 190930', 'Boise', 'Ada', 'ID', '83719', '2083672396', '2083670285', 'PO Box 190930', 'Boise', 'Ada', 'ID', '83719', '2083672396', '2083670285', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|', '1477864411', 0, 'N', 0, '2014-06-20', NULL, NULL, 0, 0, NULL, NULL),
('820482491', 'SACN00963', 'SACN00963', 'SACN', 'Intermountain Eye & Laser Centers', 'Adam', 'C', 'Reynolds', 'MD', 'Ophthalmology', NULL, NULL, NULL, 'O', '323 E Riverside Dr Ste 122', 'Eagle', 'Ada', 'ID', '83616', '2089384749', '2089384902', '323 E Riverside Dr Ste 122', 'Eagle', 'Ada', 'ID', '83616', '2089384749', '2089384902', 'IDSINCLAIRL', NULL, NULL, '0.00', '15.00', '0.00', 3, '2011-01-01', NULL, 0, 0, 1, 'Saint Alphonsus Medical Center Nampa', '', '', '', 'HCFA|UB|', '1417916586', 0, 'N', 0, '2011-08-09', NULL, NULL, 43.6892, -116.351, NULL, NULL),
('820482491', 'SACN00964', 'SACN00964', 'SACN', 'Intermountain Eye & Laser Centers', 'Adam', 'C', 'Reynolds', 'MD', 'Ophthalmology', NULL, NULL, NULL, 'O', '4400 E Flamingo Rd', 'Nampa', 'Canyon', 'ID', '83687', '2084662222', '2084653441', '4400 E Flamingo Rd', 'Nampa', 'Canyon', 'ID', '83687', '2084662222', '2084653441', 'IDSINCLAIRL', NULL, NULL, '0.00', '15.00', '0.00', 3, '2011-01-01', NULL, 0, 0, 1, 'Saint Alphonsus Medical Center Nampa', '', '', '', 'HCFA|UB|', '1417916586', 0, 'N', 0, '2011-08-09', NULL, NULL, 0, 0, NULL, NULL),
('820482491', 'SACN00965', 'SACN00965', 'SACN', 'Intermountain Eye & Laser Centers PLLC', 'Adam', 'C', 'Reynolds', 'MD', 'Ophthalmology', NULL, NULL, NULL, 'B', '6063 Corporal Ln', 'Boise', 'Ada', 'ID', '83704', '2083758799', '2088989924', '6063 Corporal Ln', 'Boise', 'Ada', 'ID', '83704', '2083758799', '2088989924', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 3, '2011-01-01', '2011-08-14', 0, 0, 1, 'Saint Alphonsus Medical Center Nampa', '', '', '', 'HCFA|UB|', '1417916586', 0, 'Y', 0, '2011-08-09', NULL, NULL, 0, 0, NULL, NULL),
('820482491', 'SACN00966', 'SACN00966', 'SACN', 'Intermountain Eye & Laser Centers', 'Adam', 'C', 'Reynolds', 'MD', 'Ophthalmology', NULL, NULL, NULL, 'O', '999 N Curtis Ste 205', 'Boise', 'Ada', 'ID', '83706', '2083731200', '2083731216', '999 N Curtis Ste 205', 'Boise', 'Ada', 'ID', '83706', '2083731200', '2083731216', 'IDSINCLAIRL', NULL, NULL, '0.00', '15.00', '0.00', 3, '2011-01-01', NULL, 0, 0, 1, 'Saint Alphonsus Medical Center Nampa', '', '', '', 'HCFA|UB|', '1417916586', 0, 'N', 0, '2011-08-09', NULL, NULL, 43.6132, -116.255, NULL, NULL),
('820447063', 'SACN00913', 'SACN00913', 'SACN', 'Mountain Home Eye Center', 'Terrence', 'J', 'Reynolds', 'OD', 'Optometry', '', '', NULL, 'O', '395 N 3rd East', 'Mountain Home', 'Elmore', 'ID', '83647', '2085878415', '2085878416', '395 N 3rd East', 'Mountain Home', 'Elmore', 'ID', '83647', '2085878415', '2085878416', 'IDSINCLAIRL', NULL, NULL, '0.00', '15.00', '0.00', 3, '2011-01-01', NULL, 0, 0, 1, '', '', '', '', 'HCFA|UB|', '1386628162', 0, 'N', 0, '2012-10-26', NULL, NULL, 0, 0, NULL, NULL),
('820447063', 'SACN00914', 'SACN00914', 'SACN', 'Mountain Home Eye Center', 'Terrence', 'J', 'Reynolds', 'OD', 'Optometry', '', '', NULL, 'B', '395 N 3rd St East', 'Mountain Home', 'Elmore', 'ID', '83647', '2085878415', '2085878416', '395 N 3rd St East', 'Mountain Home', 'Elmore', 'ID', '83647', '2085878415', '2085878416', 'IDSINCLAIRL', NULL, NULL, '0.00', '15.00', '0.00', 3, '2011-01-01', NULL, 0, 0, 1, '', '', '', '', 'HCFA|UB|', '1386628162', 0, 'Y', 0, '2012-10-26', NULL, NULL, 0, 0, NULL, NULL),
('820447063', 'SACN00915', 'SACN00915', 'SACN', 'Capital Eye Care', 'Terrence', 'J', 'Reynolds', 'OD', 'Optometry', '', '', NULL, 'O', '6700 W Emerald St', 'Boise', 'Ada', 'ID', '83704', '2083367100', '2083212710', '6700 W Emerald St', 'Boise', 'Ada', 'ID', '83704', '2083367100', '2083212710', 'IDSINCLAIRL', NULL, NULL, '0.00', '15.00', '0.00', 3, '2011-01-01', NULL, 0, 0, 1, '', '', '', '', 'HCFA|UB|', '1386628162', 0, 'N', 0, '2012-10-26', NULL, NULL, 0, 0, NULL, NULL),
('201300128', 'SACN01397', 'SACN01397', 'SACN', 'Idaho Urologic Institute', 'David', 'B', 'Rice', 'MD', 'Urology', '', '', NULL, 'O', '2855 E Magic View Dr', 'Meridian', 'Ada', 'ID', '83642', '2086394900', NULL, '2855 E Magic View Dr', 'Meridian', 'Ada', 'ID', '83642', '2086394900', '', 'IDSINCLAIRL', 'WUSTDHCPC5', NULL, '0.00', '15.00', '0.00', 3, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Medical Center Nampa', NULL, NULL, NULL, 'HCFA|UB|', '1740232248', 0, 'n', 0, '2012-02-29', NULL, NULL, 43.599, -116.36, NULL, NULL),
('830330554', 'W12022031', 'W12022031', 'WY01', 'Evanston Clinic', 'Eric', 'N', 'Swensen', 'DO', 'Family Practice', '', '', NULL, 'O', '196 Arrowhead Dr Ste 4', 'Evanston', 'Uinta', 'WY', '82930', '3077838190', '3077838191', '196 Arrowhead Dr Ste 4', 'Evanston', 'Uinta', 'WY', '82930', '3077838190', '3077838191', 'WYSTD', 'WYHCPCS', '', '0.00', '35.00', '0.00', 3, '2012-11-01', NULL, 0, 0, 0, 'Evanston Regional Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1700013661', 0, 'N', 0, '2013-06-28', NULL, NULL, 41.2435, -110.998, NULL, NULL),
('261736078', 'ELHCA0224', 'ELHCA0224', 'TXHOUSTD', 'Women Assoc', 'Subha', NULL, 'Sundaram', 'MD', 'Obstetrics and Gynecology', '', '', NULL, 'B', 'PO Box 281181      ', 'Atlanta', 'Fulton', 'GA', '30384', NULL, NULL, 'PO Box 281181      ', 'Atlanta', 'Fulton', 'GA', '30384', '', '', 'HCA', 'TXHCPC13', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Bayshore Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1912117151', 0, 'Y', 0, '2013-05-01', NULL, NULL, 0, 0, NULL, NULL),
('820315557', 'SACN01471', 'SACN01471', 'SACN', 'Boise Psychological Services', 'Wanda', 'J', 'Rincover', 'LCSW', 'Mental Health', 'Social Worker', '', NULL, 'O', '315 N Allumbaugh', 'Boise', 'Ada', 'ID', '83704', '2083763546', NULL, '315 N Allumbaugh', 'Boise', 'Ada', 'ID', '83704', '2083763546', '          ', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', '2012-03-01', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1790925303', 0, 'N', 0, '2013-09-11', NULL, NULL, 0, 0, NULL, NULL),
('202630141', 'SACN00237', 'SACN00237', 'SACN', 'Primary Health Medical Group', 'Shelley', 'R', 'Ringo', 'MD', 'Family Practice', 'Sports Medicine', '', NULL, 'O', '6052 W State St', 'Boise', 'Ada', 'ID', '83703', '2083447799', '2089471945', '6052 W State St', 'Boise', 'Ada', 'ID', '83703', '2083447799', '2089471945', 'IDSINCLAIRL', 'WUSTDHCPC5', '', '0.00', '15.00', '0.00', 3, '2011-01-01', '2013-02-28', 0, 0, 1, '', '', '', '', 'HCFA|UB|', '1316143886', 0, 'N', 0, '2014-07-21', NULL, NULL, 43.6597, -116.264, NULL, NULL),
('202630141', 'SACN00238', 'SACN00238', 'SACN', 'Primary Health Medical Group', 'Shelley', 'R', 'Ringo', 'MD', 'Family Practice', 'Sports Medicine', '', NULL, 'B', 'PO Box 191050', 'Boise', 'Ada', 'ID', '83719', '2084553545', '', 'PO Box 191050', 'Boise', 'Ada', 'ID', '83719', '2084553545', '', 'IDSINCLAIRL', 'WUSTDHCPC5', '', '0.00', '15.00', '0.00', 3, '2011-01-01', '2013-02-28', 0, 0, 1, '', '', '', '', 'HCFA|UB|', '1316143886', 0, 'N', 0, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('331078261', 'SACN00198', 'SACN00198', 'SACN', 'Saint Alphonsus Physicians PA', 'Mary', 'E', 'River', 'MD', 'Neurology', '', '', NULL, 'O', '901 N Curtis Ste 403', 'Boise', 'Ada', 'ID', '83706', '2083673330', '2083673331', '901 N Curtis Ste 403', 'Boise', 'Ada', 'ID', '83706', '2083673330', '2083673331', 'IDSINCLAIRL', NULL, '', '0.00', '15.00', '0.00', 3, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Regional Medical Center', '', '', '', 'HCFA|UB|', '1205882743', 0, 'n', 0, '2014-05-20', NULL, NULL, 43.6126, -116.255, NULL, NULL);
INSERT INTO `providers_new` (`Provider_Tax_ID`, `Provider_Suffix`, `Provider_Network_ID`, `Provider_Region`, `Provider_Name`, `Provider_Doctor_First_Name`, `Provider_Doctor_Middle_Name`, `Provider_Doctor_Last_Name`, `Provider_Doctor_Degree`, `Provider_Specialty_1`, `Provider_Specialty_2`, `Provider_Specialty_3`, `Provider_Specialty_4`, `Provider_Address_Type`, `Provider_Address`, `Provider_City`, `Provider_County`, `Provider_State`, `Provider_Zip`, `Provider_Phone`, `Provider_Fax`, `Provider_Mailing_Address`, `Provider_Mailing_City`, `Provider_Mailing_County`, `Provider_Mailing_State`, `Provider_Mailing_Zip`, `Provider_Mailing_Phone`, `Provider_Mailing_Fax`, `Provider_Primary_Schedule`, `Provider_Secondary_Schedule`, `Provider_Rate_Sheet`, `Provider_Anes_Rate`, `Provider_Default_Rate`, `Provider_Max_DOS`, `Provider_Min_Match_Value`, `Provider_Effective_Date`, `Provider_Term_Date`, `Provider_Pend`, `Provider_Anes_Minutes`, `Provider_PPO`, `Provider_Hospital_1`, `Provider_Hospital_2`, `Provider_Hospital_3`, `Provider_Hospital_4`, `Provider_Type`, `Provider_NPI`, `Provider_Check_Override`, `Exclude_Dir`, `Audit_Status`, `Last_Change_Date`, `Medicare_ID`, `Provider_Lang`, `Provider_Latitude`, `Provider_Longitude`, `Provider_school`, `Provider_cert`) VALUES
('820200895', 'SACN00199', 'SACN00199', 'SACN', 'Idaho Neurology Saint Alphonsus', 'Mary', 'E', 'River', 'MD', 'Neurology', '', '', NULL, 'O', '1818 S 10th Ave Ste 200', 'Caldwell', 'Canyon', 'ID', '83605', '2083677272', '2083677111', '1818 S 10th Ave Ste 200', 'Caldwell', 'Canyon', 'ID', '83605', '2083677272', '2083677111', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Regional Medical Center', '', '', '', 'HCFA|', '1205882743', 0, 'N', 0, '2014-05-20', NULL, NULL, 43.6538, -116.693, NULL, NULL),
('820200895', 'SACN00200', 'SACN00200', 'SACN', 'Idaho Neurology Saint Alphonsus', 'Mary', 'E', 'River', 'MD', 'Neurology', '', '', NULL, 'O', '706 S Main St', 'Hailey', 'Blaine', 'ID', '83333', '2083677272', '2083677111', '706 S Main St', 'Hailey', 'Blaine', 'ID', '83333', '2083677272', '2083677111', 'IDSINCLAIRL', NULL, '', '0.00', '15.00', '0.00', 6, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Regional Medical Center', '', '', '', 'HCFA|', '1205882743', 0, 'Y', 0, '2014-05-20', NULL, NULL, 43.5137, -114.31, NULL, NULL),
('820200895', 'SACN00201', 'SACN00201', 'SACN', 'Saint Alphonsus Medical Group Neurology Boise', 'Mary', 'E', 'River', 'MD', 'Neurology', '', '', NULL, 'O', '901 N Curtis Ste 403', 'Boise', 'Ada', 'ID', '83706', '2083677272', '2083677111', '901 N Curtis Ste 403', 'Boise', 'Ada', 'ID', '83706', '2083677272', '2083677111', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Regional Medical Center', '', '', '', 'HCFA|', '1205882743', 0, 'N', 0, '2014-05-20', NULL, NULL, 43.6126, -116.255, NULL, NULL),
('820200895', 'SACN01128', 'SACN01128', 'SACN', 'Saint Alphonsus Medical Group Family Medicine Dominican', 'Michael', 'L', 'Roach', 'MD', 'Family Practice', '', '', NULL, 'O', '1118 NW 16th St Ste A', 'Fruitland', 'Payette', 'ID', '83619', '2084526851', '2083676170', '1118 NW 16th St Ste A', 'Fruitland', 'Payette', 'ID', '83619', '2084526851', '2083676170', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', '2013-07-13', 0, 0, 0, 'West Valley Medical Center', NULL, NULL, NULL, 'HCFA|', '1528004389', 0, 'N', 0, '2013-09-05', NULL, NULL, 44.025, -116.928, NULL, NULL),
('820200895', 'SACN01129', 'SACN01129', 'SACN', 'Saint Alphonsus Medical Group Elm Family Medicine', 'Michael', 'L', 'Roach', 'MD', 'Family Practice', '', '', NULL, 'O', '315 E Elm St Ste 100', 'Caldwell', 'Canyon', 'ID', '83605', '2084597415', '2084533307', '315 E Elm St Ste 100', 'Caldwell', 'Canyon', 'ID', '83605', '2084597415', '2084533307', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', NULL, 0, 0, 0, 'West Valley Medical Center', NULL, NULL, NULL, 'HCFA|', '1528004389', 0, 'N', 0, '2013-09-05', NULL, NULL, 43.6539, -116.695, NULL, NULL),
('820477852', 'SACN01130', 'SACN01130', 'SACN', 'Saint Alphonsus Medical Group Elm Family Medicine', 'Michael', 'L', 'Roach', 'MD', 'Family Practice', '', '', NULL, 'o', '315 E Elm St Ste 100', 'Caldwell', 'Canyon', 'ID', '83605', '2084593621', '2084545107', '315 E Elm St Ste 100', 'Caldwell', 'Canyon', 'ID', '83605', '2084593621', '2084545107', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', '2013-07-15', 0, 0, 0, 'West Valley Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1528004389', 0, 'N', 0, '2014-01-23', NULL, NULL, 43.6539, -116.695, NULL, NULL),
('820425454', 'SACN00099', 'SACN00099', 'SACN', 'Boise Anesthesia, PA', 'Lisa', '', 'Rogien', 'CRNA', 'Nurse Anesthetist', '', '', NULL, 'o', '1055 N Curtis Rd', 'Boise', 'Ada', 'ID', '83706', '2083676416', '2083759530', '1055 N Curtis Rd', 'Boise', 'Ada', 'ID', '83706', '2083676416', '2083759530', '', '', '', '58.45', '10.00', '0.00', 3, '2011-01-01', NULL, 1, 15, 0, '', '', '', '', 'HCFA|UB|', '1871752782', 0, 'N', 0, '2012-11-01', NULL, NULL, 43.6127, -116.254, NULL, NULL),
('820425454', 'SACN00100', 'SACN00100', 'SACN', 'Boise Anesthesia, PA', 'Lisa', '', 'Rogien', 'CRNA', 'Nurse Anesthetist', '', '', NULL, 'o', '1717 Arlington Ave', 'Caldwell', 'Canyon', 'ID', '83605', '2084594641', NULL, '1717 Arlington Ave', 'Caldwell', 'Canyon', 'ID', '83605', '2084594641', '0         ', '', '', '', '58.45', '10.00', '0.00', 3, '2011-01-01', NULL, 1, 15, 0, '', '', '', '', 'HCFA|UB|', '1871752782', 0, 'N', 0, '2012-11-01', NULL, NULL, 0, 0, NULL, NULL),
('260553931', 'SACN01173', 'SACN01173', 'SACN', 'Saint Alphonsus Medical Group Heart Care Boise', 'Jean', 'M', 'Rohrer', 'NP-C', 'Cardiovascular Disease', NULL, NULL, NULL, 'O', '1070 N Curtis Ste 125', 'Boise', 'Ada', 'ID', '83706', '2083771415', '2083753451', '1070 N Curtis Ste 125', 'Boise', 'Ada', 'ID', '83706', '2083771415', '2083753451', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', '2012-04-26', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1578635405', 0, 'N', 0, '2014-01-24', NULL, NULL, 43.6141, -116.253, NULL, NULL),
('260553931', 'SACN01174', 'SACN01174', 'SACN', 'Saint Alphonsus Medical Group Heart Care Emmett', 'Jean', 'M', 'Rohrer', 'NP-C', 'Cardiovascular Disease', NULL, NULL, NULL, 'O', '1202 E Locust St', 'Emmett', 'Gem', 'ID', '83617', '2083771415', '2083753451', '1202 E Locust St', 'Emmett', 'Gem', 'ID', '83617', '2083771415', '2083753451', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', '2012-04-26', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1578635405', 0, 'N', 0, '2012-06-26', NULL, NULL, 43.8791, -116.485, NULL, NULL),
('260553931', 'SACN01175', 'SACN01175', 'SACN', 'Saint Alphonsus Medical Group Heart Care Eagle', 'Jean', 'M', 'Rohrer', 'NP-C', 'Cardiovascular Disease', NULL, NULL, NULL, 'O', '323 E Riverside Dr Ste 224', 'Eagle', 'Ada', 'ID', '83616', '2083675734', '2083675744', '323 E Riverside Dr Ste 224', 'Eagle', 'Ada', 'ID', '83616', '2083675734', '2083675744', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', '2012-04-26', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1578635405', 0, 'N', 0, '2012-06-26', NULL, NULL, 43.6892, -116.351, NULL, NULL),
('260553931', 'SACN01176', 'SACN01176', 'SACN', 'Saint Alphonsus Medical Group Heart Care', 'Jean', 'M', 'Rohrer', 'NP-C', 'Cardiovascular Disease', NULL, NULL, NULL, 'O', '520 S Eagle Rd Ste 2205', 'Meridian', 'Ada', 'ID', '83642', '2088840036', '2088843805', '520 S Eagle Rd Ste 2205', 'Meridian', 'Ada', 'ID', '83642', '2088840036', '2088843805', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', '2012-04-26', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1578635405', 0, 'N', 0, '2012-06-26', NULL, NULL, 43.5995, -116.352, NULL, NULL),
('260553931', 'SACN01177', 'SACN01177', 'SACN', 'Saint Alphonsus Medical Group Heart Care Boise', 'Jean', 'M', 'Rohrer', 'NP-C', 'Cardiovascular Disease', NULL, NULL, NULL, 'O', '6140 W Curtisian Ave Ste 200', 'Boise', 'Ada', 'ID', '83704', '2083674278', '2083675200', '6140 W Curtisian Ave Ste 200', 'Boise', 'Ada', 'ID', '83704', '2083674278', '2083675200', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', '2012-04-26', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1578635405', 0, 'N', 0, '2014-01-24', NULL, NULL, 43.6151, -116.256, NULL, NULL),
('820315557', 'SACN00586', 'SACN00586', 'SACN', 'Boise Psychological Services', 'Laura', 'E', 'Root', 'LCSW', 'Mental Health', 'Social Worker', '', NULL, 'O', '315 N Allumbaugh', 'Boise', 'Ada', 'ID', '83704', '2083763546', NULL, '315 N Allumbaugh', 'Boise', 'Ada', 'ID', '83704', '2083763546', '', 'IDSINCLAIRL', NULL, NULL, '0.00', '15.00', '0.00', 6, '2011-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1023171428', 0, 'n', 0, '2014-04-14', NULL, NULL, 0, 0, NULL, NULL),
('261736078', 'ELHCA0223', 'ELHCA0223', 'TXHOUSTD', 'Womens Associates', 'Subha', NULL, 'Sundaram', 'MD', 'Obstetrics and Gynecology', '', '', NULL, 'O', '4600 Fairmont Pkwy                                 Ste 200', 'Pasadena', 'Harris', 'TX', '77504', '2814872371', '2814873689', '4600 Fairmont Pkwy                                 Ste 200', 'Pasadena', 'Harris', 'TX', '77504', '2814872371', '2814873689', 'HCA', 'TXHCPC13', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Bayshore Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1912117151', 0, 'N', 0, '2013-05-01', NULL, NULL, 29.6495, -95.1736, NULL, NULL),
('263830594', 'ELHCA0222', 'ELHCA0222', 'TXHOUSTD', 'Summers, Kathy', 'Kathy', '', 'Summers', 'MD', 'Obstetrics and Gynecology', '', '', NULL, 'B', 'PO Box 405902                                     ', 'Atlanta', 'Fulton', 'GA', '30384', '          ', NULL, 'PO Box 405902                                     ', 'Atlanta', 'Fulton', 'GA', '30384', '          ', '          ', 'HCA', 'TXHCPC13', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'The Womans Hospital of Texas', NULL, NULL, NULL, 'HCFA|UB|', '1972505808', 0, 'Y', 0, '2013-05-01', NULL, NULL, 0, 0, NULL, NULL),
('820200895', 'SACN01079', 'SACN01079', 'SACN', 'Saint Alphonsus Medical Group Family Medicine Dominican', 'Louis', 'A', 'Roser', 'MD', 'Family Practice', '', '', NULL, 'O', '1118 NW 16th St Ste A', 'Fruitland', 'Payette', 'ID', '83619', '2084526851', '2083676170', '1118 NW 16th St Ste A', 'Fruitland', 'Payette', 'ID', '83619', '2084526851', '2083676170', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Regional Medical Center', NULL, NULL, NULL, 'HCFA|', '1497715866', 0, 'N', 0, '2012-11-16', NULL, NULL, 44.025, -116.928, NULL, NULL),
('820200895', 'SACN01080', 'SACN01080', 'SACN', 'Saint Alphonsus Medical Group Federal Way Family Medicine', 'Louis', 'A', 'Roser', 'MD', 'Family Practice', '', '', NULL, 'O', '1880 W Judith Ln', 'Boise', 'Ada', 'ID', '83705', '2083676910', '2083676170', '1880 W Judith Ln', 'Boise', 'Ada', 'ID', '83705', '2083676910', '2083676170', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Regional Medical Center', NULL, NULL, NULL, 'HCFA|', '1497715866', 0, 'N', 0, '2012-11-16', NULL, NULL, 43.5916, -116.204, NULL, NULL),
('820200895', 'SACN01081', 'SACN01081', 'SACN', 'CARE Maternal/Child Health Program - Do Not Publish', 'Louis', 'A', 'Roser', 'MD', 'Family Practice', '', '', NULL, 'O', '900 N Liberty St Ste 100', 'Boise', 'Ada', 'ID', '83704', '2083672126', '2083674505', '900 N Liberty St Ste 100', 'Boise', 'Ada', 'ID', '83704', '2083672126', '2083674505', 'IDSINCLAIRL', NULL, NULL, '0.00', '15.00', '0.00', 6, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Regional Medical Center', NULL, NULL, NULL, 'HCFA|', '1497715866', 0, 'Y', 0, '2012-11-16', NULL, NULL, 43.6133, -116.259, NULL, NULL),
