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
('522229954', 'W11000733', 'W11000733', 'UT01', 'Mountain Land Orthopedic & Sports Physical Therapy', 'Melissa', 'Lynne', 'Pearce', 'PT', 'Physical Therapy', NULL, NULL, NULL, 'B', 'PO Box 74125', 'Salt Lake City', 'Salt Lake', 'UT', '84171', '8019422729', NULL, 'PO Box 74125', 'Salt Lake City', '', 'UT', '84171', '', '', 'WestRehab', 'WUSTDHCPC5', NULL, '0.00', '0.00', '58.00', 3, '2006-05-01', '2008-08-01', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1679635957', 0, 'Y', 0, '2007-02-12', NULL, NULL, 0, 0, NULL, NULL),
('522229954', 'W11000734', 'W11000734', 'UT01', 'Therapy West', 'Rhodri', NULL, 'Purcell', 'PT', 'Physical Therapy', NULL, NULL, NULL, 'B', 'PO Box 74125', 'Salt Lake City', 'Salt Lake', 'UT', '84171', '8019422729', NULL, 'PO Box 74125', 'Salt Lake City', '', 'UT', '84171', '', '', 'WestRehab', 'WUSTDHCPC5', NULL, '0.00', '0.00', '58.00', 3, '2006-05-01', '2008-08-01', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1417916784', 0, 'Y', 0, '2007-02-12', NULL, NULL, 0, 0, NULL, NULL),
('522229954', 'W11000735', 'W11000735', 'UT01', 'Wasatch Therapy', 'Sherman', 'D', 'Stanley', 'OT', 'Physical Therapy', 'Occupational Therapy', '', NULL, 'B', 'PO Box 74125', 'Salt Lake City', 'Salt Lake', 'UT', '84171', '8019422729', NULL, 'PO Box 74125', 'Salt Lake City', 'Salt Lake', 'UT', '84171', '8019422729', '          ', 'WestRehab', 'WUSTDHCPC5', '', '0.00', '0.00', '58.00', 3, '2006-05-01', '2008-09-30', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1285685420', 0, 'Y', 0, '2010-11-09', NULL, NULL, 0, 0, NULL, NULL),
('522229954', 'W11000736', 'W11000736', 'UT01', 'Mountain Land Rehabilitation Home Health', 'Dean', 'C', 'Turner', 'PT', 'Physical Therapy', NULL, NULL, NULL, 'B', 'PO Box 74125', 'Salt Lake City', 'Salt Lake', 'UT', '84171', '8019422729', NULL, 'PO Box 74125', 'Salt Lake City', '', 'UT', '84171', '', '', 'WestRehab', 'WUSTDHCPC5', NULL, '0.00', '0.00', '58.00', 3, '2006-05-01', '2008-09-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1215025093', 0, 'Y', 0, '2008-10-03', NULL, NULL, 0, 0, NULL, NULL),
('522229954', 'W11000737', 'W11000737', 'UT01', 'Peak Performance Physical Therapy', 'Rodney', 'Edward (Ed)', 'Wade', 'PT', 'Physical Therapy', '', '', NULL, 'B', 'PO Box 74125', 'Salt Lake City', 'Salt Lake', 'UT', '84171', '8019422729', NULL, 'PO Box 74125', 'Salt Lake City', 'Salt Lake', 'UT', '84171', '8019422729', '          ', 'WestRehab', 'WUSTDHCPC5', '', '0.00', '0.00', '58.00', 3, '2006-05-01', '2008-09-30', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1164448080', 0, 'Y', 0, '2011-10-19', NULL, NULL, 0, 0, NULL, NULL),
('522229954', 'W11000738', 'W11000738', 'UT01', 'Bear Lake Physical Therapy', 'Bryce', 'S', 'Woodfield', 'PT', 'Physical Therapy', '', '', NULL, 'B', 'PO Box 74125', 'Salt Lake City', 'Salt Lake', 'UT', '84171', '8019422729', NULL, 'PO Box 74125', 'Salt Lake City', 'Salt Lake', 'UT', '84171', '8019422729', '          ', 'WestRehab', 'WUSTDHCPC5', '', '0.00', '0.00', '58.00', 3, '2006-05-01', '2008-09-30', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1063508885', 0, 'Y', 0, '2012-08-16', NULL, NULL, 0, 0, NULL, NULL),
('522229954', 'W11000739', 'W11000739', 'UT01', 'Mountain Land Rehabilitation Home Health', 'Quinn', '', 'Christensen', 'OT', 'Physical Therapy', '', '', NULL, 'B', 'PO Box 74125', 'Salt Lake City', 'Salt Lake', 'UT', '84171', '8019422729', NULL, 'PO Box 74125', 'Salt Lake City', 'Salt Lake', 'UT', '84171', '8019422729', '          ', 'WestRehab', 'WUSTDHCPC5', '', '0.00', '0.00', '58.00', 3, '2006-05-01', '2008-09-30', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1972691749', 0, 'Y', 0, '2012-04-18', NULL, NULL, 0, 0, NULL, NULL),