('820477852', 'SACN01082', 'SACN01082', 'SACN', 'Saint Alphonsus Medical Group Federal Way', 'Louis', 'A', 'Roser', 'MD', 'Family Practice', '', '', NULL, 'O', '1880 W Judith Ln', 'Boise', 'Ada', 'ID', '83705', '2083676910', NULL, '1880 W Judith Ln', 'Boise', 'Ada', 'ID', '83705', '2083676910', '', 'IDSINCLAIRL', NULL, NULL, '0.00', '15.00', '0.00', 6, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Regional Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1497715866', 0, 'n', 0, '2012-11-16', NULL, NULL, 43.5916, -116.204, NULL, NULL),
('820477852', 'SACN01083', 'SACN01083', 'SACN', 'CARE Maternal/Child Health Program - Do Not Publish', 'Louis', 'A', 'Roser', 'MD', 'Family Practice', '', '', NULL, 'O', '900 N Liberty St Ste 100', 'Boise', 'Ada', 'ID', '83704', '2083672126', '2083674505', '900 N Liberty St Ste 100', 'Boise', 'Ada', 'ID', '83704', '2083672126', '2083674505', 'IDSINCLAIRL', NULL, NULL, '0.00', '15.00', '0.00', 6, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Regional Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1497715866', 0, 'Y', 0, '2012-11-16', NULL, NULL, 43.6133, -116.259, NULL, NULL),
('263830594', 'ELHCA0221', 'ELHCA0221', 'TXHOUSTD', 'Summers, Kathy', 'Kathy', '', 'Summers', 'MD', 'Obstetrics and Gynecology', '', '', NULL, 'O', '7400 Fannin St Ste 1150', 'Houston', 'Harris', 'TX', '77054', '7137955054', '7137955825', '7400 Fannin St Ste 1150', 'Houston', 'Harris', 'TX', '77054', '7137955054', '7137955825', 'HCA', 'TXHCPC13', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'The Womans Hospital of Texas', NULL, NULL, NULL, 'HCFA|UB|', '1972505808', 0, 'N', 0, '2013-05-01', NULL, NULL, 29.6956, -95.4009, NULL, NULL),
('820227163', 'SACN00141', 'SACN00141', 'SACN', 'Jerome Family Clinic', 'Elizabeth', 'H', 'Sugden', 'MD', 'Family Practice', '', '', NULL, 'B', '128 5th Ave W', 'Jerome', 'Jerome', 'ID', '83338', '2083241122', '2083246778', NULL, NULL, NULL, NULL, NULL, NULL, NULL, 'IDSINCLAIRL', NULL, NULL, '0.00', '15.00', '0.00', 3, '2011-01-01', NULL, 0, 0, 1, '', '', '', '', 'HCFA|UB|', '0000008950', 0, 'Y', 0, '2013-02-28', NULL, NULL, 0, 0, NULL, NULL),
('820414478', 'SACN01638', 'SACN01638', 'SACN', 'Boise Arthritis Clinic', 'Peggy Ann', 'F', 'Rupp', 'MD', 'Rheumatology', '', '', NULL, 'O', '901 N Curtis Ste 404', 'Boise', 'Ada', 'ID', '83706', '2083221920', NULL, '901 N Curtis Ste 404', 'Boise', 'Ada', 'ID', '83706', '2083221920', '', 'IDSINCLAIRL', 'WUSTDHCPC5', '', '0.00', '15.00', '0.00', 3, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Regional Medical Center', '', '', '', 'HCFA|UB|', '1932199437', 0, 'N', 0, '2014-06-25', NULL, NULL, 43.6126, -116.255, NULL, NULL),
('820200895', 'SACN01119', 'SACN01119', 'SACN', 'Saint Alphonsus Medical Group Hospitalist Boise ', 'Emily', 'D', 'Ruprecht', 'NP-C', 'Internal Medicine', 'Nurse Practitioner', '', NULL, 'B', '1055 N Curtis Rd', 'Boise', 'Ada', 'ID', '83706', '2083672121', '2083675180', '1055 N Curtis Rd', 'Boise', 'Ada', 'ID', '83706', '2083672121', '2083675180', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', '2013-09-01', 0, 0, 0, 'Saint Alphonsus Medical Center Nampa', '', '', '', 'HCFA|', '1518059534', 0, 'Y', 0, '2013-12-11', NULL, NULL, 43.6127, -116.254, NULL, NULL),
('841394139', 'SACN00847', 'SACN00847', 'SACN', 'Southwest Idaho ENT ', 'Todd', 'J', 'Rustad', 'MD', 'Ear, Nose and Throat', '', '', NULL, 'O', '900 N Liberty St Ste 400', 'Boise', 'Ada', 'ID', '83704', '2083673320', '          ', '900 N Liberty St Ste 400', 'Boise', 'Ada', 'ID', '83704', '2083673320', '          ', 'IDSINCLAIRL', 'WUSTDHCPC5', '', '0.00', '15.00', '0.00', 6, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Medical Center Nampa', NULL, '', '', 'HCFA|UB|', '1306829973', 0, 'N', 0, '2014-06-26', NULL, NULL, 43.6133, -116.259, NULL, NULL),
('820161600', 'SACN01670', 'SACN01670', 'SACN', 'Idaho Family Physicians Inc', 'Mark', 'A', 'Rutherford', 'MD', 'Family Practice', '', '', NULL, 'O', '130 E Boise Ave', 'Boise', 'Ada', 'ID', '83706', '2083454066', NULL, '130 E Boise Ave', 'Boise', 'Ada', 'ID', '83706', '2083454066', '          ', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 8, '2011-01-01', '2011-11-07', 0, 0, 1, '', '', '', '', 'HCFA|UB|', '1972693786', 0, 'N', 0, '2013-10-16', NULL, NULL, 0, 0, NULL, NULL),
('205898813', 'SACN01646', 'SACN01646', 'SACN', 'Initial Point Family Medicine', 'Paul', 'V', 'Ryan', 'MD', 'Family Practice', '', '', NULL, 'O', '2640 S Eagle Rd', 'Meridian', 'Ada', 'ID', '83642', '2088840835', NULL, '2640 S Eagle Rd', 'Meridian', 'Ada', 'ID', '83642', '2088840835', '', 'IDSINCLAIRL', 'WUSTDHCPC5', NULL, '0.00', '15.00', '0.00', 3, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Medical Center Nampa', NULL, '', '', 'HCFA|UB|', '1962439356', 0, 'n', 0, '2011-12-14', NULL, NULL, 43.5804, -116.354, NULL, NULL),
('820200895', 'SACN01013', 'SACN01013', 'SACN', 'Saint Alphonsus Medical Group Garrity', 'Jared', 'T', 'Rye', 'NP-C', 'Nurse Practitioner', '', '', NULL, 'O', '1200 Garrity Blvd', 'Nampa', 'Canyon', 'ID', '83687', '2084669092', '2084665322', '1200 Garrity Blvd', 'Nampa', 'Canyon', 'ID', '83687', '2084669092', '2084665322', 'IDSINCLAIRL', NULL, NULL, '0.00', '15.00', '0.00', 6, '2011-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|', '1457596413', 0, 'Y', 0, '2014-01-24', NULL, NULL, 43.587, -116.549, NULL, NULL),
('820200895', 'SACN01014', 'SACN01014', 'SACN', 'Saint Alphonsus Express Care, Inc.', 'Jared', 'T', 'Rye', 'NP-C', 'Nurse Practitioner', '', '', NULL, 'O', '1515 W State St', 'Boise', 'Ada', 'ID', '83702', '2083456768', NULL, '1515 W State St', 'Boise', 'Ada', 'ID', '83702', '2083456768', '', 'IDSINCLAIRL', NULL, NULL, '0.00', '15.00', '0.00', 6, '2011-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|', '1457596413', 0, 'Y', 0, '2014-01-24', NULL, NULL, 43.6228, -116.21, NULL, NULL),
('820200895', 'SACN01015', 'SACN01015', 'SACN', 'Saint Alphonsus Medical Group Diabetic Education', 'Jared', 'T', 'Rye', 'NP-C', 'Nurse Practitioner', '', '', NULL, 'O', '3025 W Cherry Ln Ste B', 'Meridian', 'Ada', 'ID', '83642', '2083678550', '2083678555', '3025 W Cherry Ln Ste B', 'Meridian', 'Ada', 'ID', '83642', '2083678550', '2083678555', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|', '1457596413', 0, 'Y', 0, '2014-01-24', NULL, NULL, 43.6188, -116.431, NULL, NULL),
('820200895', 'SACN01016', 'SACN01016', 'SACN', 'Saint Alphonsus Medical Group Elm Family Medicine', 'Jared', 'T', 'Rye', 'NP-C', 'Nurse Practitioner', '', '', NULL, 'O', '315 E Elm St Ste 100', 'Caldwell', 'Canyon', 'ID', '83605', '2084597415', '2084533307', '315 E Elm St Ste 100', 'Caldwell', 'Canyon', 'ID', '83605', '2084597415', '2084533307', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|', '1457596413', 0, 'Y', 0, '2014-01-24', NULL, NULL, 43.6539, -116.695, NULL, NULL),
('820200895', 'SACN01017', 'SACN01017', 'SACN', 'Saint Alphonsus Express Care, Inc.', 'Jared', 'T', 'Rye', 'NP-C', 'Nurse Practitioner', '', '', NULL, 'O', '4700 N Eagle Rd', 'Boise', 'Ada', 'ID', '83713', '2089384797', NULL, '4700 N Eagle Rd', 'Boise', 'Ada', 'ID', '83713', '2089384797', '', 'IDSINCLAIRL', NULL, NULL, '0.00', '15.00', '0.00', 6, '2011-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|', '1457596413', 0, 'Y', 0, '2014-01-24', NULL, NULL, 43.6474, -116.352, NULL, NULL),
('820200895', 'SACN01018', 'SACN01018', 'SACN', 'Saint Alphonsus Medical Group Emerald Family  Medicine', 'Jared', 'T', 'Rye', 'NP-C', 'Nurse Practitioner', '', '', NULL, 'O', '6533 Emerald St', 'Boise', 'Ada', 'ID', '83704', '2083674170', '2083678135', '6533 Emerald St', 'Boise', 'Ada', 'ID', '83704', '2083674170', '2083678135', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|', '1457596413', 0, 'Y', 0, '2014-01-24', NULL, NULL, 43.6119, -116.268, NULL, NULL),
('820312175', 'SACN01529', 'SACN01529', 'SACN', 'Idaho Emergency Physicians PA', 'Kristen', 'H', 'Saak', 'MD', 'Emergency Medicine', '', '', NULL, 'o', '1055 N Curtis Rd', 'Boise', 'Ada', 'ID', '83704', '2083221730', '2083221731', '1055 N Curtis Rd', 'Boise', 'Ada', 'ID', '83704', '2083221730', '2083221731', 'IDSINCLAIRL', NULL, NULL, '0.00', '15.00', '0.00', 3, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Regional Medical Center', 'West Valley Medical Center', NULL, NULL, 'HCFA|UB|', '1821128018', 0, 'n', 0, '2012-01-31', NULL, NULL, 43.6136, -116.256, NULL, NULL),
('820312175', 'SACN01530', 'SACN01530', 'SACN', 'Idaho Emergency Physicians PA', 'Kristen', 'H', 'Saak', 'MD', 'Emergency Medicine', '', '', NULL, 'O', '1717 Arlington', 'Caldwell', 'Canyon', 'ID', '83605', '2083221730', '2083221731', '1717 Arlington', 'Caldwell', 'Canyon', 'ID', '83605', '2083221730', '2083221731', 'IDSINCLAIRL', NULL, NULL, '0.00', '15.00', '0.00', 3, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Regional Medical Center', 'West Valley Medical Center', NULL, NULL, 'HCFA|UB|', '1821128018', 0, 'N', 0, '2012-01-31', NULL, NULL, 0, 0, NULL, NULL),
('820312175', 'SACN01531', 'SACN01531', 'SACN', 'Idaho Emergency Physicians PA', 'Kristen', 'H', 'Saak', 'MD', 'Emergency Medicine', '', '', NULL, 'B', '2963 E Copper Point Dr', 'Meridian', 'Ada', 'ID', '83642', '2083221730', NULL, '2963 E Copper Point Dr', 'Meridian', 'Ada', 'ID', '83642', '2083221730', '          ', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 3, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Regional Medical Center', 'West Valley Medical Center', NULL, NULL, 'HCFA|UB|', '1821128018', 0, 'Y', 0, '2012-01-31', NULL, NULL, 0, 0, NULL, NULL),
('820312175', 'SACN01532', 'SACN01532', 'SACN', 'Idaho Emergency Physicians PA', 'Kristen', 'H', 'Saak', 'MD', 'Emergency Medicine', '', '', NULL, 'o', '323 E Riverside Dr', 'Eagle', 'Ada', 'ID', '83616', '2083221730', '2083221731', '323 E Riverside Dr', 'Eagle', 'Ada', 'ID', '83616', '2083221730', '2083221731', 'IDSINCLAIRL', NULL, NULL, '0.00', '15.00', '0.00', 3, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Regional Medical Center', 'West Valley Medical Center', NULL, NULL, 'HCFA|UB|', '1821128018', 0, 'n', 0, '2012-01-31', NULL, NULL, 43.6892, -116.351, NULL, NULL),
('205934739', 'SACN00321', 'SACN00321', 'SACN', 'Family Medicine Residency of Idaho Inc', 'James', 'G', 'Saccomando', 'MD', 'Mental Health', 'Psychiatry', '', NULL, 'O', '121 E Fort St', 'Boise', 'Ada', 'ID', '83712', '2083811775', NULL, '121 E Fort St', 'Boise', 'Ada', 'ID', '83712', '2083811775', '          ', 'IDSINCLAIRL', 'WUSTDHCPC5', '', '0.00', '15.00', '0.00', 3, '2011-01-01', '2012-04-05', 0, 0, 1, 'Saint Alphonsus Regional Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1487602330', 0, 'N', 0, '2012-04-05', NULL, NULL, 0, 0, NULL, NULL),
('205934739', 'SACN00322', 'SACN00322', 'SACN', 'Family Medicine Residency of Idaho Inc', 'James', 'G', 'Saccomando', 'MD', 'Mental Health', 'Psychiatry', '', NULL, 'O', '777 N Raymond St', 'Boise', 'Ada', 'ID', '83704', '2083676042', NULL, '777 N Raymond St', 'Boise', 'Ada', 'ID', '83704', '2083676042', '          ', 'IDSINCLAIRL', 'WUSTDHCPC5', '', '0.00', '15.00', '0.00', 3, '2011-01-01', '2012-04-05', 0, 0, 1, 'Saint Alphonsus Regional Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1487602330', 0, 'N', 0, '2012-04-05', NULL, NULL, 0, 0, NULL, NULL),
('208276569', 'SACN00323', 'SACN00323', 'SACN', NULL, 'James', 'G', 'Saccomando', 'MD', 'Mental Health', 'Psychiatry', '', NULL, 'O', '413 N Allumbaugh Ste 101', 'Boise', 'Ada', 'ID', '83704', '2083231125', NULL, '413 N Allumbaugh Ste 101', 'Boise', 'Ada', 'ID', '83704', '2083231125', '', 'IDSINCLAIRL', NULL, NULL, '0.00', '15.00', '0.00', 3, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Regional Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1487602330', 0, 'n', 0, '2011-11-10', NULL, NULL, 0, 0, NULL, NULL),
('820161600', 'SACN00551', 'SACN00551', 'SACN', 'Idaho Family Physicians Inc', 'Irv', 'E', 'Sackman', 'MD', 'Family Practice', '', '', NULL, 'O', '130 E Boise Ave', 'Boise', 'Ada', 'ID', '83706', '2083454066', NULL, '130 E Boise Ave', 'Boise', 'Ada', 'ID', '83706', '2083454066', '          ', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 8, '2011-01-01', '2011-11-07', 0, 0, 1, '', '', '', '', 'HCFA|UB|', '1003919473', 0, 'N', 0, '2013-10-16', NULL, NULL, 0, 0, NULL, NULL),
('820477852', 'SACN00389', 'SACN00389', 'SACN', 'Saint Alphonsus Medical Group Federal Way', '', '', 'Saint Alphonsus Regional Medical Center ', 'Group', 'Hospital', '', '', NULL, 'B', '1880 W Judith Ln', 'Boise', 'Ada', 'ID', '83705', '2083676910', NULL, '1880 W Judith Ln', 'Boise', 'Ada', 'ID', '83705', '2083676910', '', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', '2012-04-03', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1861676298', 0, 'Y', 0, '2014-06-13', NULL, NULL, 43.5916, -116.204, NULL, NULL),
('820200895', 'SACN01068', 'SACN01068', 'SACN', 'Saint Alphonsus Medical Group MHP Family  do not list on websites', 'Charlotte', 'R', 'Wilkes', 'CNM', 'Obstetrics and Gynecology', '', '', NULL, 'O', '3025 W Cherry Ln Ste B', 'Meridian', 'Ada', 'ID', '83642', '2083678550', '2083678555', '3025 W Cherry Ln Ste B', 'Meridian', 'Ada', 'ID', '83642', '2083678550', '2083678555', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', '2011-12-01', 0, 0, 0, 'Saint Alphonsus Medical Center Nampa', '', '', '', 'HCFA|', '1487899373', 0, 'Y', 0, '2013-09-18', NULL, NULL, 43.6188, -116.431, NULL, NULL),
('820200895', 'SACN01069', 'SACN01069', 'SACN', 'Saint Alphonsus Medical Group Eagle Health Plaza', 'Charlotte', 'R', 'Wilkes', 'CNM', 'Obstetrics and Gynecology', '', '', NULL, 'O', '323 E Riverside Dr Ste 224', 'Eagle', 'Ada', 'ID', '83616', '2083675750', '2083675765', '323 E Riverside Dr Ste 224', 'Eagle', 'Ada', 'ID', '83616', '2083675750', '2083675765', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', '2011-12-01', 0, 0, 0, 'Saint Alphonsus Medical Center Nampa', '', '', '', 'HCFA|', '1487899373', 0, 'Y', 0, '2013-09-18', NULL, NULL, 43.6892, -116.351, NULL, NULL),
('820200895', 'SACN01070', 'SACN01070', 'SACN', 'Saint Alphonsus Medical Group OB/GYN Boise Moreau Bldg', 'Charlotte', 'R', 'Wilkes', 'CNM', 'Obstetrics and Gynecology', '', '', NULL, 'O', '6140 W Curtisian Ste 100', 'Boise', 'Ada', 'ID', '83704', '2083674224', '2083677806', '6140 W Curtisian Ste 100', 'Boise', 'Ada', 'ID', '83704', '2083674224', '2083677806', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', '2013-08-01', 0, 0, 0, 'Saint Alphonsus Medical Center Nampa', '', '', '', 'HCFA|', '1487899373', 0, 'Y', 0, '2013-09-18', NULL, NULL, 43.6151, -116.256, NULL, NULL),
('820200895', 'SACN01071', 'SACN01071', 'SACN', 'Saint Alphonsus Medical Group OB/GYN Boise Liberty Bldg  do not list on websites', 'Charlotte', 'R', 'Wilkes', 'CNM', 'Obstetrics and Gynecology', '', '', NULL, 'O', '900 N Liberty Ste 204', 'Boise', 'Ada', 'ID', '83704', '2083672229', '2083674242', '900 N Liberty Ste 204', 'Boise', 'Ada', 'ID', '83704', '2083672229', '2083674242', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', '2014-01-30', 0, 0, 0, 'Saint Alphonsus Medical Center Nampa', '', '', '', 'HCFA|', '1487899373', 0, 'Y', 0, '2014-02-26', NULL, NULL, 43.6133, -116.259, NULL, NULL),
('820200895', 'SACN01072', 'SACN01072', 'SACN', 'CARE Maternal/Child Health Program - Do Not Publish', 'Charlotte', 'R', 'Wilkes', 'CNM', 'Obstetrics and Gynecology', '', '', NULL, 'O', '900 N Liberty St Ste 100', 'Boise', 'Ada', 'ID', '83704', '2083672126', '2083674505', '900 N Liberty St Ste 100', 'Boise', 'Ada', 'ID', '83704', '2083672126', '2083674505', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', '2014-01-30', 0, 0, 0, 'Saint Alphonsus Medical Center Nampa', '', '', '', 'HCFA|', '1487899373', 0, 'Y', 0, '2014-02-26', NULL, NULL, 43.6133, -116.259, NULL, NULL),
('820477852', 'SACN01073', 'SACN01073', 'SACN', 'Saint Alphonsus Medical Group Cherry Lane - do not list on w', 'Charlotte', 'R', 'Wilkes', 'CNM', 'Obstetrics and Gynecology', '', '', NULL, 'O', '3025 W Cherry Ln Ste B', 'Meridian', 'Ada', 'ID', '83642', '2083678550', '2083678555', '3025 W Cherry Ln Ste B', 'Meridian', 'Ada', 'ID', '83642', '2083678550', '2083678555', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', '2011-12-01', 0, 0, 0, 'Saint Alphonsus Medical Center Nampa', '', '', '', 'HCFA|UB|', '1487899373', 0, 'Y', 0, '2013-09-18', NULL, NULL, 43.6188, -116.431, NULL, NULL),
('820477852', 'SACN01074', 'SACN01074', 'SACN', 'Saint Alphonsus Medical Group Eagle Health Plaza - do not li', 'Charlotte', 'R', 'Wilkes', 'CNM', 'Obstetrics and Gynecology', '', '', NULL, 'O', '323 E Riverside Dr Ste 224', 'Eagle', 'Ada', 'ID', '83616', '2083675750', '2083675765', '323 E Riverside Dr Ste 224', 'Eagle', 'Ada', 'ID', '83616', '2083675750', '2083675765', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', '2011-12-01', 0, 0, 0, 'Saint Alphonsus Medical Center Nampa', '', '', '', 'HCFA|UB|', '1487899373', 0, 'Y', 0, '2013-09-18', NULL, NULL, 43.6892, -116.351, NULL, NULL),
('820477852', 'SACN01075', 'SACN01075', 'SACN', 'Saint Alphonsus Medical Group Womens Health', 'Charlotte', 'R', 'Wilkes', 'CNM', 'Obstetrics and Gynecology', '', '', NULL, 'O', '6140 W Curtisian Ste 100', 'Boise', 'Ada', 'ID', '83704', '2083674224', '2083677806', '6140 W Curtisian Ste 100', 'Boise', 'Ada', 'ID', '83704', '2083674224', '2083677806', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', '2013-08-01', 0, 0, 0, 'Saint Alphonsus Medical Center Nampa', '', '', '', 'HCFA|UB|', '1487899373', 0, 'N', 0, '2013-09-18', NULL, NULL, 43.6151, -116.256, NULL, NULL),
('820477852', 'SACN01076', 'SACN01076', 'SACN', 'Saint Alphonsus Medical Group Womens Health - do not list o', 'Charlotte', 'R', 'Wilkes', 'CNM', 'Obstetrics and Gynecology', '', '', NULL, 'O', '900 N Liberty Ste 204', 'Boise', 'Ada', 'ID', '83704', '2083672229', '2083674242', '900 N Liberty Ste 204', 'Boise', 'Ada', 'ID', '83704', '2083672229', '2083674242', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', '2013-08-01', 0, 0, 0, 'Saint Alphonsus Medical Center Nampa', '', '', '', 'HCFA|UB|', '1487899373', 0, 'Y', 0, '2013-09-18', NULL, NULL, 43.6133, -116.259, NULL, NULL),
('820477852', 'SACN01077', 'SACN01077', 'SACN', 'CARE Maternal/Child Health Program - Do Not Publish', 'Charlotte', 'R', 'Wilkes', 'CNM', 'Obstetrics and Gynecology', '', '', NULL, 'O', '900 N Liberty St Ste 100', 'Boise', 'Ada', 'ID', '83704', '2083672126', '2083674505', '900 N Liberty St Ste 100', 'Boise', 'Ada', 'ID', '83704', '2083672126', '2083674505', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', '2013-08-01', 0, 0, 0, 'Saint Alphonsus Medical Center Nampa', '', '', '', 'HCFA|UB|', '1487899373', 0, 'Y', 0, '2013-09-18', NULL, NULL, 43.6133, -116.259, NULL, NULL),
('820478504', 'SACN01164', 'SACN01164', 'SACN', 'Personal Solutions', 'Anthony', 'J', 'Salkas', 'LCSW', 'Mental Health', 'Social Worker', '', NULL, 'O', '2596 N Stokesberry Pl Ste 100', 'Meridian', 'Ada', 'ID', '83646', '2088678631', NULL, '2596 N Stokesberry Pl Ste 100', 'Meridian', 'Ada', 'ID', '83646', '2088678631', '', 'IDSINCLAIRL', NULL, NULL, '0.00', '15.00', '0.00', 3, '2011-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1568423044', 0, 'n', 0, '2013-10-17', NULL, NULL, 0, 0, NULL, NULL),
('820161600', 'SACN00649', 'SACN00649', 'SACN', 'St Lukes Idaho Endocrinology', 'Lisa', '', 'Sanders', 'PA-C', 'Physician Assistant', '', '', NULL, 'O', '403 S 11th St Ste 100', 'Boise', 'Ada', 'ID', '83702', '2084290300', '2084290305', '403 S 11th St Ste 100', 'Boise', 'Ada', 'ID', '83702', '2084290300', '2084290305', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 8, '2011-01-01', '2012-06-11', 0, 0, 1, '', '', '', '', 'HCFA|UB|', '1073787297', 0, 'N', 0, '2013-10-16', NULL, NULL, 0, 0, NULL, NULL),
('820425454', 'SACN00026', 'SACN00026', 'SACN', 'Boise Anesthesia, PA', 'Robert', 'T', 'Sargeant', 'CRNA', 'Nurse Anesthetist', '', '', NULL, 'o', '1055 N Curtis Rd', 'Boise', 'Ada', 'ID', '83706', '2083676416', '2083759530', '1055 N Curtis Rd', 'Boise', 'Ada', 'ID', '83706', '2083676416', '2083759530', '', '', '', '58.45', '10.00', '0.00', 3, '2011-01-01', NULL, 1, 15, 0, '', '', '', '', 'HCFA|UB|', '1346431012', 0, 'N', 0, '2012-11-01', NULL, NULL, 43.6127, -116.254, NULL, NULL),
('820425454', 'SACN00027', 'SACN00027', 'SACN', 'Boise Anesthesia, PA', 'Robert', 'T', 'Sargeant', 'CRNA', 'Nurse Anesthetist', '', '', NULL, 'o', '1717 Arlington Ave', 'Caldwell', 'Canyon', 'ID', '83605', '2084594641', NULL, '1717 Arlington Ave', 'Caldwell', 'Canyon', 'ID', '83605', '2084594641', '0         ', '', '', '', '58.45', '10.00', '0.00', 3, '2011-01-01', NULL, 1, 15, 0, '', '', '', '', 'HCFA|UB|', '1346431012', 0, 'N', 0, '2012-11-01', NULL, NULL, 0, 0, NULL, NULL),
('205506855', 'SACN00332', 'SACN00332', 'SACN', 'Northwest Radiation Oncology', 'Timothy', 'E', 'Sawyer', 'MD', 'Radiation Oncology', '', '', NULL, 'O', '1055 N Curtis', 'Boise', 'Ada', 'ID', '83706', '2083673131', NULL, '1055 N Curtis', 'Boise', 'Ada', 'ID', '83706', '2083673131', '', 'IDSINCLAIRL', 'WUSTDHCPC5', NULL, '0.00', '15.00', '0.00', 3, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Medical Center Nampa', '', 'West Valley Medical Center', 'Saint Alphonsus Medical Center Nampa', 'HCFA|UB|', '1548206584', 0, 'N', 0, '2013-01-04', NULL, NULL, 43.6127, -116.254, NULL, NULL),
('205506855', 'SACN00333', 'SACN00333', 'SACN', 'Northwest Radiation Oncology', 'Timothy', 'E', 'Sawyer', 'MD', 'Radiation Oncology', '', '', NULL, 'O', '2855 E Magic View Dr', 'Meridian', 'Ada', 'ID', '83642', '2086394900', NULL, '2855 E Magic View Dr', 'Meridian', 'Ada', 'ID', '83642', '2086394900', '', 'IDSINCLAIRL', 'WUSTDHCPC5', NULL, '0.00', '15.00', '0.00', 3, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Medical Center Nampa', '', 'West Valley Medical Center', 'Saint Alphonsus Medical Center Nampa', 'HCFA|UB|', '1548206584', 0, 'N', 0, '2013-01-04', NULL, NULL, 43.599, -116.36, NULL, NULL),
('205506855', 'SACN00334', 'SACN00334', 'SACN', 'Northwest Radiation Oncology', 'Timothy', 'E', 'Sawyer', 'MD', 'Radiation Oncology', '', '', NULL, 'O', '3123 Commercial Way', 'Caldwell', 'Canyon', 'ID', '83605', '2084532033', NULL, '3123 Commercial Way', 'Caldwell', 'Canyon', 'ID', '83605', '2084532033', '', 'IDSINCLAIRL', 'WUSTDHCPC5', NULL, '0.00', '15.00', '0.00', 3, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Medical Center Nampa', '', 'West Valley Medical Center', 'Saint Alphonsus Medical Center Nampa', 'HCFA|UB|', '1548206584', 0, 'N', 0, '2013-01-04', NULL, NULL, 43.6591, -116.658, NULL, NULL),
('205506855', 'SACN00335', 'SACN00335', 'SACN', 'Northwest Radiation Oncology', 'Timothy', 'E', 'Sawyer', 'MD', 'Radiation Oncology', '', '', NULL, 'B', 'PO Box 5145', 'Boise', 'Ada', 'ID', '83706', '2083673131', NULL, 'PO Box 5145', 'Boise', 'Ada', 'ID', '83706', '2083673131', '', 'IDSINCLAIRL', 'WUSTDHCPC5', NULL, '0.00', '15.00', '0.00', 3, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Medical Center Nampa', '', 'West Valley Medical Center', 'Saint Alphonsus Medical Center Nampa', 'HCFA|UB|', '1548206584', 0, 'y', 0, '2013-01-04', NULL, NULL, 0, 0, NULL, NULL),
('820200895', 'SACN00590', 'SACN00590', 'SACN', 'Saint Alphonsus Regional Medical Center', 'Mark', 'P', 'Schaffeld', 'LCSW', 'Mental Health', 'Counseling', '', NULL, 'o', '1055 N Curtis', 'Boise', 'Ada', 'ID', '83706', '2083676238', '2083670285', '1055 N Curtis', 'Boise', 'Ada', 'ID', '83706', '2083676238', '2083670285', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|', '1033144548', 0, 'Y', 0, '2014-06-20', NULL, NULL, 43.6127, -116.254, NULL, NULL),
('200324983', 'SACN00605', 'SACN00605', 'SACN', 'Idaho Sports Medicine Institute PA', 'Scot', 'B', 'Scheffel', 'MD; Sports Med', 'Orthopedic Surgery', NULL, NULL, NULL, 'O', '1188 University Dr', 'Boise', 'Ada', 'ID', '83706', '2083368250', '2083459514', '1188 University Dr', 'Boise', 'Ada', 'ID', '83706', '2083368250', '2083459514', 'IDSINCLAIRL', NULL, NULL, '0.00', '15.00', '0.00', 3, '2011-01-01', NULL, 0, 0, 1, 'Saint Alphonsus Regional Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1043216823', 0, 'N', 0, '2012-10-17', NULL, NULL, 43.601, -116.196, NULL, NULL),
('820425454', 'SACN00055', 'SACN00055', 'SACN', 'Boise Anesthesia, PA', 'Phillip', 'G', 'Schmid', 'MD', 'Anesthesiology', '', '', NULL, 'o', '1055 N Curtis Rd', 'Boise', 'Ada', 'ID', '83706', '2083676416', '2083759530', '1055 N Curtis Rd', 'Boise', 'Ada', 'ID', '83706', '2083676416', '2083759530', '', '', '', '58.45', '10.00', '0.00', 3, '2011-01-01', '2012-04-20', 1, 15, 0, 'Saint Alphonsus Medical Center Nampa', '', 'West Valley Medical Center', '', 'HCFA|UB|', '1598718843', 0, 'N', 0, '2012-04-19', NULL, NULL, 43.6127, -116.254, NULL, NULL),
('820425454', 'SACN00056', 'SACN00056', 'SACN', 'Boise Anesthesia, PA', 'Phillip', 'G', 'Schmid', 'MD', 'Anesthesiology', '', '', NULL, 'o', '1717 Arlington Ave', 'Caldwell', 'Canyon', 'ID', '83605', '2084594641', NULL, '1717 Arlington Ave', 'Caldwell', 'Canyon', 'ID', '83605', '2084594641', '0         ', '', '', '', '58.45', '10.00', '0.00', 3, '2011-01-01', '2012-04-20', 1, 15, 0, 'Saint Alphonsus Medical Center Nampa', '', 'West Valley Medical Center', '', 'HCFA|UB|', '1598718843', 0, 'N', 0, '2012-04-19', NULL, NULL, 0, 0, NULL, NULL),
('820425454', 'SACN00057', 'SACN00057', 'SACN', 'Boise Anesthesia, PA', 'Phillip', 'G', 'Schmid', 'MD', 'Anesthesiology', '', '', NULL, 'o', '3025 W Cherry Ln', 'Meridian', 'Ada', 'ID', '83642', '2083678500', NULL, '3025 W Cherry Ln', 'Meridian', 'Ada', 'ID', '83642', '2083678500', '0         ', '', '', '', '58.45', '10.00', '0.00', 3, '2011-01-01', '2012-04-20', 1, 15, 0, 'Saint Alphonsus Medical Center Nampa', '', 'West Valley Medical Center', '', 'HCFA|UB|', '1598718843', 0, 'N', 0, '2012-04-19', NULL, NULL, 43.6188, -116.431, NULL, NULL),
('205934739', 'SACN00319', 'SACN00319', 'SACN', 'Family Medicine Health Center', 'David', 'F', 'Schmitz', 'MD', 'Family Practice', '', '', NULL, 'O', '121 E Fort St', 'Boise', 'Ada', 'ID', '83712', '2083811775', NULL, '121 E Fort St', 'Boise', 'Ada', 'ID', '83712', '2083811775', '', 'IDSINCLAIRL', 'WUSTDHCPC5', NULL, '0.00', '15.00', '0.00', 3, '2011-01-01', NULL, 0, 0, 1, 'Saint Alphonsus Medical Center Nampa', '', '', '', 'HCFA|UB|', '1477595551', 0, 'n', 0, '2012-07-02', NULL, NULL, 0, 0, NULL, NULL),
('205934739', 'SACN00320', 'SACN00320', 'SACN', 'Family Medicine Health Center', 'David', 'F', 'Schmitz', 'MD', 'Family Practice', '', '', NULL, 'O', '777 N Raymond St', 'Boise', 'Ada', 'ID', '83704', '2085142500', NULL, '777 N Raymond St', 'Boise', 'Ada', 'ID', '83704', '2085142500', '', 'IDSINCLAIRL', 'WUSTDHCPC5', NULL, '0.00', '15.00', '0.00', 3, '2011-01-01', NULL, 0, 0, 1, 'Saint Alphonsus Medical Center Nampa', '', '', '', 'HCFA|UB|', '1477595551', 0, 'n', 0, '2012-07-02', NULL, NULL, 0, 0, NULL, NULL),
('820425454', 'SACN00069', 'SACN00069', 'SACN', 'Boise Anesthesia, PA', 'Cassandra', 'L', 'Schnell', 'CRNA', 'Nurse Anesthetist', '', '', NULL, 'o', '1055 N Curtis Rd', 'Boise', 'Ada', 'ID', '83706', '2083676416', '2083759530', '1055 N Curtis Rd', 'Boise', 'Ada', 'ID', '83706', '2083676416', '2083759530', '', '', '', '58.45', '10.00', '0.00', 3, '2011-01-01', NULL, 1, 15, 0, '', '', '', '', 'HCFA|UB|', '1669419313', 0, 'N', 0, '2012-11-01', NULL, NULL, 43.6127, -116.254, NULL, NULL),
('820425454', 'SACN00070', 'SACN00070', 'SACN', 'Boise Anesthesia, PA', 'Cassandra', 'L', 'Schnell', 'CRNA', 'Nurse Anesthetist', '', '', NULL, 'o', '1717 Arlington Ave', 'Caldwell', 'Canyon', 'ID', '83605', '2084594641', NULL, '1717 Arlington Ave', 'Caldwell', 'Canyon', 'ID', '83605', '2084594641', '0         ', '', '', '', '58.45', '10.00', '0.00', 3, '2011-01-01', NULL, 1, 15, 0, '', '', '', '', 'HCFA|UB|', '1669419313', 0, 'N', 0, '2012-11-01', NULL, NULL, 0, 0, NULL, NULL),
('200324983', 'SACN00727', 'SACN00727', 'SACN', 'Idaho Sports Medicine Institute', 'Elizabeth', 'H', 'Schoenfeld', 'PT', 'Physical Therapy', NULL, NULL, NULL, 'O', '1188 University Dr', 'Boise', 'Ada', 'ID', '83706', '2083368250', '2083459514', '1188 University Dr', 'Boise', 'Ada', 'ID', '83706', '2083368250', '2083459514', 'IDSINCLAIRL', NULL, NULL, '0.00', '15.00', '0.00', 3, '2011-01-01', NULL, 0, 0, 1, 'Saint Alphonsus Regional Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1184699787', 0, 'N', 0, '2012-07-26', NULL, NULL, 43.601, -116.196, NULL, NULL),
('208515551', 'SACN01534', 'SACN01534', 'SACN', 'West Valley Medical Center', 'Michaela', '', 'Schulte', 'MD', 'Hospitalist', '', '', NULL, 'O', '1717 Arlington Ave', 'Caldwell', 'Canyon', 'ID', '83605', '2084553890', '2084553895', '1717 Arlington Ave', 'Caldwell', 'Canyon', 'ID', '83605', '2084553890', '2084553895', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 3, '2011-01-01', NULL, 0, 0, 1, '', '', '', 'Saint Alphonsus Medical Center Nampa', 'HCFA|UB|', '1821201179', 0, 'N', 0, '2013-09-04', NULL, NULL, 0, 0, NULL, NULL),
('460500210', 'SACN00794', 'SACN00794', 'SACN', 'Saint Alphonsus Oncology Physician Services', 'Karl', 'J', 'Schultheiss', 'MD', 'Hematology and Oncology', 'Oncology', '', NULL, 'O', '1055 N Curtis Rd', 'Boise', 'Ada', 'ID', '83706', '2083673131', '2083673174', '1055 N Curtis Rd', 'Boise', 'Ada', 'ID', '83706', '2083673131', '2083673174', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', '2013-10-21', 0, 0, 0, 'Saint Alphonsus Medical Center Nampa', '', 'West Valley Medical Center', 'Saint Alphonsus Medical Center Nampa', 'HCFA|UB|', '1265478325', 0, 'N', 0, '2014-05-28', NULL, NULL, 43.6127, -116.254, NULL, NULL),
('460500210', 'SACN00795', 'SACN00795', 'SACN', 'Saint Alphonsus Oncology Physician Services', 'Karl', 'J', 'Schultheiss', 'MD', 'Hematology and Oncology', 'Oncology', '', NULL, 'O', '1202 E Locust', 'Emmett', 'Gem', 'ID', '83617', '2083653561', NULL, '1202 E Locust', 'Emmett', 'Gem', 'ID', '83617', '2083653561', '', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', '2013-10-21', 0, 0, 0, 'Saint Alphonsus Medical Center Nampa', '', 'West Valley Medical Center', 'Saint Alphonsus Medical Center Nampa', 'HCFA|UB|', '1265478325', 0, 'N', 0, '2014-05-28', NULL, NULL, 43.8791, -116.485, NULL, NULL),
('460500210', 'SACN00796', 'SACN00796', 'SACN', 'Saint Alphonsus Oncology Physician Services', 'Karl', 'J', 'Schultheiss', 'MD', 'Hematology and Oncology', 'Oncology', '', NULL, 'O', '3123 Medical Dr', 'Caldwell', 'Canyon', 'ID', '83605', '2083674810', '2083674817', '3123 Medical Dr', 'Caldwell', 'Canyon', 'ID', '83605', '2083674810', '2083674817', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', '2013-10-21', 0, 0, 0, 'Saint Alphonsus Medical Center Nampa', '', 'West Valley Medical Center', 'Saint Alphonsus Medical Center Nampa', 'HCFA|UB|', '1265478325', 0, 'N', 0, '2014-05-28', NULL, NULL, 43.6596, -116.658, NULL, NULL),
('205294327', 'SACN00684', 'SACN00684', 'SACN', 'Digestive Health Clinic ', 'Stephen', 'M', 'Schutz', 'MD', 'Gastroenterology', '', '', NULL, 'O', '6259 W Emerald St', 'Boise', 'Ada', 'ID', '83704', '2084891900', NULL, '6259 W Emerald St', 'Boise', 'Ada', 'ID', '83704', '2084891900', '', 'IDSINCLAIRL', 'WUSTDHCPC5', NULL, '0.00', '15.00', '0.00', 6, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Regional Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1114994977', 0, 'n', 0, '2011-11-14', NULL, NULL, 43.6114, -116.259, NULL, NULL),
('432010107', 'SACN00893', 'SACN00893', 'SACN', '', 'Roman', '', 'Schwartsman', 'MD; Shoulder, Jnt Replace/Reconst, General', 'Orthopedic Surgery', NULL, NULL, NULL, 'O', '6590 W Norwood Dr', 'Boise', 'Ada', 'ID', '83704', '2083774003', '2083779006', '6590 W Norwood Dr', 'Boise', 'Ada', 'ID', '83704', '2083774003', '2083779006', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 3, '2011-01-01', NULL, 0, 0, 1, 'Saint Alphonsus Medical Center Nampa', NULL, '', '', 'HCFA|UB|', '1356378723', 0, 'N', 0, '2012-10-18', NULL, NULL, 0, 0, NULL, NULL),
('841394139', 'SACN01683', 'SACN01683', 'SACN', 'McCall Clinic', 'Matthew', 'B', 'Schwarz', 'MD', 'Ear, Nose and Throat', '', '', NULL, 'O', '1000 State St', 'McCall', 'Valley', 'ID', '83638', '2083673320', '          ', '1000 State St', 'McCall', 'Valley', 'ID', '83638', '2083673320', '          ', 'IDSINCLAIRL', 'WUSTDHCPC5', '', '0.00', '15.00', '0.00', 6, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Medical Center Nampa', NULL, '', '', 'HCFA|UB|', '1992788434', 0, 'N', 0, '2014-06-26', NULL, NULL, 44.9094, -116.11, NULL, NULL),
('841394139', 'SACN01684', 'SACN01684', 'SACN', 'Southwest Idaho ENT ', 'Matthew', 'B', 'Schwarz', 'MD', 'Ear, Nose and Throat', '', '', NULL, 'O', '900 N Liberty St Ste 400', 'Boise', 'Ada', 'ID', '83704', '2083673320', '          ', '900 N Liberty St Ste 400', 'Boise', 'Ada', 'ID', '83704', '2083673320', '          ', 'IDSINCLAIRL', 'WUSTDHCPC5', '', '0.00', '15.00', '0.00', 6, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Medical Center Nampa', NULL, '', '', 'HCFA|UB|', '1992788434', 0, 'N', 0, '2014-06-26', NULL, NULL, 43.6133, -116.259, NULL, NULL),
('820425454', 'SACN00024', 'SACN00024', 'SACN', 'Boise Anesthesia, PA', 'LeslieAnn', '', 'Schweiger', 'CRNA', 'Nurse Anesthetist', '', '', NULL, 'o', '1055 N Curtis Rd', 'Boise', 'Ada', 'ID', '83706', '2083676416', '2083759530', '1055 N Curtis Rd', 'Boise', 'Ada', 'ID', '83706', '2083676416', '2083759530', '', '', '', '58.45', '10.00', '0.00', 3, '2011-01-01', '2014-01-30', 1, 15, 0, '', '', '', '', 'HCFA|UB|', '1306892807', 0, 'N', 0, '2014-02-20', NULL, NULL, 43.6127, -116.254, NULL, NULL),
('820425454', 'SACN00025', 'SACN00025', 'SACN', 'Boise Anesthesia, PA', 'LeslieAnn', '', 'Schweiger', 'CRNA', 'Nurse Anesthetist', '', '', NULL, 'o', '1717 Arlington Ave', 'Caldwell', 'Canyon', 'ID', '83605', '2084594641', NULL, '1717 Arlington Ave', 'Caldwell', 'Canyon', 'ID', '83605', '2084594641', '0         ', '', '', '', '58.45', '10.00', '0.00', 3, '2011-01-01', '2014-01-30', 1, 15, 0, '', '', '', '', 'HCFA|UB|', '1306892807', 0, 'N', 0, '2014-02-20', NULL, NULL, 0, 0, NULL, NULL),
('820200895', 'SACN01137', 'SACN01137', 'SACN', 'Saint Alphonsus Medical Group Emerald Family Medicine', 'Scott', 'N', 'Schwendiman', 'MD', 'Family Practice', '', '', NULL, 'O', '6533 Emerald St', 'Boise', 'Ada', 'ID', '83704', '2083674170', '2083678135', '6533 Emerald St', 'Boise', 'Ada', 'ID', '83704', '2083674170', '2083678135', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Medical Center Nampa', '', '', '', 'HCFA|', '1538110234', 0, 'N', 0, '2014-06-20', NULL, NULL, 43.6119, -116.268, NULL, NULL),
('820477852', 'SACN01138', 'SACN01138', 'SACN', 'Saint Alphonsus Medical Group Emerald', 'Scott', 'N', 'Schwendiman', 'MD', 'Family Practice', '', '', NULL, 'o', '6533 Emerald St', 'Boise', 'Ada', 'ID', '83704', '2083674170', '2083678135', '6533 Emerald St', 'Boise', 'Ada', 'ID', '83704', '2083674170', '2083678135', 'IDSINCLAIRL', NULL, '', '0.00', '15.00', '0.00', 6, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Medical Center Nampa', '', '', '', 'HCFA|UB|', '1538110234', 0, 'n', 0, '2014-06-20', NULL, NULL, 43.6119, -116.268, NULL, NULL),
('260553931', 'SACN00432', 'SACN00432', 'SACN', 'Saint Alphonsus Medical Group Heart Care Ketchum', 'Walter', 'L', 'Seale', 'MD', 'Cardiology', '', '', NULL, 'O', '100 Hospital Dr', 'Ketchum', 'Blaine', 'ID', '83340', '2083674278', NULL, '100 Hospital Dr', 'Ketchum', 'Blaine', 'ID', '83340', '2083674278', '          ', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', '2013-11-01', 0, 0, 0, 'Saint Alphonsus Regional Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1720033459', 0, 'Y', 0, '2014-01-24', NULL, NULL, 43.6485, -114.35, NULL, NULL),
('260553931', 'SACN00433', 'SACN00433', 'SACN', 'Saint Alphonsus Specialty Services, Inc', 'Walter', 'L', 'Seale', 'MD', 'Cardiology', '', '', NULL, 'O', '1000 State St', 'McCall', 'Valley', 'ID', '83638', '2086342221', NULL, '1000 State St', 'McCall', 'Valley', 'ID', '83638', '2086342221', '          ', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', '2013-11-01', 0, 0, 0, 'Saint Alphonsus Regional Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1720033459', 0, 'Y', 0, '2014-01-24', NULL, NULL, 44.9094, -116.11, NULL, NULL),
('260553931', 'SACN00434', 'SACN00434', 'SACN', 'Saint Alphonsus Medical Group Heart Care Fruitland ', 'Walter', 'L', 'Seale', 'MD', 'Cardiology', '', '', NULL, 'O', '1118 NW 16th St Ste A', 'Fruitland', 'Payette', 'ID', '83619', '2084526851', '2084522140', '1118 NW 16th St Ste A', 'Fruitland', 'Payette', 'ID', '83619', '2084526851', '2084522140', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', '2013-11-01', 0, 0, 0, 'Saint Alphonsus Regional Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1720033459', 0, 'Y', 0, '2014-01-24', NULL, NULL, 44.025, -116.928, NULL, NULL),
('260553931', 'SACN00435', 'SACN00435', 'SACN', 'Saint Alphonsus Medical group Heart Care Calwell', 'Walter', 'L', 'Seale', 'MD', 'Cardiology', '', '', NULL, 'O', '1818 S 10th Ave Ste 200', 'Caldwell', 'Canyon', 'ID', '83605', '2083675734', '2083675744', '1818 S 10th Ave Ste 200', 'Caldwell', 'Canyon', 'ID', '83605', '2083675734', '2083675744', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', '2013-11-01', 0, 0, 0, 'Saint Alphonsus Regional Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1720033459', 0, 'Y', 0, '2014-01-24', NULL, NULL, 43.6538, -116.693, NULL, NULL),
('260553931', 'SACN00436', 'SACN00436', 'SACN', 'Saint Alphonsus Medical Group Heart Care Hailey', 'Walter', 'L', 'Seale', 'MD', 'Cardiology', '', '', NULL, 'O', '21 E Maple St Ste A', 'Hailey', 'Blaine', 'ID', '83333', '2083674278', NULL, '21 E Maple St Ste A', 'Hailey', 'Blaine', 'ID', '83333', '2083674278', '          ', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', '2013-11-01', 0, 0, 0, 'Saint Alphonsus Regional Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1720033459', 0, 'Y', 0, '2014-01-24', NULL, NULL, 43.5143, -114.31, 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