('522229954', 'W11000740', 'W11000740', 'UT01', 'Registered Physical Therapists', 'Russell', 'L', 'Clarke', 'PT', 'Physical Therapy', NULL, NULL, NULL, 'B', 'PO Box 74125', 'Salt Lake City', 'Salt Lake', 'UT', '84171', '8019422729', NULL, 'PO Box 74125', 'Salt Lake City', '', 'UT', '84171', '', '', 'WestRehab', 'WUSTDHCPC5', NULL, '0.00', '0.00', '58.00', 3, '2006-05-01', '2008-09-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1396894267', 0, 'Y', 0, '2008-10-03', NULL, NULL, 0, 0, NULL, NULL),
('522229954', 'W11000741', 'W11000741', 'UT01', 'Registered Physical Therapists', 'Russell', 'L', 'Clarke', 'PT', 'Physical Therapy', NULL, NULL, NULL, 'O', '1577 W 7000 S Ste 100', 'West Jordan', 'Salt Lake', 'UT', '84088', '8015666301', NULL, 'PO Box 74125', 'Salt Lake City', '', 'UT', '84171', '', '', 'WestRehab', 'WUSTDHCPC5', NULL, '0.00', '0.00', '58.00', 3, '2006-05-01', '2008-09-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1396894267', 0, 'N', 0, '2008-10-03', NULL, NULL, 0, 0, NULL, NULL),
('522229954', 'W11000742', 'W11000742', 'UT01', 'Mountain Land Rehabilitation Home Health', 'Quinn', '', 'Christensen', 'OT', 'Physical Therapy', '', '', NULL, 'O', '1745 E 280 N', 'St George', 'Washington', 'UT', '84790', '4356285701', NULL, '1745 E 280 N', 'St George', 'Washington', 'UT', '84790', '4356285701', '          ', 'WestRehab', 'WUSTDHCPC5', '', '0.00', '0.00', '58.00', 3, '2006-05-01', '2008-09-30', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1972691749', 0, 'N', 0, '2012-04-18', NULL, NULL, 0, 0, NULL, NULL),
('522229954', 'W11000743', 'W11000743', 'UT01', 'Bear Lake Physical Therapy', 'Bryce', 'S', 'Woodfield', 'PT', 'Physical Therapy', '', '', NULL, 'O', '90 W Logan Rd', 'Garden City', 'Rich', 'UT', '84028', '4359462777', NULL, '90 W Logan Rd', 'Garden City', 'Rich', 'UT', '84028', '4359462777', '          ', 'WestRehab', 'WUSTDHCPC5', '', '0.00', '0.00', '58.00', 3, '2006-05-01', '2008-09-30', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1063508885', 0, 'N', 0, '2012-08-16', NULL, NULL, 0, 0, NULL, NULL),
('522229954', 'W11000744', 'W11000744', 'UT01', 'Peak Performance Physical Therapy', 'Rodney', 'Edward (Ed)', 'Wade', 'PT', 'Physical Therapy', '', '', NULL, 'O', '23 S Main St', 'Coalville', 'Summit', 'UT', '84017', '4353365440', NULL, '23 S Main St', 'Coalville', 'Summit', 'UT', '84017', '4353365440', '          ', 'WestRehab', 'WUSTDHCPC5', '', '0.00', '0.00', '58.00', 3, '2006-05-01', '2008-09-30', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1164448080', 0, 'N', 0, '2011-10-19', NULL, NULL, 0, 0, NULL, NULL),
('522229954', 'W11000745', 'W11000745', 'UT01', 'Mountain Land Rehabilitation Home Health', 'Dean', 'C', 'Turner', 'PT', 'Physical Therapy', NULL, NULL, NULL, 'O', '1745 E 280 N', 'St George', 'Washington', 'UT', '84790', '4356285701', NULL, 'PO Box 74125', 'Salt Lake City', '', 'UT', '84171', '', '', 'WestRehab', 'WUSTDHCPC5', NULL, '0.00', '0.00', '58.00', 3, '2006-05-01', '2008-09-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1215025093', 0, 'N', 0, '2008-10-03', NULL, NULL, 0, 0, NULL, NULL),
('522229954', 'W11000746', 'W11000746', 'UT01', 'Wasatch Therapy', 'Sherman', 'D', 'Stanley', 'OT', 'Physical Therapy', 'Occupational Therapy', '', NULL, 'O', '5349 S Adams Ave Ste A', 'Ogden', 'Weber', 'UT', '84405', '8014799865', NULL, '5349 S Adams Ave Ste A', 'Ogden', 'Weber', 'UT', '84405', '8014799865', '          ', 'WestRehab', 'WUSTDHCPC5', '', '0.00', '0.00', '58.00', 3, '2006-05-01', '2008-09-30', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1285685420', 0, 'N', 0, '2010-11-09', NULL, NULL, 0, 0, NULL, NULL),