('260553931', 'SACN00437', 'SACN00437', 'SACN', 'Saint Alphonsus Medical group Heart Care Elm', 'Walter', 'L', 'Seale', 'MD', 'Cardiology', '', '', NULL, 'O', '315 E Elm St Ste 100', 'Caldwell', 'Canyon', 'ID', '83605', '2083674278', '2083675200', '315 E Elm St Ste 100', 'Caldwell', 'Canyon', 'ID', '83605', '2083674278', '2083675200', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', '2013-11-01', 0, 0, 0, 'Saint Alphonsus Regional Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1720033459', 0, 'Y', 0, '2014-01-24', NULL, NULL, 43.6539, -116.695, NULL, NULL),
('260553931', 'SACN00438', 'SACN00438', 'SACN', 'Saint Alphonsus Medical Group Heart Care Boise ', 'Walter', 'L', 'Seale', 'MD', 'Cardiology', '', '', NULL, 'O', '6140 W Curtisian Ste 200', 'Boise', 'Ada', 'ID', '83704', '2083674278', '2083675200', '6140 W Curtisian Ste 200', 'Boise', 'Ada', 'ID', '83704', '2083674278', '2083675200', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', '2013-11-01', 0, 0, 0, 'Saint Alphonsus Regional Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1720033459', 0, 'Y', 0, '2014-01-24', NULL, NULL, 43.6151, -116.256, NULL, NULL),
('260553931', 'SACN00439', 'SACN00439', 'SACN', 'Saint Alphonsus Specialty Services, Inc', 'Walter', 'L', 'Seale', 'MD', 'Cardiology', '', '', NULL, 'O', '645 E 5th St', 'Weiser', 'Washington', 'ID', '83672', '2085493152', NULL, '645 E 5th St', 'Weiser', 'Washington', 'ID', '83672', '2085493152', '          ', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', '2013-11-01', 0, 0, 0, 'Saint Alphonsus Regional Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1720033459', 0, 'Y', 0, '2014-01-24', NULL, NULL, 44.2487, -116.962, NULL, NULL),
('331078261', 'SACN00440', 'SACN00440', 'SACN', 'St Lukes Medical Center Wood River', 'Walter', 'L', 'Seale', 'MD', 'Cardiology', '', '', NULL, 'B', '100 Hospital Dr', 'Ketchum', 'Blaine', 'ID', '83340', '2087278240', NULL, '100 Hospital Dr', 'Ketchum', 'Blaine', 'ID', '83340', '2087278240', '0         ', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 3, '2011-01-01', '2012-12-13', 0, 0, 0, 'Saint Alphonsus Regional Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1720033459', 0, 'Y', 0, '2014-01-24', NULL, NULL, 43.6485, -114.35, NULL, NULL),
('331078261', 'SACN00441', 'SACN00441', 'SACN', 'McCall Memorial Hospital', 'Walter', 'L', 'Seale', 'MD', 'Cardiology', '', '', NULL, 'B', '1000 State St', 'McCall', 'Valley', 'ID', '83638', '2086342221', NULL, '1000 State St', 'McCall', 'Valley', 'ID', '83638', '2086342221', '0         ', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 3, '2011-01-01', '2012-12-13', 0, 0, 0, 'Saint Alphonsus Regional Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1720033459', 0, 'Y', 0, '2014-01-24', NULL, NULL, 44.9094, -116.11, NULL, NULL),
('331078261', 'SACN00442', 'SACN00442', 'SACN', 'Family Practice Associates', 'Walter', 'L', 'Seale', 'MD', 'Cardiology', '', '', NULL, 'B', '21 E Maple St Ste  A', 'Hailey', 'Blaine', 'ID', '83333', '2087883200', NULL, '21 E Maple St Ste  A', 'Hailey', 'Blaine', 'ID', '83333', '2087883200', '0         ', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 3, '2011-01-01', '2012-12-13', 0, 0, 0, 'Saint Alphonsus Regional Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1720033459', 0, 'Y', 0, '2014-01-24', NULL, NULL, 43.5143, -114.31, NULL, NULL),
('331078261', 'SACN00443', 'SACN00443', 'SACN', 'Saint Alphonsus Physicians PA', 'Walter', 'L', 'Seale', 'MD', 'Cardiology', '', '', NULL, 'o', '315 E Elm St Ste 100', 'Caldwell', 'Canyon', 'ID', '83605', '2083674278', '2083675200', '315 E Elm St Ste 100', 'Caldwell', 'Canyon', 'ID', '83605', '2083674278', '2083675200', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 3, '2011-01-01', '2012-12-13', 0, 0, 0, 'Saint Alphonsus Regional Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1720033459', 0, 'Y', 0, '2014-01-24', NULL, NULL, 43.6539, -116.695, NULL, NULL),
('331078261', 'SACN00444', 'SACN00444', 'SACN', 'Saint Alphonsus Physicians PA', 'Walter', 'L', 'Seale', 'MD', 'Cardiology', '', '', NULL, 'o', '6140 W Curtisian Ste 200', 'Boise', 'Ada', 'ID', '83704', '2083674278', '2083675200', '6140 W Curtisian Ste 200', 'Boise', 'Ada', 'ID', '83704', '2083674278', '2083675200', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 3, '2011-01-01', '2012-12-13', 0, 0, 0, 'Saint Alphonsus Regional Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1720033459', 0, 'Y', 0, '2014-01-24', NULL, NULL, 43.6151, -116.256, NULL, NULL),
('331078261', 'SACN00445', 'SACN00445', 'SACN', 'Weiser Memorial Hospital', 'Walter', 'L', 'Seale', 'MD', 'Cardiology', '', '', NULL, 'B', '645 E 5th St', 'Weiser', 'Washington', 'ID', '83672', '2085493152', NULL, '645 E 5th St', 'Weiser', 'Washington', 'ID', '83672', '2085493152', '0         ', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 3, '2011-01-01', '2012-12-13', 0, 0, 0, 'Saint Alphonsus Regional Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1720033459', 0, 'Y', 0, '2014-01-24', NULL, NULL, 44.2487, -116.962, NULL, NULL),
('820200895', 'SACN00446', 'SACN00446', 'SACN', 'Saint Alphonsus Regional Medical Center - Reading Panel', 'Walter', 'L', 'Seale', 'MD', 'Cardiology', '', '', NULL, 'B', '1055 N Curtis', 'Boise', 'Ada', 'ID', '83706', '2083673722', NULL, '1055 N Curtis', 'Boise', 'Ada', 'ID', '83706', '2083673722', '0         ', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', '2013-11-01', 0, 0, 0, 'Saint Alphonsus Regional Medical Center', NULL, NULL, NULL, 'HCFA|', '1720033459', 0, 'Y', 0, '2014-01-24', NULL, NULL, 43.6127, -116.254, NULL, NULL),
('820200895', 'SACN00828', 'SACN00828', 'SACN', 'Saint Alphonsus Medical Group Family Medicine Dominican', 'Cherese', 'R', 'Severson', 'NPC', 'Family Practice', '', '', NULL, 'O', '1118 NW 16th St Ste A', 'Fruitland', 'Payette', 'ID', '83619', '2084526851', '2084522140', '1118 NW 16th St Ste A', 'Fruitland', 'Payette', 'ID', '83619', '2084526851', '2084522140', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Medical Center Nampa', NULL, NULL, NULL, 'HCFA|', '1275631244', 0, 'N', 0, '2013-09-05', NULL, NULL, 44.025, -116.928, NULL, NULL),
('820200895', 'SACN00829', 'SACN00829', 'SACN', 'Saint Alphonsus Medical Group Garrity Family Medicine', 'Cherese', 'R', 'Severson', 'NPC', 'Family Practice', '', '', NULL, 'O', '1200 Garrity Blvd', 'Nampa', 'Canyon', 'ID', '83687', '2084669092', '2084665322', '1200 Garrity Blvd', 'Nampa', 'Canyon', 'ID', '83687', '2084669092', '2084665322', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Medical Center Nampa', NULL, NULL, NULL, 'HCFA|', '1275631244', 0, 'N', 0, '2013-09-05', NULL, NULL, 43.587, -116.549, NULL, NULL),
('820200895', 'SACN00830', 'SACN00830', 'SACN', 'Saint Alphonsus Medical Group MPH Family Medicine', 'Cherese', 'R', 'Severson', 'NPC', 'Family Practice', '', '', NULL, 'O', '3025 W Cherry Ln Ste B', 'Meridian', 'Ada', 'ID', '83642', '2083678550', '2083678555', '3025 W Cherry Ln Ste B', 'Meridian', 'Ada', 'ID', '83642', '2083678550', '2083678555', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Medical Center Nampa', NULL, NULL, NULL, 'HCFA|', '1275631244', 0, 'N', 0, '2013-09-05', NULL, NULL, 43.6188, -116.431, NULL, NULL),
('820200895', 'SACN00831', 'SACN00831', 'SACN', 'Saint Alphonsus Medical Group Elm Family Medicine', 'Cherese', 'R', 'Severson', 'NPC', 'Family Practice', '', '', NULL, 'O', '315 E Elm St Ste 100', 'Caldwell', 'Canyon', 'ID', '83605', '2084597415', '2084533307', '315 E Elm St Ste 100', 'Caldwell', 'Canyon', 'ID', '83605', '2084597415', '2084533307', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Medical Center Nampa', NULL, NULL, NULL, 'HCFA|', '1275631244', 0, 'N', 0, '2013-09-05', NULL, NULL, 43.6539, -116.695, NULL, NULL),
('820200895', 'SACN00832', 'SACN00832', 'SACN', 'Saint Alphonsus Medical Group Emerald Family Medicine', 'Cherese', 'R', 'Severson', 'NPC', 'Family Practice', '', '', NULL, 'O', '6533 Emerald St', 'Boise', 'Ada', 'ID', '83704', '2083674170', '2083678135', '6533 Emerald St', 'Boise', 'Ada', 'ID', '83704', '2083674170', '2083678135', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Medical Center Nampa', NULL, NULL, NULL, 'HCFA|', '1275631244', 0, 'N', 0, '2013-09-05', NULL, NULL, 43.6119, -116.268, NULL, NULL),
('205506855', 'SACN00778', 'SACN00778', 'SACN', 'Northwest Radiation Oncology', 'Jennifer', 'T', 'Shalz', 'MD', 'Internal Medicine', '', '', NULL, 'O', '1055 N Curtis', 'Boise', 'Ada', 'ID', '83706', '2083673131', '2083673174', '1055 N Curtis', 'Boise', 'Ada', 'ID', '83706', '2083673131', '2083673174', 'IDSINCLAIRL', 'WUSTDHCPC5', '', '0.00', '15.00', '0.00', 3, '2011-01-01', '2011-10-05', 0, 0, 0, 'Saint Alphonsus Medical Center Nampa', '', '', '', 'HCFA|UB|', '1245346303', 0, 'N', 0, '2012-07-23', NULL, NULL, 43.6127, -116.254, NULL, NULL),
('205506855', 'SACN00779', 'SACN00779', 'SACN', 'Northwest Radiation Oncology', 'Jennifer', 'T', 'Shalz', 'MD', 'Internal Medicine', '', '', NULL, 'O', '1202 E Locust', 'Emmett', 'Gem', 'ID', '83617', '2083653561', NULL, '1202 E Locust', 'Emmett', 'Gem', 'ID', '83617', '2083653561', '          ', 'IDSINCLAIRL', 'WUSTDHCPC5', '', '0.00', '15.00', '0.00', 3, '2011-01-01', '2011-10-05', 0, 0, 0, 'Saint Alphonsus Medical Center Nampa', '', '', '', 'HCFA|UB|', '1245346303', 0, 'N', 0, '2012-07-23', NULL, NULL, 43.8791, -116.485, NULL, NULL),
('205506855', 'SACN00780', 'SACN00780', 'SACN', 'Northwest Radiation Oncology', 'Jennifer', 'T', 'Shalz', 'MD', 'Internal Medicine', '', '', NULL, 'O', '3123 Medical Way', 'Caldwell', 'Canyon', 'ID', '83605', '2083674810', '2083674817', '3123 Medical Way', 'Caldwell', 'Canyon', 'ID', '83605', '2083674810', '2083674817', 'IDSINCLAIRL', 'WUSTDHCPC5', '', '0.00', '15.00', '0.00', 3, '2011-01-01', '2011-10-05', 0, 0, 0, 'Saint Alphonsus Medical Center Nampa', '', '', '', 'HCFA|UB|', '1245346303', 0, 'N', 0, '2012-07-23', NULL, NULL, 43.6596, -116.658, NULL, NULL),
('205506855', 'SACN00781', 'SACN00781', 'SACN', 'Northwest Radiation Oncology', 'Jennifer', 'T', 'Shalz', 'MD', 'Internal Medicine', '', '', NULL, 'B', 'PO Box 5145', 'Boise', 'Ada', 'ID', '83706', '2083673131', NULL, 'PO Box 5145', 'Boise', 'Ada', 'ID', '83706', '2083673131', '          ', 'IDSINCLAIRL', 'WUSTDHCPC5', '', '0.00', '15.00', '0.00', 3, '2011-01-01', '2011-10-05', 0, 0, 0, 'Saint Alphonsus Medical Center Nampa', '', '', '', 'HCFA|UB|', '1245346303', 0, 'N', 0, '2012-07-23', NULL, NULL, 0, 0, NULL, NULL),
('460500210', 'SACN00782', 'SACN00782', 'SACN', '', 'Jennifer', 'T', 'Shalz', 'MD', 'Internal Medicine', '', '', NULL, 'O', '1055 N Curtis Rd', 'Boise', 'Ada', 'ID', '83706', '2083673131', NULL, '1055 N Curtis Rd', 'Boise', 'Ada', 'ID', '83706', '2083673131', '          ', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', '2011-10-05', 0, 0, 0, 'Saint Alphonsus Medical Center Nampa', '', '', '', 'HCFA|UB|', '1245346303', 0, 'N', 0, '2012-07-23', NULL, NULL, 43.6127, -116.254, NULL, NULL),
('460500210', 'SACN00783', 'SACN00783', 'SACN', '', 'Jennifer', 'T', 'Shalz', 'MD', 'Internal Medicine', '', '', NULL, 'O', '1202 E Locust', 'Emmett', 'Gem', 'ID', '83617', '2083653561', NULL, '1202 E Locust', 'Emmett', 'Gem', 'ID', '83617', '2083653561', '          ', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', '2011-10-05', 0, 0, 0, 'Saint Alphonsus Medical Center Nampa', '', '', '', 'HCFA|UB|', '1245346303', 0, 'N', 0, '2012-07-23', NULL, NULL, 43.8791, -116.485, NULL, NULL),
('460500210', 'SACN00784', 'SACN00784', 'SACN', '', 'Jennifer', 'T', 'Shalz', 'MD', 'Internal Medicine', '', '', NULL, 'O', '3123 Medical Dr', 'Caldwell', 'Canyon', 'ID', '83605', '2083674810', NULL, '3123 Medical Dr', 'Caldwell', 'Canyon', 'ID', '83605', '2083674810', '          ', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', '2011-10-05', 0, 0, 0, 'Saint Alphonsus Medical Center Nampa', '', '', '', 'HCFA|UB|', '1245346303', 0, 'N', 0, '2012-07-23', NULL, NULL, 43.6596, -116.658, NULL, NULL),
('460500210', 'SACN00785', 'SACN00785', 'SACN', '', 'Jennifer', 'T', 'Shalz', 'MD', 'Internal Medicine', '', '', NULL, 'B', 'PO Box 9589', 'Boise', 'Ada', 'ID', '83708', '2084728115', NULL, 'PO Box 9589', 'Boise', 'Ada', 'ID', '83708', '2084728115', '          ', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', '2011-10-05', 0, 0, 0, 'Saint Alphonsus Medical Center Nampa', '', '', '', 'HCFA|UB|', '1245346303', 0, 'Y', 0, '2012-07-23', NULL, NULL, 0, 0, NULL, NULL),
('820227163', 'SACN00871', 'SACN00871', 'SACN', 'Fifth Avenue Surgery Clinic', 'Glen', 'D', 'Shapiro', 'MD', 'Orthopedic Surgery', 'Sports Medicine', '', NULL, 'B', '128 5th Ave W', 'Jerome', 'Jerome', 'ID', '83338', '2083248831', '2083246778', '128 5th Ave W', 'Jerome', 'Jerome', 'ID', '83338', '2083248831', '2083246778', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 3, '2011-01-01', '2012-01-01', 0, 0, 1, NULL, '', '', '', 'HCFA|UB|', '1336283779', 0, 'Y', 0, '2012-08-30', NULL, NULL, 0, 0, NULL, NULL),
('820227163', 'SACN00140', 'SACN00140', 'SACN', 'St Benedicts Family Medical Center', 'Vicki', 'W', 'Shapiro', 'MD', 'Emergency Medicine', '', '', NULL, 'B', '709 N Lincoln', 'Jerome', 'Jerome', 'ID', '83338', '2083241122', '2083243878', '709 N Lincoln', 'Jerome', 'Jerome', 'ID', '83338', '2083241122', '2083243878', 'IDSINCLAIRL', NULL, NULL, '0.00', '15.00', '0.00', 3, '2011-01-01', NULL, 0, 0, 1, '', '', '', '', 'HCFA|UB|', '0000008679', 0, 'Y', 0, '2012-07-19', NULL, NULL, 0, 0, NULL, NULL),
('820200895', 'SACN01259', 'SACN01259', 'SACN', 'Saint Alphonsus Medical Group Overland Family Medicine', 'Scott', 'A', 'Shappard', 'DO', 'Family Practice', '', '', NULL, 'O', '10255 W Overland Rd', 'Boise', 'Ada', 'ID', '83709', '2083677205', '2083677204', '10255 W Overland Rd', 'Boise', 'Ada', 'ID', '83709', '2083677205', '2083677204', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Regional Medical Center', '', '', '', 'HCFA|', '1649275587', 0, 'N', 0, '2014-06-20', NULL, NULL, 43.5899, -116.31, NULL, NULL),
('820477852', 'SACN01260', 'SACN01260', 'SACN', 'Saint Alphonsus Medical Group Overland', 'Scott', 'A', 'Shappard', 'DO', 'Family Practice', '', '', NULL, 'O', '10255 W Overland Rd', 'Boise', 'Ada', 'ID', '83709', '2083677205', '2083677204', '10255 W Overland Rd', 'Boise', 'Ada', 'ID', '83709', '2083677205', '2083677204', 'IDSINCLAIRL', NULL, '', '0.00', '15.00', '0.00', 6, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Regional Medical Center', '', '', '', 'HCFA|UB|', '1649275587', 0, 'N', 0, '2014-06-20', NULL, NULL, 43.5899, -116.31, NULL, NULL),
('205934739', 'SACN00187', 'SACN00187', 'SACN', 'Family Medicine Health Center', 'Kimberly', 'K', 'Stutzman', 'MD', 'Family Practice', '', '', NULL, 'O', '777 N Raymond St', 'Boise', 'Ada', 'ID', '83704', '2085142500', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, 'IDSINCLAIRL', 'WUSTDHCPC5', NULL, '0.00', '15.00', '0.00', 3, '2011-01-01', NULL, 0, 0, 1, 'Saint Alphonsus Medical Center Nampa', '', '', '', 'HCFA|UB|', '1144212689', 0, 'n', 0, '2013-02-28', NULL, NULL, 0, 0, NULL, NULL),
('205934739', 'SACN00186', 'SACN00186', 'SACN', 'Family Medicine Health Center', 'Kimberly', 'K', 'Stutzman', 'MD', 'Family Practice', '', '', NULL, 'O', '121 E Fort St', 'Boise', 'Ada', 'ID', '83712', '2083811775', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, 'IDSINCLAIRL', 'WUSTDHCPC5', NULL, '0.00', '15.00', '0.00', 3, '2011-01-01', NULL, 0, 0, 1, 'Saint Alphonsus Medical Center Nampa', '', '', '', 'HCFA|UB|', '1144212689', 0, 'n', 0, '2013-02-28', NULL, NULL, 0, 0, NULL, NULL),
('942938348', 'W40021392', 'W40021392', 'UTMH1', 'Valley Mental Health  Inc', 'Robert', 'K', 'Strachan', 'PHD', 'Mental Health', 'Psychology', '', NULL, 'B', '5965 S 900 E Ste 430', 'Salt Lake City', 'Salt Lake', 'UT', '84121', '8012637100', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, 'UTVMHMA', NULL, NULL, '0.00', '40.00', '0.00', 6, '2013-02-15', NULL, NULL, 0, NULL, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1497725055', 0, 'Y', 0, '2013-02-28', NULL, NULL, 0, 0, NULL, NULL),
('942938348', 'W40006927', 'W40006927', 'UTMH1', 'Valley Mental Health  Inc', 'Robert', 'E', 'Strong', 'MD', 'Mental Health', 'Psychiatry', '', NULL, 'B', '5965 S 900 E Ste 430', 'Salt Lake City', 'Salt Lake', 'UT', '84121', '8012637100', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, 'UTMD-2', NULL, NULL, '0.00', '40.00', '0.00', 6, '2013-02-15', NULL, NULL, 0, NULL, 'University Health Care University Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1740370378', 0, 'Y', 0, '2013-02-28', NULL, NULL, 0, 0, NULL, NULL),
('260553931', 'SACN00449', 'SACN00449', 'SACN', 'Saint Alphonsus Medical Group Pediatric Orthopedics Boise', 'Jeffrey', '', 'Shilt', 'MD; General, Pediatrics', 'Pediatric Orthopedic Surgery', NULL, NULL, NULL, 'O', '6500 Emerald', 'Boise', 'Ada', 'ID', '83704', '2083770777', '2083771070', '6500 Emerald', 'Boise', 'Ada', 'ID', '83704', '2083770777', '2083771070', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', '2013-05-01', 0, 0, 0, 'Saint Alphonsus Medical Center Nampa', '', '', '', 'HCFA|UB|', '1730165366', 0, 'Y', 0, '2013-08-26', NULL, NULL, 43.612, -116.262, NULL, NULL),
('331078261', 'SACN00450', 'SACN00450', 'SACN', 'Saint Alphonsus Physicians PA', 'Jeffrey', '', 'Shilt', 'MD; General, Pediatrics', 'Pediatric Orthopedic Surgery', NULL, NULL, NULL, 'O', '6500 W Emerald', 'Boise', 'Ada', 'ID', '83704', '2083770777', NULL, '6500 W Emerald', 'Boise', 'Ada', 'ID', '83704', '2083770777', '          ', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 3, '2011-01-01', '2013-05-01', 0, 0, 0, 'Saint Alphonsus Medical Center Nampa', '', '', '', 'HCFA|UB|', '1730165366', 0, 'Y', 0, '2013-08-26', NULL, NULL, 0, 0, NULL, NULL),
('820200895', 'SACN01091', 'SACN01091', 'SACN', 'Saint Alphonsus Medical Group Garrity Family Medicine', 'John', '', 'Shilt', 'PA-C', 'Family Practice', 'Physician Assistant', '', NULL, 'o', '1200 Garrity Blvd', 'Nampa', 'Canyon', 'ID', '83687', '2084669092', NULL, '1200 Garrity Blvd', 'Nampa', 'Canyon', 'ID', '83687', '2084669092', '          ', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|', '1497930101', 0, 'N', 0, '2012-02-27', NULL, NULL, 43.587, -116.549, NULL, NULL),
('820200895', 'SACN01092', 'SACN01092', 'SACN', 'Saint Alphonsus Medical Group MHP Family Medicine ', 'John', '', 'Shilt', 'PA-C', 'Family Practice', 'Physician Assistant', '', NULL, 'o', '3025 W Cherry Ln Ste B', 'Meridian', 'Ada', 'ID', '83642', '2083678550', NULL, '3025 W Cherry Ln Ste B', 'Meridian', 'Ada', 'ID', '83642', '2083678550', '          ', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|', '1497930101', 0, 'N', 0, '2012-02-27', NULL, NULL, 43.6188, -116.431, NULL, NULL),
('820200895', 'SACN01093', 'SACN01093', 'SACN', 'Saint Alphonsus Medical Group Elm Family Medicine', 'John', '', 'Shilt', 'PA-C', 'Family Practice', 'Physician Assistant', '', NULL, 'o', '315 E Elm St Ste 100', 'Caldwell', 'Canyon', 'ID', '83605', '2084597415', NULL, '315 E Elm Ste 100', 'Caldwell', 'Canyon', 'ID', '83605', '2084597415', '          ', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|', '1497930101', 0, 'N', 0, '2012-02-27', NULL, NULL, 43.6539, -116.695, NULL, NULL),
('820200895', 'SACN01094', 'SACN01094', 'SACN', 'Saint Alphonsus Medical Group Emerald Family Medicine', 'John', '', 'Shilt', 'PA-C', 'Family Practice', 'Physician Assistant', '', NULL, 'O', '6500 Emerald', 'Boise', 'Ada', 'ID', '83704', '2083770777', '2083771070', '6500 Emerald', 'Boise', 'Ada', 'ID', '83704', '2083770777', '2083771070', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|', '1497930101', 0, 'N', 0, '2012-02-27', NULL, NULL, 43.612, -116.262, NULL, NULL),
('820200895', 'SACN01095', 'SACN01095', 'SACN', 'Saint Alphonsus Pediatric Orthopedics', 'John', '', 'Shilt', 'PA-C', 'Family Practice', 'Physician Assistant', '', NULL, 'o', '6500 W Emerald', 'Boise', 'Ada', 'ID', '83704', '2083770777', NULL, '6500 W Emerald', 'Boise', 'Ada', 'ID', '83704', '2083770777', '', 'IDSINCLAIRL', NULL, NULL, '0.00', '15.00', '0.00', 6, '2011-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|', '1497930101', 0, 'n', 0, '2012-02-27', NULL, NULL, 0, 0, NULL, NULL),
('820200895', 'SACN01096', 'SACN01096', 'SACN', 'Saint Alphonsus Medical Group Emerald Family Medicine', 'John', '', 'Shilt', 'PA-C', 'Family Practice', 'Physician Assistant', '', NULL, 'o', '6533 Emerald St', 'Boise', 'Ada', 'ID', '83704', '2083674197', NULL, '6533 Emerald St', 'Boise', 'Ada', 'ID', '83704', '2083674197', '          ', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|', '1497930101', 0, 'N', 0, '2014-01-23', NULL, NULL, 43.6119, -116.268, NULL, NULL),
('820200895', 'SACN01097', 'SACN01097', 'SACN', 'Saint Alphonsus Medical Group Coughlin Clinic Boise 503', 'John', '', 'Shilt', 'PA-C', 'Family Practice', 'Physician Assistant', '', NULL, 'o', '901 N Curtis Ste 503', 'Boise', 'Ada', 'ID', '83706', '8013771000', NULL, '901 N Curtis Ste 503', 'Boise', 'Ada', 'ID', '83706', '8013771000', '          ', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|', '1497930101', 0, 'N', 0, '2012-02-27', NULL, NULL, 43.6126, -116.255, NULL, NULL),
('820425454', 'SACN00004', 'SACN00004', 'SACN', 'Boise Anesthesia, PA', 'Diana', '', 'Shimko', 'CRNA', 'Nurse Anesthetist', '', '', NULL, 'o', '1055 N Curtis Rd', 'Boise', 'Ada', 'ID', '83706', '2083676416', '2083759530', '1055 N Curtis Rd', 'Boise', 'Ada', 'ID', '83706', '2083676416', '2083759530', '', '', '', '58.45', '10.00', '0.00', 3, '2011-01-01', '2012-03-01', 1, 15, 0, '', '', '', '', 'HCFA|UB|', '1033159439', 0, 'N', 0, '2012-06-26', NULL, NULL, 43.6127, -116.254, NULL, NULL),
('820425454', 'SACN00005', 'SACN00005', 'SACN', 'Boise Anesthesia, PA', 'Diana', '', 'Shimko', 'CRNA', 'Nurse Anesthetist', '', '', NULL, 'o', '1717 Arlington Ave', 'Caldwell', 'Canyon', 'ID', '83605', '2084594641', NULL, '1717 Arlington Ave', 'Caldwell', 'Canyon', 'ID', '83605', '2084594641', '0         ', '', '', '', '58.45', '10.00', '0.00', 3, '2011-01-01', '2012-03-01', 1, 15, 0, '', '', '', '', 'HCFA|UB|', '1033159439', 0, 'N', 0, '2012-06-26', NULL, NULL, 0, 0, NULL, NULL),
('820425454', 'SACN00088', 'SACN00088', 'SACN', 'Boise Anesthesia, PA', 'James', 'I', 'Shippers', 'CRNA', 'Nurse Anesthetist', '', '', NULL, 'O', '1055 N Curtis', 'Boise', 'Ada', 'ID', '83706', '2083759530', '2083759530', '1055 N Curtis', 'Boise', 'Ada', 'ID', '83706', '2083759530', '2083759530', '', '', '', '58.45', '10.00', '0.00', 3, '2011-01-01', NULL, 1, 15, 0, '', '', '', '', 'HCFA|UB|', '1801841820', 0, 'N', 0, '2012-11-01', NULL, NULL, 43.6127, -116.254, NULL, NULL),
('820425454', 'SACN00089', 'SACN00089', 'SACN', 'Boise Anesthesia, PA', 'James', 'I', 'Shippers', 'CRNA', 'Nurse Anesthetist', '', '', NULL, 'O', '1717 Arlington Ave', 'Caldwell', 'Canyon', 'ID', '83605', '2084594641', '2083759530', '1717 Arlington Ave', 'Caldwell', 'Canyon', 'ID', '83605', '2084594641', '2083759530', '', '', '', '58.45', '10.00', '0.00', 3, '2011-01-01', NULL, 1, 15, 0, '', '', '', '', 'HCFA|UB|', '1801841820', 0, 'N', 0, '2012-11-01', NULL, NULL, 0, 0, NULL, NULL),
('820471268', 'SACN01440', 'SACN01440', 'SACN', 'Sage Health Care', 'Laura', 'S', 'Shockley', 'LCPC', 'Mental Health', 'Counseling', '', NULL, 'O', '413 N Allumbaugh St Ste 101', 'Boise', 'Ada', 'ID', '83704', '2083231125', '          ', '413 N Allumbaugh St Ste 101', 'Boise', 'Ada', 'ID', '83704', '2083231125', '          ', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', '2014-06-14', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1750447173', 0, 'N', 0, '2014-05-08', NULL, NULL, 43.6086, -116.268, NULL, NULL),
('820200895', 'SACN01438', 'SACN01438', 'SACN', 'Saint Alphonsus Regional Medical Center - Reading Panel', 'David', 'N', 'Sim', 'MD', 'Cardiovascular Disease', '', '', NULL, 'B', '1055 N Curtis', 'Boise', 'Ada', 'ID', '83706', '2083673722', NULL, '1055 N Curtis', 'Boise', 'Ada', 'ID', '83706', '2083673722', '0         ', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Medical Center Nampa', NULL, '', '', 'HCFA|', '1114106952', 0, 'Y', 0, '2014-03-26', NULL, NULL, 43.6127, -116.254, NULL, NULL),
('820327294', 'SACN01439', 'SACN01439', 'SACN', NULL, 'David', 'N', 'Sim', 'MD', 'Cardiovascular Disease', '', '', NULL, 'O', '6014 Emerald', 'Boise', 'Ada', 'ID', '83704', '2083768666', '2083769804', '6014 Emerald', 'Boise', 'Ada', 'ID', '83704', '2083768666', '2083769804', 'IDSINCLAIRL', NULL, NULL, '0.00', '15.00', '0.00', 3, '2011-01-01', NULL, 0, 0, 1, 'Saint Alphonsus Medical Center Nampa', NULL, '', '', 'HCFA|UB|', '1114106952', 0, 'N', 0, '2014-03-26', NULL, NULL, 0, 0, NULL, NULL),
('820200895', 'SACN00509', 'SACN00509', 'SACN', 'Saint Alphonsus Employee Assistance Program', 'Mary', '', 'Simon', 'LCSW', 'Mental Health', 'Social Worker', '', NULL, 'o', '6140 W Emerald', 'Boise', 'Ada', 'ID', '83704', '2083673300', NULL, '6140 W Emerald', 'Boise', 'Ada', 'ID', '83704', '2083673300', '          ', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', '2013-08-06', 0, 0, 0, '', '', '', '', 'HCFA|', '1922298603', 0, 'N', 0, '2013-08-14', NULL, NULL, 0, 0, NULL, NULL),
('820200895', 'SACN00468', 'SACN00468', 'SACN', 'Dominican Health Services', 'Jocele', 'A', 'Skinner', 'MD', 'Family Practice', '', '', NULL, 'O', '1118 NW 16th St Ste A', 'Fruitland', 'Payette', 'ID', '83619', '2084526851', '2083676170', '1118 NW 16th St Ste A', 'Fruitland', 'Payette', 'ID', '83619', '2084526851', '2083676170', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Regional Medical Center', '', '', '', 'HCFA|', '1831133164', 0, 'N', 0, '2014-06-13', NULL, NULL, 44.025, -116.928, NULL, NULL),
('820200895', 'SACN00469', 'SACN00469', 'SACN', 'Saint Alphonsus Medical Group Elm Family Medicine', 'Jocele', 'A', 'Skinner', 'MD', 'Family Practice', '', '', NULL, 'O', '315 E Elm St Ste 100', 'Caldwell', 'Canyon', 'ID', '83605', '2084597415', '2084533307', '315 E Elm St Ste 100', 'Caldwell', 'Canyon', 'ID', '83605', '2084597415', '2084533307', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Regional Medical Center', '', '', '', 'HCFA|', '1831133164', 0, 'N', 0, '2014-06-13', NULL, NULL, 43.6539, -116.695, NULL, NULL),
('820477852', 'SACN00470', 'SACN00470', 'SACN', 'Saint Alphonsus Medical Group Elm Family Medicine', 'Jocele', 'A', 'Skinner', 'MD', 'Family Practice', '', '', NULL, 'o', '315 E Elm St Ste 100', 'Caldwell', 'Canyon', 'ID', '83605', '2084597415', '2084545107', '315 E Elm St Ste 100', 'Caldwell', 'Canyon', 'ID', '83605', '2084597415', '2084545107', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', '2012-04-03', 0, 0, 0, 'Saint Alphonsus Regional Medical Center', '', '', '', 'HCFA|UB|', '1831133164', 0, 'N', 0, '2014-06-13', NULL, NULL, 43.6539, -116.695, NULL, NULL),
('820425454', 'SACN00120', 'SACN00120', 'SACN', 'Boise Anesthesia PA', 'Joseph', 'C', 'Skinner', 'CRNA', 'Nurse Anesthetist', '', '', NULL, 'O', '1055 N Curtis Rd', 'Boise', 'Ada', 'ID', '83706', '2083676416', '2083759530', '1055 N Curtis Rd', 'Boise', 'Ada', 'ID', '83706', '2083676416', '2083759530', '', '', '', '58.45', '10.00', '0.00', 3, '2011-01-01', '2011-06-30', 1, 15, 0, 'Saint Alphonsus Medical Center Nampa', '', '', '', 'HCFA|UB|', '1356325666', 0, 'N', 0, '2013-06-28', NULL, NULL, 43.6127, -116.254, NULL, NULL),
('820425454', 'SACN00121', 'SACN00121', 'SACN', 'Boise Anesthesia PA', 'Joseph', 'C', 'Skinner', 'CRNA', 'Nurse Anesthetist', '', '', NULL, 'O', '1717 Arlington Ave', 'Caldwell', 'Canyon', 'ID', '83605', '2084594641', NULL, '1717 Arlington Ave', 'Caldwell', 'Canyon', 'ID', '83605', '2084594641', '          ', '', '', '', '58.45', '10.00', '0.00', 3, '2011-01-01', '2011-06-30', 1, 15, 0, 'Saint Alphonsus Medical Center Nampa', '', '', '', 'HCFA|UB|', '1356325666', 0, 'N', 0, '2013-06-28', NULL, NULL, 0, 0, NULL, NULL),
('820425454', 'SACN00122', 'SACN00122', 'SACN', 'Boise Anesthesia PA', 'Joseph', 'C', 'Skinner', 'CRNA', 'Nurse Anesthetist', '', '', NULL, 'O', '900 N Liberty St Ste 450', 'Boise', 'Ada', 'ID', '83704', '2083677431', NULL, '900 N Liberty St Ste 450', 'Boise', 'Ada', 'ID', '83704', '2083677431', '          ', '', '', '', '58.45', '10.00', '0.00', 3, '2011-01-01', '2011-06-30', 1, 15, 0, 'Saint Alphonsus Medical Center Nampa', '', '', '', 'HCFA|UB|', '1356325666', 0, 'N', 0, '2013-06-28', NULL, NULL, 43.6133, -116.259, NULL, NULL),
('820425454', 'SACN00123', 'SACN00123', 'SACN', 'Boise Anesthesia PA', 'Joseph', 'C', 'Skinner', 'CRNA', 'Nurse Anesthetist', '', '', NULL, 'B', 'PO Box 4268', 'Portland', 'Multnomah', 'OR', '97208', '8002758752', NULL, 'PO Box 4268', 'Portland', 'Multnomah', 'OR', '97208', '8002758752', '          ', '', '', '', '58.45', '10.00', '0.00', 3, '2011-01-01', '2011-06-30', 1, 15, 0, 'Saint Alphonsus Medical Center Nampa', '', '', '', 'HCFA|UB|', '1356325666', 0, 'Y', 0, '2013-06-28', NULL, NULL, 0, 0, NULL, NULL),
('820200895', 'SACN01034', 'SACN01034', 'SACN', 'Saint Alphonsus Medical Group MHP Family Medicine ', 'Lawrence', 'J', 'Sladich', 'MD', 'Family Practice', '', '', NULL, 'O', '3025 W Cherry Ln Ste B', 'Meridian', 'Ada', 'ID', '83642', '2083678550', '2083678555', '3025 W Cherry Ln Ste B', 'Meridian', 'Ada', 'ID', '83642', '2083678550', '2083678555', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Regional Medical Center', NULL, NULL, NULL, 'HCFA|', '1477598258', 0, 'N', 0, '2012-12-13', NULL, NULL, 43.6188, -116.431, NULL, NULL),
('820477852', 'SACN01035', 'SACN01035', 'SACN', 'Saint Alphonsus Medical Group Cherry Lane', 'Lawrence', 'J', 'Sladich', 'MD', 'Family Practice', '', '', NULL, 'o', '3025 W Cherry Ln Ste B', 'Meridian', 'Ada', 'ID', '83642', '2083678550', '2083678555', '3025 W Cherry Ln Ste B', 'Meridian', 'Ada', 'ID', '83642', '2083678550', '2083678555', 'IDSINCLAIRL', NULL, NULL, '0.00', '15.00', '0.00', 6, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Regional Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1477598258', 0, 'n', 0, '2012-12-13', NULL, NULL, 43.6188, -116.431, NULL, NULL),
('202630141', 'W40013476', 'W40013476', 'IDBOISTD', 'Primary Health Medical Group', 'Janine', 'A', 'Stone', 'MD', 'Family Practice', '', '', NULL, 'O', '10787 W Ustick', 'Boise', 'Ada', 'ID', '83713', '2083788011', '2083228095', '10787 W Ustick', 'Boise', 'Ada', 'ID', '83713', '2083788011', '2083228095', 'IDPRIMARY', 'WUSTDHCPC5', '', '0.00', '30.00', '0.00', 3, '2013-03-01', '2013-04-04', 0, 0, 0, 'Saint Alphonsus Medical Center Nampa', '', '', '', 'HCFA|UB|', '1306948062', 0, 'N', 0, '2013-04-05', NULL, NULL, 43.6338, -116.317, NULL, NULL),
('202630141', 'W40013475', 'W40013475', 'IDBOISTD', 'Primary Health Medical Group', 'Mark', '', 'Stolpe', 'MD', 'Family Practice', '', '', NULL, 'B', '1907 S Broadway Ave Ste 101', 'Boise', 'Ada', 'ID', '83706', '2083451222', '2083451261', '1907 S Broadway Ave Ste 101', 'Boise', 'Ada', 'ID', '83706', '2083451222', '2083451261', 'IDPRIMARY', 'WUSTDHCPC5', '', '0.00', '30.00', '0.00', 3, '2013-03-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1821065368', 0, 'Y', 0, '2013-06-10', NULL, NULL, 43.5896, -116.194, NULL, NULL),
('942854057', 'W12021807', 'W12021807', 'UTIHC01', 'Childrens Justice Center', 'Karen', 'R', 'Stilling', 'APRN', 'Advanced Practice Registered Nurse', '', '', NULL, 'O', '125 S Main St', 'Farmington', 'Davis', 'UT', '84025', '8014513560', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '', '', '', '0.00', '10.00', '0.00', 8, '2012-06-01', NULL, NULL, 0, NULL, 'Primary Childrens Medical Center', '', '', '', 'HCFA|UB|', '1821002262', 0, 'N', 0, '2013-02-28', NULL, NULL, 0, 0, NULL, NULL),
('942938348', 'W40006749', 'W40006749', 'UTMH1', 'Valley Mental Health  Inc', 'MITZY', NULL, 'STEWART', 'APRN', 'Mental Health', '', '', NULL, 'B', '5965 S 900 E Ste 430', 'Salt Lake City', 'Salt Lake', 'UT', '84121', '8012637100', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, 'UTVMHARNP', NULL, NULL, '0.00', '40.00', '0.00', 6, '2013-02-15', NULL, NULL, 0, NULL, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1538147418', 0, 'Y', 0, '2013-02-28', NULL, NULL, 0, 0, NULL, NULL),
('383809303', 'SACN01676', 'SACN01676', 'SACN', 'Treasure Valley Psychological Services', 'Melody', 'L', 'Snider', 'PHD', 'Mental Health', 'Psychology', '', NULL, 'O', '6003 Overland Rd Ste 301', 'Boise', 'Ada', 'ID', '83709', '2086728699', NULL, '6003 Overland Rd Ste 301', 'Boise', 'Ada', 'ID', '83709', '2086728699', '          ', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 3, '2011-01-01', '2012-07-31', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1982734984', 0, 'N', 0, '2012-08-17', NULL, NULL, 0, 0, NULL, NULL),
('820200895', 'SACN00216', 'SACN00216', 'SACN', 'Northwest Pulmonary Saint Alphonsus', 'Margery', '', 'Soni', 'NP-C', 'Nurse Practitioner', '', '', NULL, 'O', '1075 N Curtis Ste 201', 'Boise', 'Ada', 'ID', '83706', '2083678333', NULL, '1075 N Curtis Ste 201', 'Boise', 'Ada', 'ID', '83706', '2083678333', '          ', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', '2012-04-03', 0, 0, 0, 'Saint Alphonsus Medical Center Nampa', '', '', '', 'HCFA|', '1245294529', 0, 'N', 0, '2012-04-03', NULL, NULL, 43.6143, -116.258, NULL, NULL),
('820200895', 'SACN00217', 'SACN00217', 'SACN', 'Northwest Pulmonary Saint Alphonsus', 'Margery', '', 'Soni', 'NP-C', 'Nurse Practitioner', '', '', NULL, 'O', '6140 W Curtisian Ste B10', 'Boise', 'Ada', 'ID', '83704', '2083678333', '2083672003', '6140 W Curtisian Ste B10', 'Boise', 'Ada', 'ID', '83704', '2083678333', '2083672003', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', '2012-04-03', 0, 0, 0, 'Saint Alphonsus Medical Center Nampa', '', '', '', 'HCFA|', '1245294529', 0, 'N', 0, '2012-04-03', NULL, NULL, 43.6151, -116.256, NULL, NULL),
('205934739', 'SACN00897', 'SACN00897', 'SACN', 'Family Medicine Residency of Idaho', 'Toni', '', 'Sparks', 'ARNP', 'Mental Health', 'Psychiatry', '', NULL, 'O', '6094 W Emerald St', 'Boise', 'Ada', 'ID', '83704', '2085142505', '2085142504', '6094 W Emerald St', 'Boise', 'Ada', 'ID', '83704', '2085142505', '2085142504', 'IDSINCLAIRL', 'WUSTDHCPC5', '', '0.00', '15.00', '0.00', 3, '2011-01-01', '2012-04-05', 0, 0, 1, 'Saint Alphonsus Medical Center Nampa', '', '', '', 'HCFA|UB|', '1356454839', 0, 'N', 0, '2013-08-16', NULL, NULL, 0, 0, NULL, NULL),
('205934739', 'SACN00898', 'SACN00898', 'SACN', 'Family Medicine Residency of Idaho', 'Toni', '', 'Sparks', 'ARNP', 'Mental Health', 'Psychiatry', '', NULL, 'O', '777 N Raymond St', 'Boise', 'Ada', 'ID', '83704', '2085142500', '2083752217', '777 N Raymond St', 'Boise', 'Ada', 'ID', '83704', '2085142500', '2083752217', 'IDSINCLAIRL', 'WUSTDHCPC5', '', '0.00', '15.00', '0.00', 3, '2011-01-01', '2012-04-05', 0, 0, 1, 'Saint Alphonsus Medical Center Nampa', '', '', '', 'HCFA|UB|', '1356454839', 0, 'N', 0, '2013-08-16', NULL, NULL, 0, 0, NULL, NULL),
('820475342', 'SACN00899', 'SACN00899', 'SACN', 'All Together Now Inc', 'Toni', '', 'Sparks', 'ARNP', 'Mental Health', 'Psychiatry', '', NULL, 'O', '1111 S Orchard St Ste 650', 'Boise', 'Ada', 'ID', '83705', '2083364504', NULL, '1111 S Orchard St Ste 650', 'Boise', 'Ada', 'ID', '83705', '2083364504', '          ', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', '2013-07-31', 0, 0, 0, 'Saint Alphonsus Medical Center Nampa', '', '', '', 'HCFA|UB|', '1356454839', 0, 'N', 0, '2013-08-16', NULL, NULL, 0, 0, NULL, NULL),
('820475342', 'SACN00900', 'SACN00900', 'SACN', 'All Together Now Inc', 'Toni', '', 'Sparks', 'ARNP', 'Mental Health', 'Psychiatry', '', NULL, 'B', 'PO Box 7786', 'Boise', 'Ada', 'ID', '83707', '2083364504', NULL, 'PO Box 7786', 'Boise', 'Ada', 'ID', '83707', '2083364504', '          ', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', '2013-07-31', 0, 0, 0, 'Saint Alphonsus Medical Center Nampa', '', '', '', 'HCFA|UB|', '1356454839', 0, 'N', 0, '2013-08-16', NULL, NULL, 0, 0, NULL, NULL),
('820482736', 'SACN00355', 'SACN00355', 'SACN', '', 'Kimberly (Kim)', '', 'Spears', 'ARNP', 'Mental Health', 'Psychiatry', '', NULL, 'O', '413 N Allumbaugh Ste 103', 'Boise', 'Ada', 'ID', '83704', '2086580800', NULL, '413 N Allumbaugh Ste 103', 'Boise', 'Ada', 'ID', '83704', '2086580800', '', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', '2012-05-11', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1558564138', 0, 'N', 0, '2014-04-24', NULL, NULL, 0, 0, NULL, NULL),
('202809445', 'SACN01656', 'SACN01656', 'SACN', '', 'Mark', 'A', 'Spelich', 'MD; Jnt Replc/Recon, Genrl, Foot/Ankle, Peds', 'Orthopedic Surgery', '', '', NULL, 'O', '6590 W Norwood Dr', 'Boise', 'Ada', 'ID', '83704', '2088552410', '2088550157', '6590 W Norwood Dr', 'Boise', 'Ada', 'ID', '83704', '2088552410', '2088550157', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 3, '2011-01-01', '2011-06-23', 0, 0, 1, 'Saint Alphonsus Medical Center Nampa', NULL, '', '', 'HCFA|UB|', '1972513083', 0, 'N', 0, '2012-10-18', NULL, NULL, 0, 0, NULL, NULL),
('820487790', 'SACN00262', 'SACN00262', 'SACN', 'Selah Medical Center', 'Stephen', '', 'Spencer', 'MD', 'Internal Medicine', '', '', NULL, 'O', '6565 W Emerald St', 'Boise', 'Ada', 'ID', '83704', '2083775055', NULL, '6565 W Emerald St', 'Boise', 'Ada', 'ID', '83704', '2083775055', '', 'IDSINCLAIRL', 'WUSTDHCPC5', NULL, '0.00', '15.00', '0.00', 3, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Medical Center Nampa', '', '', '', 'HCFA|UB|', '1376548230', 0, 'n', 0, '2011-11-14', NULL, NULL, 43.6119, -116.268, NULL, NULL),
('275429896', 'SACN00652', 'SACN00652', 'SACN', '', 'Dorothy', 'A', 'Spenner', 'LCPC LMFT', 'Mental Health', 'Marriage and Family Therapy', 'Counseling', NULL, 'O', '136 S Academy Ave', 'Eagle', 'Ada', 'ID', '83616', '2088597256', NULL, '136 S Academy Ave', 'Eagle', 'Ada', 'ID', '83616', '2088597256', '          ', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 3, '2011-01-01', '2014-06-01', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1093768756', 0, 'N', 0, '2014-02-13', NULL, NULL, 0, 0, NULL, NULL),
('820200895', 'SACN00955', 'SACN00955', 'SACN', 'Northwest Pulmonary Saint Alphonsus ', 'Suzanne', 'C', 'Spurgeon', 'NP-C', 'Nurse Practitioner', '', '', NULL, 'O', '1075 N Curtis Ste 201', 'Boise', 'Ada', 'ID', '83706', '2083678333', '2083672003', '1075 N Curtis Ste 201', 'Boise', 'Ada', 'ID', '83706', '2083678333', '2083672003', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', '2012-04-03', 0, 0, 0, '', '', '', '', 'HCFA|', '1407898596', 0, 'Y', 0, '2012-04-03', NULL, NULL, 43.6143, -116.258, NULL, NULL),
('820200895', 'SACN00956', 'SACN00956', 'SACN', 'Northwest Pulmonary Saint Alphonsus ', 'Suzanne', 'C', 'Spurgeon', 'NP-C', 'Nurse Practitioner', '', '', NULL, 'O', '6140 W Curtisian Ste B10', 'Boise', 'Ada', 'ID', '83704', '2083678333', '2083672003', '6140 W Curtisian Ste B10', 'Boise', 'Ada', 'ID', '83704', '2083678333', '2083672003', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', '2012-04-03', 0, 0, 0, '', '', '', '', 'HCFA|', '1407898596', 0, 'N', 0, '2012-04-03', NULL, NULL, 43.6151, -116.256, NULL, NULL),
('260455803', 'SACN01371', 'SACN01371', 'SACN', 'Idaho Endocrinology', 'Irinel', '', 'Stanciu', 'MD', 'Endocrinology', '', '', NULL, 'O', '403 S 11th St Ste 100', 'Boise', 'Ada', 'ID', '83702', '2084290300', '2084290305', '403 S 11th St Ste 100', 'Boise', 'Ada', 'ID', '83702', '2084290300', '2084290305', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 3, '2011-01-01', '2012-06-11', 0, 0, 1, 'Saint Alphonsus Medical Center Nampa', '', '', '', 'HCFA|UB|', '1720068760', 0, 'N', 0, '2013-10-16', NULL, NULL, 0, 0, NULL, NULL),
('820161600', 'SACN01372', 'SACN01372', 'SACN', 'Idaho Endocrinology', 'Irinel', '', 'Stanciu', 'MD', 'Endocrinology', '', '', NULL, 'O', '403 S 11th St Ste 100', 'Boise', 'Ada', 'ID', '83702', '2084290300', '2084290305', '403 S 11th St Ste 100', 'Boise', 'Ada', 'ID', '83702', '2084290300', '2084290305', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 8, '2011-01-01', '2012-06-11', 0, 0, 1, 'Saint Alphonsus Medical Center Nampa', '', '', '', 'HCFA|UB|', '1720068760', 0, 'N', 0, '2013-10-16', NULL, NULL, 0, 0, NULL, NULL),
('820200895', 'SACN01685', 'SACN01685', 'SACN', 'Saint Alphonsus Medical Group Elm Family Medicine', 'Carl', 'W', 'Steinmann', 'PA-C', 'Physician Assistant', '', '', NULL, 'O', '315 E Elm St Ste 100', 'Caldwell', 'Canyon', 'ID', '83605', '2084597415', '2084533307', '315 E Elm Ste 100', 'Caldwell', 'Canyon', 'ID', '83605', '2084597415', '2084533307', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', NULL, 0, 0, 0, 'West Valley Medical Center', NULL, NULL, NULL, 'HCFA|', '1992994776', 0, 'N', 0, '2011-06-29', NULL, NULL, 43.6539, -116.695, NULL, NULL),
('201773062', 'W40016027', 'W40016027', 'ID01', 'Access Behavioral Health Services Inc', 'Lindsey', '', 'Stenshoel', 'FNP', 'Mental Health', '', '', NULL, 'O', '3307 Caldwell Blvd Ste 104', 'Nampa', 'Canyon', 'ID', '83651', '2084654833', '2083384699', '3307 Caldwell Blvd Ste 104', 'Nampa', 'Canyon', 'ID', '83651', '2084654833', '2083384699', 'IDSTD', 'WUSTDHCPC5', '', '0.00', '40.00', '0.00', 3, '2013-02-15', '2014-06-23', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1902185168', 0, 'N', 0, '2014-04-24', NULL, NULL, 43.6156, -116.618, NULL, NULL),
('820496280', 'SACN00663', 'SACN00663', 'SACN', 'Dermatology Clinic of ID', 'James', 'H', 'Stewart', 'MD PHD', 'Dermatology', '', '', NULL, 'O', '271 Duffers Ln', 'Cascade', 'Valley', 'ID', '83611', '2083764776', NULL, '271 Duffers Ln', 'Cascade', 'Valley', 'ID', '83611', '2083764776', '          ', 'IDSINCLAIRL', 'WUSTDHCPC5', '', '0.00', '15.00', '0.00', 3, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Regional Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1104870567', 0, 'N', 0, '2012-10-15', NULL, NULL, 44.5085, -116.058, NULL, NULL),
('820496280', 'SACN00664', 'SACN00664', 'SACN', 'Dermatology Clinic of ID', 'James', 'H', 'Stewart', 'MD PHD', 'Dermatology', '', '', NULL, 'O', '661 S Rivershore Ln Ste 130', 'Eagle', 'Ada', 'ID', '83616', '2089394599', NULL, '661 S Rivershore Ln Ste 130', 'Eagle', 'Ada', 'ID', '83616', '2089394599', '          ', 'IDSINCLAIRL', 'WUSTDHCPC5', '', '0.00', '15.00', '0.00', 3, '2011-01-01', '2014-05-05', 0, 0, 0, 'Saint Alphonsus Regional Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1104870567', 0, 'N', 0, '2014-03-12', NULL, NULL, 43.6886, -116.356, NULL, NULL),
('820496280', 'SACN00665', 'SACN00665', 'SACN', 'Dermatology Clinic of ID', 'James', 'H', 'Stewart', 'MD PHD', 'Dermatology', '', '', NULL, 'O', '7733 W Emerald', 'Boise', 'Ada', 'ID', '83704', '2083764776', NULL, '7733 W Emerald', 'Boise', 'Ada', 'ID', '83704', '2083764776', '', 'IDSINCLAIRL', 'WUSTDHCPC5', NULL, '0.00', '15.00', '0.00', 3, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Regional Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1104870567', 0, 'n', 0, '2012-10-15', NULL, NULL, 43.6127, -116.278, NULL, NULL),
('820200895', 'SACN01332', 'SACN01332', 'SACN', 'Saint Alphonsus Medical Group Family Medicine Dominican', 'Jenifer', '', 'Stewart Greene', 'NP-C', 'Family Practice', '', '', NULL, 'M', '1118 Nw 16th St Ste A', 'Fruitland', 'Payette', 'ID', '83619', '2084526851', '2084522140', '1118 Nw 16th St Ste A', 'Fruitland', 'Payette', 'ID', '83619', '2084526851', '2084522140', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Regional Medical Center', '', '', '', 'HCFA|', '1679892335', 0, 'N', 0, '2014-06-13', NULL, NULL, 44.025, -116.928, NULL, NULL),
('820200895', 'SACN01333', 'SACN01333', 'SACN', 'Saint Alphonsus Medical Group Garrity Family Medicine', 'Jenifer', '', 'Stewart Greene', 'NP-C', 'Family Practice', '', '', NULL, 'O', '1200 Garrity Blvd', 'Nampa', 'Canyon', 'ID', '83687', '2084669092', '2084665322', '1200 Garrity Blvd', 'Nampa', 'Canyon', 'ID', '83687', '2084669092', '2084665322', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Regional Medical Center', '', '', '', 'HCFA|', '1679892335', 0, 'N', 0, '2014-06-13', NULL, NULL, 43.587, -116.549, NULL, NULL),
('820200895', 'SACN01334', 'SACN01334', 'SACN', 'Saint Alphonsus Medical Group MHP Family Medicine', 'Jenifer', '', 'Stewart Greene', 'NP-C', 'Family Practice', '', '', NULL, 'O', '3025 W Cherry Ln Ste B', 'Meridian', 'Ada', 'ID', '83642', '2083678550', '2083678555', '3025 W Cherry Ln Ste B', 'Meridian', 'Ada', 'ID', '83642', '2083678550', '2083678555', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Regional Medical Center', '', '', '', 'HCFA|', '1679892335', 0, 'N', 0, '2014-06-13', NULL, NULL, 43.6188, -116.431, NULL, NULL),
('820200895', 'SACN01335', 'SACN01335', 'SACN', 'Saint Alphonsus Medical Group Elm Family Medicine', 'Jenifer', '', 'Stewart Greene', 'NP-C', 'Family Practice', '', '', NULL, 'O', '315 E Elm St Ste 100', 'Caldwell', 'Canyon', 'ID', '83605', '2084597415', '2084533307', '315 E Elm St Ste 100', 'Caldwell', 'Canyon', 'ID', '83605', '2084597415', '2084533307', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Regional Medical Center', '', '', '', 'HCFA|', '1679892335', 0, 'N', 0, '2014-06-13', NULL, NULL, 43.6539, -116.695, NULL, NULL),
('820200895', 'SACN01336', 'SACN01336', 'SACN', 'Saint Alphonsus Medical Group Emerald Family Medicine', 'Jenifer', '', 'Stewart Greene', 'NP-C', 'Family Practice', '', '', NULL, 'O', '6533 Emerald St', 'Boise', 'Ada', 'ID', '83704', '2083674170', '2083678135', '6533 Emerald St', 'Boise', 'Ada', 'ID', '83704', '2083674170', '2083678135', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Regional Medical Center', '', '', '', 'HCFA|', '1679892335', 0, 'N', 0, '2014-06-13', NULL, NULL, 43.6119, -116.268, NULL, NULL),
('460500210', 'SACN01125', 'SACN01125', 'SACN', 'Saint Alphonsus Trauma Physician Services', 'Harry', 'K', 'Stinger', 'MD', 'General Surgery', '', '', NULL, 'O', '1055 N Curtis', 'Boise', 'Ada', 'ID', '83706', '2083672121', '2083673174', '1055 N Curtis', 'Boise', 'Ada', 'ID', '83706', '2083672121', '2083673174', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Regional Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1518935055', 0, 'N', 0, '2013-11-22', NULL, NULL, 43.6127, -116.254, NULL, NULL),
('460500210', 'SACN01126', 'SACN01126', 'SACN', 'Saint Alphonsus Trauma Physician Services', 'Harry', 'K', 'Stinger', 'MD', 'General Surgery', '', '', NULL, 'O', '901 N Curtis Rd Ste 401', 'Boise', 'Ada', 'ID', '83706', '2083677676', '2083676849', '901 N Curtis Rd Ste 401', 'Boise', 'Ada', 'ID', '83706', '2083677676', '2083676849', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Regional Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1518935055', 0, 'N', 0, '2013-11-22', NULL, NULL, 43.6126, -116.255, NULL, NULL),
('460500210', 'SACN01127', 'SACN01127', 'SACN', 'Saint Alphonsus Trauma Physician Services', 'Harry', 'K', 'Stinger', 'MD', 'General Surgery', '', '', NULL, 'B', 'PO Box 9589', 'Boise', 'Ada', 'ID', '83707', '2084728111', '2083673174', 'PO Box 9589', 'Boise', 'Ada', 'ID', '83707', '2084728111', '2083673174', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Regional Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1518935055', 0, 'N', 0, '2013-11-22', NULL, NULL, 0, 0, NULL, NULL),
('260553931', 'SACN01251', 'SACN01251', 'SACN', 'Saint Alphonsus Medical Group Heart Care Emmett', 'Donald', 'K', 'Stott', 'MD', 'Cardiology', '', '', NULL, 'O', '1202 E Locust Dr', 'Emmett', 'Gem', 'ID', '83617', '2083653561', NULL, '1202 E Locust Dr', 'Emmett', 'Gem', 'ID', '83617', '2083653561', '', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Regional Medical Center', '', '', '', 'HCFA|UB|', '1649264003', 0, 'Y', 0, '2014-07-09', NULL, NULL, 43.8791, -116.485, 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
('260553931', 'SACN01252', 'SACN01252', 'SACN', 'Saint Alphonsus Medical Group Heart Care Meridian', 'Donald', 'K', 'Stott', 'MD', 'Cardiology', '', '', NULL, 'O', '3025 W Cherry Ln Ste 205', 'Meridian', 'Ada', 'ID', '83642', '2083678484', '2083678456', '3025 W Cherry Ln Ste 205', 'Meridian', 'Ada', 'ID', '83642', '2083678484', '2083678456', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Regional Medical Center', '', '', '', 'HCFA|UB|', '1649264003', 0, 'N', 0, '2014-07-09', NULL, NULL, 43.6188, -116.431, NULL, NULL),
('260553931', 'SACN01253', 'SACN01253', 'SACN', 'Saint Alphonsus Specialty Services, Inc', 'Donald', 'K', 'Stott', 'MD', 'Cardiology', '', '', NULL, 'O', '315 E Elm St Ste 100', 'Caldwell', 'Canyon', 'ID', '83605', '2083674278', '2083675200', '315 E Elm St Ste 100', 'Caldwell', 'Canyon', 'ID', '83605', '2083674278', '2083675200', 'IDSINCLAIRL', NULL, '', '0.00', '15.00', '0.00', 6, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Regional Medical Center', '', '', '', 'HCFA|UB|', '1649264003', 0, 'Y', 0, '2014-07-09', NULL, NULL, 43.6539, -116.695, NULL, NULL),
('331078261', 'SACN01254', 'SACN01254', 'SACN', 'Walter Knox Memorial Hospital', 'Donald', 'K', 'Stott', 'MD', 'Cardiology', '', '', NULL, 'o', '1202 E Locust Dr', 'Emmett', 'Gem', 'ID', '83617', '2083653561', '0', '1202 E Locust Dr', 'Emmett', 'Gem', 'ID', '83617', '2083653561', '0', 'IDSINCLAIRL', NULL, '', '0.00', '15.00', '0.00', 3, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Regional Medical Center', '', '', '', 'HCFA|UB|', '1649264003', 0, 'n', 0, '2014-07-09', NULL, NULL, 43.8791, -116.485, NULL, NULL),
('331078261', 'SACN01255', 'SACN01255', 'SACN', 'Saint Alphonsus Physicians PA', 'Donald', 'K', 'Stott', 'MD', 'Cardiology', '', '', NULL, 'o', '3025 W Cherry Ln Ste 205', 'Meridian', 'Ada', 'ID', '83642', '2083678484', '2083678456', '3025 W Cherry Ln Ste 205', 'Meridian', 'Ada', 'ID', '83642', '2083678484', '2083678456', 'IDSINCLAIRL', NULL, '', '0.00', '15.00', '0.00', 3, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Regional Medical Center', '', '', '', 'HCFA|UB|', '1649264003', 0, 'n', 0, '2014-07-09', NULL, NULL, 43.6188, -116.431, NULL, NULL),
('331078261', 'SACN01256', 'SACN01256', 'SACN', 'Saint Alphonsus Physicians PA', 'Donald', 'K', 'Stott', 'MD', 'Cardiology', '', '', NULL, 'O', '315 E Elm St Ste 100', 'Caldwell', 'Canyon', 'ID', '83605', '2083674278', '2083675200', '315 E Elm St Ste 100', 'Caldwell', 'Canyon', 'ID', '83605', '2083674278', '2083675200', 'IDSINCLAIRL', NULL, '', '0.00', '15.00', '0.00', 3, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Regional Medical Center', '', '', '', 'HCFA|UB|', '1649264003', 0, 'y', 0, '2014-07-09', NULL, NULL, 43.6539, -116.695, NULL, NULL),
('820200895', 'SACN01257', 'SACN01257', 'SACN', NULL, 'Donald', 'K', 'Stott', 'MD', 'Cardiology', '', '', NULL, 'O', '1055 N Curtis', 'Boise', 'Ada', 'ID', '83706', '2083672121', NULL, '1055 N Curtis', 'Boise', 'Ada', 'ID', '83706', '2083672121', '', 'IDSINCLAIRL', NULL, '', '0.00', '15.00', '0.00', 6, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Regional Medical Center', '', '', '', 'HCFA|', '1649264003', 0, 'Y', 0, '2014-07-09', NULL, NULL, 43.6127, -116.254, NULL, NULL),
('820200895', 'SACN01258', 'SACN01258', 'SACN', NULL, 'Donald', 'K', 'Stott', 'MD', 'Cardiology', '', '', NULL, 'B', 'PO Box 190930', 'Boise', 'Ada', 'ID', '83719', '2083672130', NULL, 'PO Box 190930', 'Boise', 'Ada', 'ID', '83719', '2083672130', '', 'IDSINCLAIRL', NULL, '', '0.00', '15.00', '0.00', 6, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Regional Medical Center', '', '', '', 'HCFA|', '1649264003', 0, 'Y', 0, '2014-07-09', NULL, NULL, 0, 0, NULL, NULL),
('820200895', 'SACN01367', 'SACN01367', 'SACN', 'Saint Alphonsus Medical Group Elm Family Medicine', 'Patrick', 'D', 'Stowell', 'MD', 'Family Practice', '', '', NULL, 'O', '315 E Elm St Ste 100', 'Caldwell', 'Canyon', 'ID', '83605', '2084597415', '2084533307', '315 E Elm St Ste 100', 'Caldwell', 'Canyon', 'ID', '83605', '2084597415', '2084533307', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', '2011-12-31', 0, 0, 0, 'Saint Alphonsus Medical Center Nampa', '', '', '', 'HCFA|', '1720022239', 0, 'N', 0, '2014-02-11', NULL, NULL, 43.6539, -116.695, NULL, NULL),
('820477852', 'SACN01368', 'SACN01368', 'SACN', 'Saint Alphonsus Medical Group Elm Family Medicine', 'Patrick', 'D', 'Stowell', 'MD', 'Family Practice', '', '', NULL, 'o', '315 E Elm St Ste 100', 'Caldwell', 'Canyon', 'ID', '83605', '2084593621', '2084545107', '315 E Elm St Ste 100', 'Caldwell', 'Canyon', 'ID', '83605', '2084593621', '2084545107', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', '2012-11-30', 0, 0, 0, 'Saint Alphonsus Medical Center Nampa', '', '', '', 'HCFA|UB|', '1720022239', 0, 'N', 0, '2014-02-11', NULL, NULL, 43.6539, -116.695, NULL, NULL),
('460500210', 'SACN01117', 'SACN01117', 'SACN', 'Saint Alphonsus Trauma Physician Services', 'Dale', '', 'Strawn', 'MD', 'General Surgery', '', '', NULL, 'O', '1055 N Curtis', 'Boise', 'Ada', 'ID', '83706', '2083677676', '2083676849', '1055 N Curtis', 'Boise', 'Ada', 'ID', '83706', '2083677676', '2083676849', 'IDSINCLAIRL', NULL, NULL, '0.00', '15.00', '0.00', 6, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Regional Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1518059427', 0, 'N', 0, '2013-11-22', NULL, NULL, 43.6127, -116.254, NULL, NULL),
('460500210', 'SACN01118', 'SACN01118', 'SACN', 'Saint Alphonsus Outpatient Trauma Services', 'Dale', '', 'Strawn', 'MD', 'General Surgery', '', '', NULL, 'O', '901 N Curtis Rd Ste 401', 'Boise', 'Ada', 'ID', '83706', '2083677676', '2083676849', '901 N Curtis Rd Ste 401', 'Boise', 'Ada', 'ID', '83706', '2083677676', '2083676849', 'IDSINCLAIRL', NULL, NULL, '0.00', '15.00', '0.00', 6, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Regional Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1518059427', 0, 'N', 0, '2013-11-22', NULL, NULL, 43.6126, -116.255, NULL, NULL),
('201773062', 'W40016026', 'W40016026', 'ID01', 'Access Behavioral Health Services Inc', 'Lindsey', '', 'Stenshoel', 'FNP', 'Mental Health', '', '', NULL, 'O', '1276 River St Ste 100', 'Boise', 'Ada', 'ID', '83702', '2083384699', '2083384699', '1276 River St Ste 100', 'Boise', 'Ada', 'ID', '83702', '2083384699', '2083384699', 'IDSTD', 'WUSTDHCPC5', '', '0.00', '40.00', '0.00', 3, '2013-02-15', '2014-06-23', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1902185168', 0, 'N', 0, '2014-04-24', NULL, NULL, 43.6149, -116.215, NULL, NULL),
('820477852', 'SACN01686', 'SACN01686', 'SACN', 'Saint Alphonsus Medical Group Elm Family Medicine', 'Carl', 'W', 'Steinmann', 'PA-C', 'Physician Assistant', '', '', NULL, 'B', '315 E Elm St Ste 100', 'Caldwell', 'Canyon', 'ID', '83605', '2084597415', '2084545107', '315 E Elm St Ste 100', 'Caldwell', 'Canyon', 'ID', '83605', '2084597415', '2084545107', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', NULL, 0, 0, 0, 'West Valley Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1992994776', 0, 'Y', 0, '2014-01-23', NULL, NULL, 43.6539, -116.695, NULL, NULL),
('942938348', 'W40006898', 'W40006898', 'UTMH1', 'Valley Mental Health  Inc', 'NAOMI J', '', 'SPENCER', 'LPC', 'Mental Health', 'Counseling', '', NULL, 'B', '5965 S 900 E Ste 430', 'Salt Lake City', 'Salt Lake', 'UT', '84121', '8012637100', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, 'UTVMHMA', NULL, NULL, '0.00', '40.00', '0.00', 6, '2013-02-15', NULL, NULL, 0, NULL, '', '', '', '', 'HCFA|UB|', '1720261324', 0, 'Y', 0, '2013-02-28', NULL, NULL, 0, 0, NULL, NULL),
('205506855', 'SACN00233', 'SACN00233', 'SACN', 'Northwest Radiation Oncology', 'Jennifer', 'L', 'Suida', 'NP', 'Radiation Oncology', 'Hematology and Oncology', '', NULL, 'O', '1055 N Curtis', 'Boise', 'Ada', 'ID', '83706', '2083673131', NULL, '1055 N Curtis', 'Boise', 'Ada', 'ID', '83706', '2083673131', '', 'IDSINCLAIRL', 'WUSTDHCPC5', NULL, '0.00', '15.00', '0.00', 3, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Medical Center Nampa', '', '', '', 'HCFA|UB|', '1316046972', 0, 'N', 0, '2013-01-04', NULL, NULL, 43.6127, -116.254, NULL, NULL),
('205506855', 'SACN00234', 'SACN00234', 'SACN', 'Northwest Radiation Oncology', 'Jennifer', 'L', 'Suida', 'NP', 'Radiation Oncology', 'Hematology and Oncology', '', NULL, 'O', '2855 E Magic View Dr', 'Meridian', 'Ada', 'ID', '83642', '2086394900', NULL, '2855 E Magic View Dr', 'Meridian', 'Ada', 'ID', '83642', '2086394900', '', 'IDSINCLAIRL', 'WUSTDHCPC5', NULL, '0.00', '15.00', '0.00', 3, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Medical Center Nampa', '', '', '', 'HCFA|UB|', '1316046972', 0, 'N', 0, '2013-01-04', NULL, NULL, 43.599, -116.36, NULL, NULL),
('205506855', 'SACN00235', 'SACN00235', 'SACN', 'Northwest Radiation Oncology', 'Jennifer', 'L', 'Suida', 'NP', 'Radiation Oncology', 'Hematology and Oncology', '', NULL, 'O', '3123 Commercial Way', 'Caldwell', 'Canyon', 'ID', '83605', '2084532033', NULL, '3123 Commercial Way', 'Caldwell', 'Canyon', 'ID', '83605', '2084532033', '', 'IDSINCLAIRL', 'WUSTDHCPC5', NULL, '0.00', '15.00', '0.00', 3, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Medical Center Nampa', '', '', '', 'HCFA|UB|', '1316046972', 0, 'N', 0, '2013-01-04', NULL, NULL, 43.6591, -116.658, NULL, NULL),
('205506855', 'SACN00236', 'SACN00236', 'SACN', 'Northwest Radiation Oncology', 'Jennifer', 'L', 'Suida', 'NP', 'Radiation Oncology', 'Hematology and Oncology', '', NULL, 'B', 'PO Box 5145', 'Boise', 'Ada', 'ID', '83706', '2083673131', NULL, 'PO Box 5145', 'Boise', 'Ada', 'ID', '83706', '2083673131', '', 'IDSINCLAIRL', 'WUSTDHCPC5', NULL, '0.00', '15.00', '0.00', 3, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Medical Center Nampa', '', '', '', 'HCFA|UB|', '1316046972', 0, 'y', 0, '2013-01-04', NULL, NULL, 0, 0, NULL, NULL),
('820425454', 'SACN00030', 'SACN00030', 'SACN', 'Boise Anesthesia, PA', 'Michael', 'J', 'Suida', 'CRNA', 'Nurse Anesthetist', '', '', NULL, 'o', '1055 N Curtis Rd', 'Boise', 'Ada', 'ID', '83706', '2083676416', '2083759530', '1055 N Curtis Rd', 'Boise', 'Ada', 'ID', '83706', '2083676416', '2083759530', '', '', '', '58.45', '10.00', '0.00', 3, '2011-01-01', NULL, 1, 15, 0, '', '', '', '', 'HCFA|UB|', '1407802127', 0, 'N', 0, '2012-11-01', NULL, NULL, 43.6127, -116.254, NULL, NULL),
('820425454', 'SACN00031', 'SACN00031', 'SACN', 'Boise Anesthesia, PA', 'Michael', 'J', 'Suida', 'CRNA', 'Nurse Anesthetist', '', '', NULL, 'o', '1717 Arlington Ave', 'Caldwell', 'Canyon', 'ID', '83605', '2084594641', NULL, '1717 Arlington Ave', 'Caldwell', 'Canyon', 'ID', '83605', '2084594641', '0         ', '', '', '', '58.45', '10.00', '0.00', 3, '2011-01-01', NULL, 1, 15, 0, '', '', '', '', 'HCFA|UB|', '1407802127', 0, 'N', 0, '2012-11-01', NULL, NULL, 0, 0, NULL, NULL),
('820200895', 'SACN01248', 'SACN01248', 'SACN', 'Saint Alphonsus Medical Group Elm Family Medicine', 'Samuel', 'M', 'Summers', 'MD', 'Family Practice', '', '', NULL, 'O', '315 E Elm St Ste 100', 'Caldwell', 'Canyon', 'ID', '83605', '2084597415', '2084533307', '315 E Elm St Ste 100', 'Caldwell', 'Canyon', 'ID', '83605', '2084597415', '2084533307', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', NULL, 0, 0, 0, 'West Valley Medical Center', '', '', '', 'HCFA|', '1649216805', 0, 'N', 0, '2014-06-20', NULL, NULL, 43.6539, -116.695, NULL, NULL),
('820477852', 'SACN01249', 'SACN01249', 'SACN', 'Saint Alphonsus Medical Group Elm Family Medicine', 'Samuel', 'M', 'Summers', 'MD', 'Family Practice', '', '', NULL, 'o', '315 E Elm St Ste 100', 'Caldwell', 'Canyon', 'ID', '83605', '2084597415', '2084545107', '315 E Elm St Ste 100', 'Caldwell', 'Canyon', 'ID', '83605', '2084597415', '2084545107', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', NULL, 0, 0, 0, 'West Valley Medical Center', '', '', '', 'HCFA|UB|', '1649216805', 0, 'N', 0, '2014-06-20', NULL, NULL, 43.6539, -116.695, NULL, NULL),
('820200895', 'SACN00864', 'SACN00864', 'SACN', 'Saint Alphonsus Regional Medical Center (this is a reading p', 'Kathleen', 'R', 'Sutherland', 'MD', 'Pulmonary', '', '', NULL, 'B', '1055 N Curtis', 'Boise', 'Ada', 'ID', '83706', '2083673722', '0', '1055 N Curtis', 'Boise', 'Ada', 'ID', '83706', '2083673722', '0', 'IDSINCLAIRL', NULL, '', '0.00', '15.00', '0.00', 6, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Regional Medical Center', '', '', '', 'HCFA|', '1326186115', 0, 'n', 0, '2014-06-20', NULL, NULL, 43.6127, -116.254, NULL, NULL),
('820200895', 'SACN00865', 'SACN00865', 'SACN', 'Saint Alphonsus Medical Group Pulmonary & Sleep Boise ', 'Kathleen', 'R', 'Sutherland', 'MD', 'Pulmonary', '', '', NULL, 'O', '1075 N Curtis Ste 201', 'Boise', 'Ada', 'ID', '83706', '2083678333', '2083672003', '1075 N Curtis Ste 201', 'Boise', 'Ada', 'ID', '83706', '2083678333', '2083672003', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Regional Medical Center', '', '', '', 'HCFA|', '1326186115', 0, 'N', 0, '2014-06-20', NULL, NULL, 43.6143, -116.258, NULL, NULL),
('820200895', 'SACN00866', 'SACN00866', 'SACN', 'Saint Alphonsus Medical Group Pulmonary & Sleep Boise ', 'Kathleen', 'R', 'Sutherland', 'MD', 'Pulmonary', '', '', NULL, 'O', '6140 W Curtisian Ste B10', 'Boise', 'Ada', 'ID', '83704', '2083678333', '2083672003', '6140 W Curtisian Ste B10', 'Boise', 'Ada', 'ID', '83704', '2083678333', '2083672003', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Regional Medical Center', '', '', '', 'HCFA|', '1326186115', 0, 'N', 0, '2014-06-20', NULL, NULL, 43.6151, -116.256, NULL, NULL),
('820477852', 'SACN00214', 'SACN00214', 'SACN', 'Saint Alphonsus Medical Group Occupational Medicine Associat', 'Ralph', 'M', 'Sutherlin', 'MD', 'Occupational Therapy', '', '', NULL, 'O', '1200 Garrity Blvd', 'Nampa', 'Canyon', 'ID', '83687', '2084669092', '2084665322', '1200 Garrity Blvd', 'Nampa', 'Canyon', 'ID', '83687', '2084669092', '2084665322', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', '2012-04-03', 0, 0, 0, 'Saint Alphonsus Regional Medical Center', '', '', '', 'HCFA|UB|', '1245291772', 0, 'N', 0, '2012-04-03', NULL, NULL, 43.587, -116.549, NULL, NULL),
('820477852', 'SACN00215', 'SACN00215', 'SACN', 'Saint Alphonsus Medical Group Occupational Medicine Associat', 'Ralph', 'M', 'Sutherlin', 'MD', 'Occupational Therapy', '', '', NULL, 'O', '3025 W Cherry Ln Ste B', 'Meridian', 'Ada', 'ID', '83642', '2083678550', '2083678555', '3025 W Cherry Ln Ste B', 'Meridian', 'Ada', 'ID', '83642', '2083678550', '2083678555', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', '2012-04-03', 0, 0, 0, 'Saint Alphonsus Regional Medical Center', '', '', '', 'HCFA|UB|', '1245291772', 0, 'N', 0, '2012-04-03', NULL, NULL, 43.6188, -116.431, NULL, NULL),
('820161600', 'SACN00310', 'SACN00310', 'SACN', 'Boise Orthopedic Clinic', 'K Russell', '', 'Swainston', 'This Provider will terminate on July 1st', 'Orthopedic Surgery', '', '', NULL, 'O', '520 S Eagle Rd Ste 3213', 'Meridian', 'Ada', 'ID', '83642', '2088980100', NULL, '520 S Eagle Rd Ste 3213', 'Meridian', 'Ada', 'ID', '83642', '2088980100', '          ', 'IDSINCLAIRL', 'WUSTDHCPC5', '', '0.00', '15.00', '0.00', 8, '2011-01-01', '2012-07-01', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1437143161', 0, 'N', 0, '2012-05-31', NULL, NULL, 43.5995, -116.352, NULL, NULL),
('820161600', 'SACN00311', 'SACN00311', 'SACN', 'Boise Orthopedic Clinic', 'K Russell', '', 'Swainston', 'This Provider will terminate on July 1st', 'Orthopedic Surgery', '', '', NULL, 'O', '703 S Americana Blvd Ste 120', 'Boise', 'Ada', 'ID', '83702', '2083232600', NULL, '703 S Americana Blvd Ste 120', 'Boise', 'Ada', 'ID', '83702', '2083232600', '          ', 'IDSINCLAIRL', 'WUSTDHCPC5', '', '0.00', '15.00', '0.00', 8, '2011-01-01', '2012-07-01', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1437143161', 0, 'N', 0, '2012-05-31', NULL, NULL, 0, 0, NULL, NULL),
('820200895', 'SACN00568', 'SACN00568', 'SACN', 'St Alphonsus Regional Medical Center', 'Joel', 'C', 'Swanson', 'MD', 'Internal Medicine', 'Hospitalist', '', NULL, 'o', '1055 N Curtis Rd', 'Boise', 'Ada', 'ID', '83706', '2083676279', '2083675180', '1055 N Curtis Rd', 'Boise', 'Ada', 'ID', '83706', '2083676279', '2083675180', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', '2011-12-31', 0, 0, 0, 'Saint Alphonsus Regional Medical Center', '', '', '', 'HCFA|', '1013956705', 0, 'N', 0, '2014-06-20', NULL, NULL, 43.6127, -116.254, NULL, NULL),
('820200895', 'SACN00570', 'SACN00570', 'SACN', 'St Alphonsus Regional Medical Center', 'Joel', 'C', 'Swanson', 'MD', 'Internal Medicine', 'Hospitalist', '', NULL, 'O', '323 E Riverside Dr Ste 224', 'Eagle', 'Ada', 'ID', '83616', '2083675750', '2083675765', '323 E Riverside Dr Ste 224', 'Eagle', 'Ada', 'ID', '83616', '2083675750', '2083675765', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Regional Medical Center', '', '', '', 'HCFA|', '1013956705', 0, 'N', 0, '2014-06-20', NULL, NULL, 43.6892, -116.351, NULL, NULL),
('820477852', 'SACN00571', 'SACN00571', 'SACN', 'St Alphonsus Regional Medical Center', 'Joel', 'C', 'Swanson', 'MD', 'Internal Medicine', 'Hospitalist', '', NULL, 'o', '323 E Riverside Dr Ste 224', 'Eagle', 'Ada', 'ID', '83616', '2083675750', '2083675765', '323 E Riverside Dr Ste 224', 'Eagle', 'Ada', 'ID', '83616', '2083675750', '2083675765', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Regional Medical Center', '', '', '', 'HCFA|UB|', '1013956705', 0, 'N', 0, '2014-06-20', NULL, NULL, 43.6892, -116.351, NULL, NULL),
('820482491', 'SACN00542', 'SACN00542', 'SACN', 'Intermountain Eye & Laser Centers', 'James', 'R', 'Swartley', 'MD', 'Ophthalmology', '', '', NULL, 'O', '222 N 2nd Ste 215', 'Boise', 'Ada', 'ID', '83702', '2083422706', '2083362278', '222 N 2nd Ste 215', 'Boise', 'Ada', 'ID', '83702', '2083422706', '2083362278', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 3, '2011-01-01', '2013-08-07', 0, 0, 1, 'Saint Alphonsus Medical Center Nampa', NULL, '', '', 'HCFA|UB|', '1003861253', 0, 'N', 0, '2013-08-23', NULL, NULL, 43.6131, -116.195, NULL, NULL),
('820482491', 'SACN00543', 'SACN00543', 'SACN', 'Intermountain Eye & Laser Centers', 'James', 'R', 'Swartley', 'MD', 'Ophthalmology', '', '', NULL, 'B', '6063 Corporal Ln', 'Boise', 'Ada', 'ID', '83704', '2083758799', '2083758798', '6063 Corporal Ln', 'Boise', 'Ada', 'ID', '83704', '2083758799', '2083758798', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 3, '2011-01-01', '2011-08-14', 0, 0, 1, 'Saint Alphonsus Medical Center Nampa', NULL, '', '', 'HCFA|UB|', '1003861253', 0, 'Y', 0, '2013-08-23', NULL, NULL, 0, 0, NULL, NULL),
('460500210', 'SACN00921', 'SACN00921', 'SACN', 'Saint Alphonsus Oncology Physician Services', 'Holly', '', 'Swensen', 'NP', 'Hematology and Oncology', 'Oncology', '', NULL, 'O', '1055 N Curtis', 'Boise', 'Ada', 'ID', '83706', '2083673131', '2083673174', '1055 N Curtis', 'Boise', 'Ada', 'ID', '83706', '2083673131', '2083673174', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', '2013-04-30', 0, 0, 0, 'Saint Alphonsus Regional Medical Center', '', '', '', 'HCFA|UB|', '1386672012', 0, 'Y', 0, '2014-06-20', NULL, NULL, 43.6127, -116.254, NULL, NULL),
('460500210', 'SACN00922', 'SACN00922', 'SACN', 'Saint Alphonsus Oncology Physician Services', 'Holly', '', 'Swensen', 'NP', 'Hematology and Oncology', 'Oncology', '', NULL, 'O', '1202 E Locust', 'Emmett', 'Gem', 'ID', '83617', '2083653561', '0         ', '1202 E Locust', 'Emmett', 'Gem', 'ID', '83617', '2083653561', '0         ', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', '2013-04-30', 0, 0, 0, 'Saint Alphonsus Regional Medical Center', '', '', '', 'HCFA|UB|', '1386672012', 0, 'N', 0, '2014-06-20', NULL, NULL, 43.8791, -116.485, NULL, NULL),
('460500210', 'SACN00923', 'SACN00923', 'SACN', 'Saint Alphonsus Oncology Physician Services', 'Holly', '', 'Swensen', 'NP', 'Hematology and Oncology', 'Oncology', '', NULL, 'O', '3123 Medical Dr', 'Caldwell', 'Canyon', 'ID', '83605', '2083674810', '2083674817', '3123 Medical Dr', 'Caldwell', 'Canyon', 'ID', '83605', '2083674810', '2083674817', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', '2013-04-30', 0, 0, 0, 'Saint Alphonsus Regional Medical Center', '', '', '', 'HCFA|UB|', '1386672012', 0, 'N', 0, '2014-06-20', NULL, NULL, 43.6596, -116.658, NULL, NULL),
('260553931', 'SACN00712', 'SACN00712', 'SACN', 'Saint Alphonsus Medical Group Vascular Services Boise 102', 'Jeffrey', 'B', 'Symmonds', 'MD', 'Cardiovascular Disease', 'Vascular Surgery', '', NULL, 'O', '6140 W Curtisian Ste 102', 'Boise', 'Ada', 'ID', '83704', '2083677787', '2083675200', '6140 W Curtisian Ste 102', 'Boise', 'Ada', 'ID', '83704', '2083677787', '2083675200', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Medical Center Nampa', '', '', '', 'HCFA|UB|', '1154370328', 0, 'N', 0, '2014-07-09', NULL, NULL, 43.6151, -116.256, NULL, NULL),
('820200895', 'SACN00713', 'SACN00713', 'SACN', 'Saint Alphonsus Regional Medical Center - trauma coverage on', 'Jeffrey', 'B', 'Symmonds', 'MD', 'Cardiovascular Disease', 'Vascular Surgery', '', NULL, 'B', '1055 N Curtis', 'Boise', 'Ada', 'ID', '83706', '2083673722', '0', '1055 N Curtis', 'Boise', 'Ada', 'ID', '83706', '2083673722', '0', 'IDSINCLAIRL', NULL, '', '0.00', '15.00', '0.00', 6, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Medical Center Nampa', '', '', '', 'HCFA|', '1154370328', 0, 'Y', 0, '2014-07-09', NULL, NULL, 43.6127, -116.254, NULL, NULL),
('205294327', 'SACN00726', 'SACN00726', 'SACN', 'Digestive Health Clinic ', 'Ike', 'D', 'Tanabe', 'MD', 'Gastroenterology', '', '', NULL, 'O', '6259 W Emerald St', 'Boise', 'Ada', 'ID', '83704', '2084891900', NULL, '6259 W Emerald St', 'Boise', 'Ada', 'ID', '83704', '2084891900', '', 'IDSINCLAIRL', 'WUSTDHCPC5', NULL, '0.00', '15.00', '0.00', 6, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Regional Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1184691602', 0, 'n', 0, '2011-11-14', NULL, NULL, 43.6114, -116.259, NULL, NULL),
('263091124', 'ELHCA0220', 'ELHCA0220', 'TXHOUSTD', 'Complete Womens Care Center', 'Laurel', NULL, 'Spence', 'PA', 'Obstetrics and Gynecology', '', '', NULL, 'B', 'PO Box 405477     ', 'Atlanta', 'Fulton', 'GA', '30384', NULL, NULL, 'PO Box 405477     ', 'Atlanta', 'Fulton', 'GA', '30384', '', '', 'HCA', 'TXHCPC13', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'The Womans Hospital of Texas', NULL, NULL, NULL, 'HCFA|UB|', '1184855744', 0, 'Y', 0, '2013-05-01', NULL, NULL, 0, 0, NULL, NULL),
('820200895', 'SACN01065', 'SACN01065', 'SACN', 'Saint Alphonsus Medical Group Pulmonary & Sleep Boise ', 'Bethany', '', 'Taylor', 'PA-C', 'Pulmonary', 'Sleep Medicine', 'Sleep Disorders', NULL, 'O', '1075 N Curtis Ste 201', 'Boise', 'Ada', 'ID', '83706', '2083678333', '2083672003', '1075 N Curtis Ste 201', 'Boise', 'Ada', 'ID', '83706', '2083678333', '2083672003', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Regional Medical Center', NULL, NULL, NULL, 'HCFA|', '1487843322', 0, 'N', 0, '2013-12-11', NULL, NULL, 43.6143, -116.258, NULL, NULL),
('820200895', 'SACN01066', 'SACN01066', 'SACN', 'Saint Alphonsus Regional Medical Center ', 'Bethany', '', 'Taylor', 'PA-C', 'Pulmonary', 'Sleep Medicine', 'Sleep Disorders', NULL, 'B', '3340 E Goldstone', 'Meridian', 'Ada', 'ID', '83642', '2083675170', '2083672003', '3340 E Goldstone', 'Meridian', 'Ada', 'ID', '83642', '2083675170', '2083672003', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Regional Medical Center', NULL, NULL, NULL, 'HCFA|', '1487843322', 0, 'N', 0, '2013-12-11', NULL, NULL, 0, 0, NULL, NULL),
('820200895', 'SACN01067', 'SACN01067', 'SACN', 'Saint Alphonsus Medical Group Pulmonary & Sleep Boise ', 'Bethany', '', 'Taylor', 'PA-C', 'Pulmonary', 'Sleep Medicine', 'Sleep Disorders', NULL, 'O', '6140 W Curtisian Ste B10', 'Boise', 'Ada', 'ID', '83704', '2083678333', '2083672003', '6140 W Curtisian Ste B10', 'Boise', 'Ada', 'ID', '83704', '2083678333', '2083672003', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Regional Medical Center', NULL, NULL, NULL, 'HCFA|', '1487843322', 0, 'N', 0, '2013-12-11', NULL, NULL, 43.6151, -116.256, NULL, NULL),
('263091124', 'ELHCA0219', 'ELHCA0219', 'TXHOUSTD', 'Complete Womens Care Center', 'Laurel', NULL, 'Spence', 'PA', 'Obstetrics and Gynecology', '', '', NULL, 'O', '7900 Fannin St Ste 3000', 'Houston', 'Harris', 'TX', '77030', '7137919100', '7137911016', '7900 Fannin St Ste 3000', 'Houston', 'Harris', 'TX', '77030', '7137919100', '7137911016', 'HCA', 'TXHCPC13', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'The Womans Hospital of Texas', NULL, NULL, NULL, 'HCFA|UB|', '1184855744', 0, 'Y', 0, '2013-05-01', NULL, NULL, 29.6896, -95.4034, NULL, NULL),
('115621509', 'SACN00863', 'SACN00863', 'SACN', 'The Pain Center', 'Sandra', 'A', 'Thompson', 'MD', 'Pain Management', '', '', NULL, 'O', '1673 W Shoreline Ste 140', 'Boise', 'Ada', 'ID', '83702', '2083429800', '2083424223', '1673 W Shoreline Ste 140', 'Boise', 'Ada', 'ID', '83702', '2083429800', '2083424223', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 3, '2011-01-01', '2011-09-01', 0, 0, 1, 'Saint Alphonsus Medical Center Nampa', '', '', '', 'HCFA|UB|', '1326085713', 0, 'N', 0, '2012-02-07', NULL, NULL, 0, 0, NULL, NULL),
('260553931', 'SACN01148', 'SACN01148', 'SACN', 'Saint Alphonsus Medical Group OB Hospitalist Boise', 'Brook', 'A', 'Thomson', 'MD', 'Hospitalist', '', '', NULL, 'O', '1055 N Curtis Rd', 'Boise', 'Ada', 'ID', '83706', '2083676222', NULL, '1055 N Curtis Rd', 'Boise', 'Ada', 'ID', '83706', '2083676222', '', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Medical Center Nampa', '', '', '', 'HCFA|UB|', '1548290141', 0, 'Y', 0, '2014-06-20', NULL, NULL, 43.6127, -116.254, NULL, NULL),
('260553931', 'SACN01149', 'SACN01149', 'SACN', 'Saint Alphonsus Medical Group Maternal Fetal Medicine Boise', 'Brook', 'A', 'Thomson', 'MD', 'Hospitalist', '', '', NULL, 'O', '900 N Liberty Ste 206', 'Boise', 'Ada', 'ID', '83704', '2083675544', '2083675543', '900 N Liberty Ste 206', 'Boise', 'Ada', 'ID', '83704', '2083675544', '2083675543', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Medical Center Nampa', '', '', '', 'HCFA|UB|', '1548290141', 0, 'Y', 0, '2014-06-20', NULL, NULL, 43.6133, -116.259, NULL, NULL),
('820200895', 'SACN01150', 'SACN01150', 'SACN', 'Saint Alphonsus OB Hospitalist Program', 'Brook', 'A', 'Thomson', 'MD', 'Hospitalist', '', '', NULL, 'O', '1055 N Curtis Rd', 'Boise', 'Ada', 'ID', '83706', '2083672121', NULL, '1055 N Curtis Rd', 'Boise', 'Ada', 'ID', '83706', '2083672121', '', 'IDSINCLAIRL', NULL, '', '0.00', '15.00', '0.00', 6, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Medical Center Nampa', '', '', '', 'HCFA|', '1548290141', 0, 'Y', 0, '2014-06-20', NULL, NULL, 43.6127, -116.254, NULL, NULL),
('820200895', 'SACN01151', 'SACN01151', 'SACN', 'Saint Alphonsus Medical Group OB/GYN Boise Moreau Bldg ', 'Brook', 'A', 'Thomson', 'MD', 'Hospitalist', '', '', NULL, 'O', '6140 W Curtisian Ste 100', 'Boise', 'Ada', 'ID', '83704', '2083674224', '2083677806', '6140 W Curtisian Ste 100', 'Boise', 'Ada', 'ID', '83704', '2083674224', '2083677806', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', '2013-08-01', 0, 0, 0, 'Saint Alphonsus Medical Center Nampa', '', '', '', 'HCFA|', '1548290141', 0, 'Y', 0, '2014-06-20', NULL, NULL, 43.6151, -116.256, NULL, NULL),
('820200895', 'SACN01152', 'SACN01152', 'SACN', 'Saint Alphonsus Medical Group  OB/GYN Liberty Bldg', 'Brook', 'A', 'Thomson', 'MD', 'Hospitalist', '', '', NULL, 'O', '900 N Liberty Ste 204', 'Boise', 'Ada', 'ID', '83704', '2083672229', '2083674242', '900 N Liberty Ste 204', 'Boise', 'Ada', 'ID', '83704', '2083672229', '2083674242', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Medical Center Nampa', '', '', '', 'HCFA|', '1548290141', 0, 'Y', 0, '2014-06-20', NULL, NULL, 43.6133, -116.259, NULL, NULL),
('261797823', 'SACN01330', 'SACN01330', 'SACN', NULL, 'Nicole', 'L', 'Thurston', 'MD', 'Mental Health', 'Psychiatry', '', NULL, 'O', '413 N Allumbaugh Ste 101', 'Boise', 'Ada', 'ID', '83704', '2083231125', NULL, '413 N Allumbaugh Ste 101', 'Boise', 'Ada', 'ID', '83704', '2083231125', '', 'IDSINCLAIRL', NULL, NULL, '0.00', '15.00', '0.00', 3, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Medical Center Nampa', '', '', '', 'HCFA|UB|', '1679782460', 0, 'n', 0, '2011-10-18', NULL, NULL, 0, 0, NULL, NULL),
('820200895', 'SACN01331', 'SACN01331', 'SACN', 'Saint Alphonsus Regional Medical Center Behavioral Health', 'Nicole', 'L', 'Thurston', 'MD', 'Mental Health', 'Psychiatry', '', NULL, 'O', '131 N Allumbaugh', 'Boise', 'Ada', 'ID', '83704', '2083676500', '2083760285', '131 N Allumbaugh', 'Boise', 'Ada', 'ID', '83704', '2083676500', '2083760285', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', '2012-02-01', 0, 0, 0, 'Saint Alphonsus Medical Center Nampa', '', '', '', 'HCFA|', '1679782460', 0, 'N', 0, '2012-01-31', NULL, NULL, 43.6059, -116.267, NULL, NULL),
('201773062', 'W40016025', 'W40016025', 'ID01', 'Access Behavioral Health Services Inc', 'Kimberly (Kim)', '', 'Spears', 'ARNP', 'Mental Health', 'Psychiatry', '', NULL, 'O', '3307 Caldwell Blvd Ste 104', 'Nampa', 'Canyon', 'ID', '83651', '2084654833', '2083384699', '3307 Caldwell Blvd Ste 104', 'Nampa', 'Canyon', 'ID', '83651', '2084654833', '2083384699', 'IDSTD', 'WUSTDHCPC5', '', '0.00', '40.00', '0.00', 3, '2013-02-15', '2014-06-23', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1558564138', 0, 'N', 0, '2014-04-24', NULL, NULL, 43.6156, -116.618, NULL, NULL),
('820477852', 'SACN00212', 'SACN00212', 'SACN', 'Saint Alphonsus Medical Group Federal Way', 'Laura', 'L', 'Tirrell', 'MD', 'Family Practice', '', '', NULL, 'O', '1880 W Judith Ln', 'Boise', 'Ada', 'ID', '83705', '2083676910', NULL, '1880 W Judith Ln', 'Boise', 'Ada', 'ID', '83705', '2083676910', '          ', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', '2012-04-03', 0, 0, 0, 'Saint Alphonsus Medical Center Nampa', '', '', '', 'HCFA|UB|', '1245271659', 0, 'N', 0, '2012-04-03', NULL, NULL, 43.5916, -116.204, NULL, NULL),
('820477852', 'SACN00213', 'SACN00213', 'SACN', 'CARE Maternal/Child Health Program - Do Not Publish', 'Laura', 'L', 'Tirrell', 'MD', 'Family Practice', '', '', NULL, 'O', '900 N Liberty St Ste 100', 'Boise', 'Ada', 'ID', '83704', '2083672126', '2083674505', '900 N Liberty St Ste 100', 'Boise', 'Ada', 'ID', '83704', '2083672126', '2083674505', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', '2012-04-03', 0, 0, 0, 'Saint Alphonsus Medical Center Nampa', '', '', '', 'HCFA|UB|', '1245271659', 0, 'Y', 0, '2012-04-03', NULL, NULL, 43.6133, -116.259, NULL, NULL),
('820312175', 'SACN00743', 'SACN00743', 'SACN', 'Idaho Emergency Physicians PA', 'Christopher', 'E', 'Tobe', 'MD', 'Emergency Medicine', '', '', NULL, 'o', '1055 N Curtis Rd', 'Boise', 'Ada', 'ID', '83704', '2083221730', '2083221731', '1055 N Curtis Rd', 'Boise', 'Ada', 'ID', '83704', '2083221730', '2083221731', 'IDSINCLAIRL', NULL, NULL, '0.00', '15.00', '0.00', 3, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Regional Medical Center', 'West Valley Medical Center', NULL, NULL, 'HCFA|UB|', '1205889136', 0, 'n', 0, '2012-01-31', NULL, NULL, 43.6136, -116.256, NULL, NULL),
('820312175', 'SACN00744', 'SACN00744', 'SACN', 'Idaho Emergency Physicians PA', 'Christopher', 'E', 'Tobe', 'MD', 'Emergency Medicine', '', '', NULL, 'O', '1717 Arlington', 'Caldwell', 'Canyon', 'ID', '83605', '2083221730', '2083221731', '1717 Arlington', 'Caldwell', 'Canyon', 'ID', '83605', '2083221730', '2083221731', 'IDSINCLAIRL', NULL, NULL, '0.00', '15.00', '0.00', 3, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Regional Medical Center', 'West Valley Medical Center', NULL, NULL, 'HCFA|UB|', '1205889136', 0, 'N', 0, '2012-01-31', NULL, NULL, 0, 0, NULL, NULL),
('820312175', 'SACN00745', 'SACN00745', 'SACN', 'Idaho Emergency Physicians PA', 'Christopher', 'E', 'Tobe', 'MD', 'Emergency Medicine', '', '', NULL, 'B', '2963 E Copper Point Dr', 'Meridian', 'Ada', 'ID', '83642', '2083221730', NULL, '2963 E Copper Point Dr', 'Meridian', 'Ada', 'ID', '83642', '2083221730', '          ', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 3, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Regional Medical Center', 'West Valley Medical Center', NULL, NULL, 'HCFA|UB|', '1205889136', 0, 'Y', 0, '2012-01-31', NULL, NULL, 0, 0, NULL, NULL),
('820312175', 'SACN00746', 'SACN00746', 'SACN', 'Idaho Emergency Physicians PA', 'Christopher', 'E', 'Tobe', 'MD', 'Emergency Medicine', '', '', NULL, 'o', '323 E Riverside Dr', 'Eagle', 'Ada', 'ID', '83616', '2083221730', '2083221731', '323 E Riverside Dr', 'Eagle', 'Ada', 'ID', '83616', '2083221730', '2083221731', 'IDSINCLAIRL', NULL, NULL, '0.00', '15.00', '0.00', 3, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Regional Medical Center', 'West Valley Medical Center', NULL, NULL, 'HCFA|UB|', '1205889136', 0, 'n', 0, '2012-01-31', NULL, NULL, 43.6892, -116.351, NULL, NULL),
('820161600', 'SACN00685', 'SACN00685', 'SACN', 'Idaho Family Physicians Inc', 'Mont', 'B', 'Tolman', 'DO', 'Family Practice', '', '', NULL, 'O', '130 E Boise Ave', 'Boise', 'Ada', 'ID', '83706', '2083454066', NULL, '130 E Boise Ave', 'Boise', 'Ada', 'ID', '83706', '2083454066', '          ', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 8, '2011-01-01', '2011-11-07', 0, 0, 1, '', '', '', '', 'HCFA|UB|', '1124069828', 0, 'N', 0, '2012-03-02', NULL, NULL, 0, 0, NULL, NULL),
('820200895', 'SACN00478', 'SACN00478', 'SACN', 'Saint Alphonsus Medical Group Overland', 'Cynda', 'L', 'Tomlinson', 'MD', 'Family Practice', '', '', NULL, 'O', '10255 W Overland Rd', 'Boise', 'Ada', 'ID', '83709', '2083677205', '2083677204', '10255 W Overland Rd', 'Boise', 'Ada', 'ID', '83709', '2083677205', '2083677204', 'IDSINCLAIRL', NULL, '', '0.00', '15.00', '0.00', 6, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Regional Medical Center', '', '', '', 'HCFA|', '1891703070', 0, 'Y', 0, '2014-06-20', NULL, NULL, 43.5899, -116.31, NULL, NULL),
('820200895', 'SACN00479', 'SACN00479', 'SACN', 'Saint Alphonsus Medical Group Garrity Family Medicine', 'Cynda', 'L', 'Tomlinson', 'MD', 'Family Practice', '', '', NULL, 'O', '1200 Garrity Blvd', 'Nampa', 'Canyon', 'ID', '83687', '2084669092', '2084665322', '1200 Garrity Blvd', 'Nampa', 'Canyon', 'ID', '83687', '2084669092', '2084665322', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Regional Medical Center', '', '', '', 'HCFA|', '1891703070', 0, 'Y', 0, '2014-06-20', NULL, NULL, 43.587, -116.549, NULL, NULL),
('820200895', 'SACN00480', 'SACN00480', 'SACN', 'Saint Alphonsus Medical Group McMillan Family Medicine', 'Cynda', 'L', 'Tomlinson', 'MD', 'Family Practice', '', '', NULL, 'O', '12273 W McMillan Rd', 'Boise', 'Ada', 'ID', '83713', '2083676330', '2083674765', '12273 W McMillan Rd', 'Boise', 'Ada', 'ID', '83713', '2083676330', '2083674765', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Regional Medical Center', '', '', '', 'HCFA|', '1891703070', 0, 'Y', 0, '2014-06-20', NULL, NULL, 43.6481, -116.335, NULL, NULL),
('820200895', 'SACN00481', 'SACN00481', 'SACN', 'Saint Alphonsus Medical Group Shoreline Family Medicine', 'Cynda', 'L', 'Tomlinson', 'MD', 'Family Practice', '', '', NULL, 'O', '1673 W Shoreline Dr Ste 120', 'Boise', 'Ada', 'ID', '83702', '2084298311', '2084298310', '1673 W Shoreline Dr Ste 120', 'Boise', 'Ada', 'ID', '83702', '2084298311', '2084298310', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Regional Medical Center', '', '', '', 'HCFA|', '1891703070', 0, 'Y', 0, '2014-06-20', NULL, NULL, 43.6171, -116.222, NULL, NULL),
('820200895', 'SACN00482', 'SACN00482', 'SACN', 'Saint Alphonsus Medical Group Federal Way Family Medicine', 'Cynda', 'L', 'Tomlinson', 'MD', 'Family Practice', '', '', NULL, 'O', '1880 W Judith Ln', 'Boise', 'Ada', 'ID', '83705', '2083676910', '2083676170', '1880 W Judith Ln', 'Boise', 'Ada', 'ID', '83705', '2083676910', '2083676170', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Regional Medical Center', '', '', '', 'HCFA|', '1891703070', 0, 'Y', 0, '2014-06-20', NULL, NULL, 43.5916, -116.204, NULL, NULL),
('820200895', 'SACN00483', 'SACN00483', 'SACN', 'Saint Alphonsus Medical Group Iowa Family Medicine', 'Cynda', 'L', 'Tomlinson', 'MD', 'Family Practice', '', '', NULL, 'O', '211 W Iowa Ave', 'Caldwell', 'Canyon', 'ID', '83686', '2084657377', '2084657397', '211 W Iowa Ave', 'Caldwell', 'Canyon', 'ID', '83686', '2084657377', '2084657397', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Regional Medical Center', '', '', '', 'HCFA|', '1891703070', 0, 'Y', 0, '2014-06-20', NULL, NULL, 43.554, -116.638, NULL, NULL),
('820200895', 'SACN00484', 'SACN00484', 'SACN', 'Saint Alphonsus Medical Group MHP Family Medicine ', 'Cynda', 'L', 'Tomlinson', 'MD', 'Family Practice', '', '', NULL, 'O', '3025 W Cherry Ln Ste B', 'Meridian', 'Ada', 'ID', '83642', '2083678550', '2083678555', '3025 W Cherry Ln Ste B', 'Meridian', 'Ada', 'ID', '83642', '2083678550', '2083678555', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Regional Medical Center', '', '', '', 'HCFA|', '1891703070', 0, 'Y', 0, '2014-06-20', NULL, NULL, 43.6188, -116.431, NULL, NULL),
('820200895', 'SACN00485', 'SACN00485', 'SACN', 'Saint Alphonsus Medical Group Elm Family Medicine', 'Cynda', 'L', 'Tomlinson', 'MD', 'Family Practice', '', '', NULL, 'O', '315 E Elm St Ste 100', 'Caldwell', 'Canyon', 'ID', '83605', '2084597415', '2084533307', '315 E Elm St Ste 100', 'Caldwell', 'Canyon', 'ID', '83605', '2084597415', '2084533307', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Regional Medical Center', '', '', '', 'HCFA|', '1891703070', 0, 'Y', 0, '2014-06-20', NULL, NULL, 43.6539, -116.695, NULL, NULL),
('820200895', 'SACN00486', 'SACN00486', 'SACN', 'Saint Alphonsus Medical Group EHP Family Medicine', 'Cynda', 'L', 'Tomlinson', 'MD', 'Family Practice', '', '', NULL, 'O', '323 E Riverside Dr Ste 224', 'Eagle', 'Ada', 'ID', '83616', '2083675750', '2083675765', '323 E Riverside Dr Ste 224', 'Eagle', 'Ada', 'ID', '83616', '2083675750', '2083675765', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Regional Medical Center', '', '', '', 'HCFA|', '1891703070', 0, 'Y', 0, '2014-06-20', NULL, NULL, 43.6892, -116.351, NULL, NULL),
('820200895', 'SACN00487', 'SACN00487', 'SACN', 'Saint Alphonsus Boise OB-Gyn', 'Cynda', 'L', 'Tomlinson', 'MD', 'Family Practice', '', '', NULL, 'O', '5966 Curtisian', 'Boise', 'Ada', 'ID', '83704', '2083758100', '2083778163', '5966 Curtisian', 'Boise', 'Ada', 'ID', '83704', '2083758100', '2083778163', 'IDSINCLAIRL', NULL, '', '0.00', '15.00', '0.00', 6, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Regional Medical Center', '', '', '', 'HCFA|', '1891703070', 0, 'Y', 0, '2014-06-20', NULL, NULL, 43.6149, -116.256, NULL, NULL),
('820200895', 'SACN00488', 'SACN00488', 'SACN', 'Saint Alphonsus Medical Group Internal Medicine', 'Cynda', 'L', 'Tomlinson', 'MD', 'Family Practice', '', '', NULL, 'O', '6094 Emerald Ste 2', 'Boise', 'Ada', 'ID', '83704', '2083676575', '2083676597', '6094 Emerald Ste 2', 'Boise', 'Ada', 'ID', '83704', '2083676575', '2083676597', 'IDSINCLAIRL', NULL, '', '0.00', '15.00', '0.00', 6, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Regional Medical Center', '', '', '', 'HCFA|', '1891703070', 0, 'Y', 0, '2014-06-20', NULL, NULL, 43.6122, -116.257, NULL, NULL),
('820200895', 'SACN00489', 'SACN00489', 'SACN', 'Saint Alphonsus Medical Group OB/GYN Boise Moreau Bldg', 'Cynda', 'L', 'Tomlinson', 'MD', 'Family Practice', '', '', NULL, 'O', '6140 W Curtisian Ste 100', 'Boise', 'Ada', 'ID', '83704', '2083674224', '2083677806', '6140 W Curtisian Ste 100', 'Boise', 'Ada', 'ID', '83704', '2083674224', '2083677806', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Regional Medical Center', '', '', '', 'HCFA|', '1891703070', 0, 'Y', 0, '2014-06-20', NULL, NULL, 43.6151, -116.256, NULL, NULL),
('820200895', 'SACN00490', 'SACN00490', 'SACN', 'Saint Alphonsus Medical Group EHP Family Medicine', 'Cynda', 'L', 'Tomlinson', 'MD', 'Family Practice', '', '', NULL, 'O', '6533 Emerald St', 'Boise', 'Ada', 'ID', '83704', '2083674170', '2083678135', '6533 Emerald St', 'Boise', 'Ada', 'ID', '83704', '2083674170', '2083678135', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Regional Medical Center', '', '', '', 'HCFA|', '1891703070', 0, 'Y', 0, '2014-06-20', NULL, NULL, 43.6119, -116.268, NULL, NULL),
('820200895', 'SACN00491', 'SACN00491', 'SACN', 'Saint Alphonsus Medical Group  OB/GYN Boise Liberty Bldg', 'Cynda', 'L', 'Tomlinson', 'MD', 'Family Practice', '', '', NULL, 'O', '900 N Liberty Ste 204', 'Boise', 'Ada', 'ID', '83704', '2083672229', NULL, '900 N Liberty Ste 204', 'Boise', 'Ada', 'ID', '83704', '2083672229', '', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Regional Medical Center', '', '', '', 'HCFA|', '1891703070', 0, 'Y', 0, '2014-06-20', NULL, NULL, 43.6133, -116.259, NULL, NULL),
('820200895', 'SACN00492', 'SACN00492', 'SACN', 'CARE Maternal/Child Health Program - Do Not Publish', 'Cynda', 'L', 'Tomlinson', 'MD', 'Family Practice', '', '', NULL, 'O', '900 N Liberty St Ste 100', 'Boise', 'Ada', 'ID', '83704', '2083672126', '2083674505', '900 N Liberty St Ste 100', 'Boise', 'Ada', 'ID', '83704', '2083672126', '2083674505', 'IDSINCLAIRL', NULL, '', '0.00', '15.00', '0.00', 6, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Regional Medical Center', '', '', '', 'HCFA|', '1891703070', 0, 'Y', 0, '2014-06-20', NULL, NULL, 43.6133, -116.259, NULL, NULL),
('820200895', 'SACN00493', 'SACN00493', 'SACN', 'Saint Alphonsus Medical Group Boise Pediatrics', 'Cynda', 'L', 'Tomlinson', 'MD', 'Family Practice', '', '', NULL, 'O', '999 N Curtis Ste 407', 'Boise', 'Ada', 'ID', '83706', '2083674321', '2083674525', '999 N Curtis Ste 407', 'Boise', 'Ada', 'ID', '83706', '2083674321', '2083674525', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Regional Medical Center', '', '', '', 'HCFA|', '1891703070', 0, 'Y', 0, '2014-06-20', NULL, NULL, 43.6132, -116.255, NULL, NULL),
('820477852', 'SACN00494', 'SACN00494', 'SACN', 'Saint Alphonsus Medical Group', 'Cynda', 'L', 'Tomlinson', 'MD', 'Family Practice', '', '', NULL, 'B', '3340 E Goldstone Way', 'Meridian', 'Ada', 'ID', '83642', '2083674170', '2083678135', '3340 E Goldstone Way', 'Meridian', 'Ada', 'ID', '83642', '2083674170', '2083678135', 'IDSINCLAIRL', NULL, '', '0.00', '15.00', '0.00', 6, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Regional Medical Center', '', '', '', 'HCFA|UB|', '1891703070', 0, 'Y', 0, '2014-06-20', NULL, NULL, 0, 0, NULL, NULL),
('820200895', 'SACN01652', 'SACN01652', 'SACN', 'Saint Alphonsus Medical Group EHP Family Medicine', 'Stacey', '', 'Townsend', 'MD', 'Pediatrics', '', '', NULL, 'O', '323 E Riverside Dr Ste 224', 'Eagle', 'Ada', 'ID', '83616', '2083675750', '2083675765', '323 E Riverside Dr Ste 224', 'Eagle', 'Ada', 'ID', '83616', '2083675750', '2083675765', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Medical Center Nampa', '', '', '', 'HCFA|', '1962554568', 0, 'N', 0, '2014-06-20', NULL, NULL, 43.6892, -116.351, NULL, NULL),
('820200895', 'SACN01653', 'SACN01653', 'SACN', 'Saint Alphonsus Medical Group Boise Pediatrics', 'Stacey', '', 'Townsend', 'MD', 'Pediatrics', '', '', NULL, 'O', '999 N Curtis Ste 407', 'Boise', 'Ada', 'ID', '83706', '2083674321', '2083674525', '999 N Curtis Ste 407', 'Boise', 'Ada', 'ID', '83706', '2083674321', '2083674525', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Medical Center Nampa', '', '', '', 'HCFA|', '1962554568', 0, 'Y', 0, '2014-06-20', NULL, NULL, 43.6132, -116.255, NULL, NULL),
('820477852', 'SACN01654', 'SACN01654', 'SACN', 'Saint Alphonsus Medical Group Eagle Health Plaza', 'Stacey', '', 'Townsend', 'MD', 'Pediatrics', '', '', NULL, 'O', '323 E Riverside Dr Ste 224', 'Eagle', 'Ada', 'ID', '83616', '2083675750', NULL, '323 E Riverside Dr Ste 224', 'Eagle', 'Ada', 'ID', '83616', '2083675750', '', 'IDSINCLAIRL', NULL, '', '0.00', '15.00', '0.00', 6, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Medical Center Nampa', '', '', '', 'HCFA|UB|', '1962554568', 0, 'n', 0, '2014-06-20', NULL, NULL, 43.6892, -116.351, NULL, NULL),
('820477852', 'SACN01655', 'SACN01655', 'SACN', 'Saint Alphonsus Medical Group Pediatrics', 'Stacey', '', 'Townsend', 'MD', 'Pediatrics', '', '', NULL, 'B', '999 N Curtis Rd Ste 407', 'Boise', 'Ada', 'ID', '83706', '2083674321', NULL, '999 N Curtis Rd Ste 407', 'Boise', 'Ada', 'ID', '83706', '2083674321', '', 'IDSINCLAIRL', NULL, '', '0.00', '15.00', '0.00', 6, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Medical Center Nampa', '', '', '', 'HCFA|UB|', '1962554568', 0, 'Y', 0, '2014-06-20', NULL, NULL, 43.6132, -116.255, NULL, NULL),
('820200895', 'SACN01568', 'SACN01568', 'SACN', 'Saint Alphonsus Medical Group Hosptialist Boise', 'Gregory', 'T', 'Trapp', 'MD', 'Hospitalist', '', '', NULL, 'o', '1055 N Curtis Rd', 'Boise', 'Ada', 'ID', '83706', '2083672121', '2083675180', '1055 N Curtis Rd', 'Boise', 'Ada', 'ID', '83706', '2083672121', '2083675180', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Regional Medical Center', '', '', '', 'HCFA|', '1851407944', 0, 'Y', 0, '2014-06-20', NULL, NULL, 43.6127, -116.254, NULL, NULL),
('201773062', 'W40016024', 'W40016024', 'ID01', 'Access Behavioral Health Services Inc', 'Kimberly (Kim)', '', 'Spears', 'ARNP', 'Mental Health', 'Psychiatry', '', NULL, 'O', '1276 River St Ste 100', 'Boise', 'Ada', 'ID', '83702', '2083384699', '2083384699', '1276 River St Ste 100', 'Boise', 'Ada', 'ID', '83702', '2083384699', '2083384699', 'IDSTD', 'WUSTDHCPC5', '', '0.00', '40.00', '0.00', 3, '2013-02-15', '2014-06-23', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1558564138', 0, 'N', 0, '2014-04-24', NULL, NULL, 43.6149, -116.215, NULL, NULL),
('460500210', 'SACN00640', 'SACN00640', 'SACN', 'Saint Alphonsus Trauma Physician Services', 'Richard', '', 'Trump', 'PA-C', 'Urgent Care', 'Physician Assistant', '', NULL, 'B', '1055 N Curtis', 'Boise', 'Ada', 'ID', '83706', '2083673674', NULL, '1055 N Curtis', 'Boise', 'Ada', 'ID', '83706', '2083673674', '0         ', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', '2013-05-01', 0, 0, 0, '', NULL, '', '', 'HCFA|UB|', '1063601177', 0, 'Y', 0, '2013-11-20', NULL, NULL, 43.6127, -116.254, NULL, NULL),
('460500210', 'SACN00641', 'SACN00641', 'SACN', 'Saint Alphonsus Trauma Physician Services', 'Richard', '', 'Trump', 'PA-C', 'Urgent Care', 'Physician Assistant', '', NULL, 'B', '901 N Curtis Rd Ste 401', 'Boise', 'Ada', 'ID', '83706', '2083677676', NULL, '901 N Curtis Rd Ste 401', 'Boise', 'Ada', 'ID', '83706', '2083677676', '0         ', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', '2013-05-01', 0, 0, 0, '', NULL, '', '', 'HCFA|UB|', '1063601177', 0, 'Y', 0, '2013-11-22', NULL, NULL, 43.6126, -116.255, NULL, NULL),
('820200895', 'SACN00739', 'SACN00739', 'SACN', 'Saint Alphonsus Medical Group Eagle Health Plaza', 'Shana', 'L', 'Tubach', 'MD', 'Pediatrics', '', '', NULL, 'O', '323 E Riverside Dr Ste 224', 'Eagle', 'Ada', 'ID', '83616', '2083675750', '2083675765', '323 E Riverside Dr Ste 224', 'Eagle', 'Ada', 'ID', '83616', '2083675750', '2083675765', 'IDSINCLAIRL', NULL, '', '0.00', '15.00', '0.00', 6, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Regional Medical Center', '', '', '', 'HCFA|', '1205879483', 0, 'Y', 0, '2014-06-20', NULL, NULL, 43.6892, -116.351, NULL, NULL);