('522229954', 'W11000747', 'W11000747', 'UT01', 'Therapy West', 'Rhodri', NULL, 'Purcell', 'PT', 'Physical Therapy', NULL, NULL, NULL, 'O', '1050 S Medical Dr', 'Mount Pleasant', 'Sanpete', 'UT', '84647', '4354620178', NULL, 'PO Box 74125', 'Salt Lake City', '', 'UT', '84171', '', '', 'WestRehab', 'WUSTDHCPC5', NULL, '0.00', '0.00', '58.00', 3, '2006-05-01', '2008-08-01', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1417916784', 0, 'N', 0, '2007-02-12', NULL, NULL, 0, 0, NULL, NULL),
('522229954', 'W11000748', 'W11000748', 'UT01', 'Mountain Land Orthopedic & Sports Physical Therapy', 'Melissa', 'Lynne', 'Pearce', 'PT', 'Physical Therapy', NULL, NULL, NULL, 'O', '1153 E 3900 S Ste 105', 'Salt Lake City', 'Salt Lake', 'UT', '84124', '8012626331', NULL, 'PO Box 74125', 'Salt Lake City', '', 'UT', '84171', '', '', 'WestRehab', 'WUSTDHCPC5', NULL, '0.00', '0.00', '58.00', 3, '2006-05-01', '2008-08-01', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1679635957', 0, 'N', 0, '2007-02-12', NULL, NULL, 0, 0, NULL, NULL),
('522229954', 'W11000749', 'W11000749', 'UT01', 'Bear Lake Physical Therapy', 'Bryce', 'S', 'Woodfield', 'PT', 'Physical Therapy', '', '', NULL, 'O', '350 N Main', 'Randolph', 'Rich', 'UT', '84064', '4359462777', NULL, '350 N Main', 'Randolph', 'Rich', 'UT', '84064', '4359462777', '          ', 'WestRehab', 'WUSTDHCPC5', '', '0.00', '0.00', '58.00', 3, '2006-05-01', '2008-09-30', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1063508885', 0, 'N', 0, '2012-08-16', NULL, NULL, 0, 0, NULL, NULL),
('870410144', 'W11000750', 'W11000750', 'UT01', 'University of Utah Dept of OB/GYN', 'Susan', 'W', 'Hall', 'APRN', 'Obstetrics and Gynecology', '', '', NULL, 'B', 'PO Box 413028', 'Salt Lake City', 'Salt Lake', 'UT', '84141', '8012133800', NULL, 'PO Box 413028', 'Salt Lake City', 'Salt Lake', 'UT', '84141', '8012133800', '          ', 'WUUUMG5', 'WUSTDHCPC5', '', '0.00', '25.00', '0.00', 3, '2006-08-01', '2012-08-19', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1982738043', 0, 'N', 0, '2012-08-20', NULL, NULL, 0, 0, NULL, NULL),
('870619420', 'W11000751', 'W11000751', 'UT01', 'College of Nursing, University of Utah', 'Susan', 'W', 'Hall', 'APRN', 'Obstetrics and Gynecology', '', '', NULL, 'B', 'PO Box 413036', 'Salt Lake City', 'Salt Lake', 'UT', '84141', '8012133800', NULL, 'PO Box 413036', 'Salt Lake City', 'Salt Lake', 'UT', '84141', '8012133800', '          ', 'WUUUMG5', 'WUSTDHCPC5', '', '0.00', '25.00', '0.00', 3, '2006-08-01', '2012-09-18', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1982738043', 0, 'N', 0, '2012-09-19', NULL, NULL, 0, 0, NULL, NULL),
('870619420', 'W11000752', 'W11000752', 'UT01', 'University Health Care', 'Susan', 'W', 'Hall', 'APRN', 'Obstetrics and Gynecology', '', '', NULL, 'O', '50 N Medical Dr', 'Salt Lake City', 'Salt Lake', 'UT', '84132', '8015812121', NULL, '50 N Medical Dr', 'Salt Lake City', 'Salt Lake', 'UT', '84132', '8015812121', '          ', 'WUUUMG5', 'WUSTDHCPC5', '', '0.00', '25.00', '0.00', 3, '2006-08-01', '2012-09-18', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1982738043', 0, 'N', 0, '2012-09-19', NULL, NULL, 0, 0, NULL, NULL),
('870410144', 'W11000753', 'W11000753', 'UT01', 'University Health Care', 'Susan', 'W', 'Hall', 'APRN', 'Obstetrics and Gynecology', '', '', NULL, 'o', '50 N Medical Dr', 'Salt Lake City', 'Salt Lake', 'UT', '84132', '8015852378', NULL, '50 N Medical Dr', 'Salt Lake City', 'Salt Lake', 'UT', '84132', '8015852378', '          ', 'WUUUMG5', 'WUSTDHCPC5', '', '0.00', '25.00', '0.00', 3, '2006-08-01', '2012-08-19', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1982738043', 0, 'N', 0, '2012-08-20', NULL, NULL, 0, 0, NULL, NULL),
('870682101', 'W11000754', 'W11000754', 'UT01', 'Salt Lake Orthopaedic Clinic', 'David', 'M', 'Dyer', 'PT', 'Physical Therapy', '', '', NULL, 'O', '1160 E 3900 S Ste 5000', 'Salt Lake City', 'Salt Lake', 'UT', '84124', '8012628486', '8012629752', '1160 E 3900 S Ste 5000', 'Salt Lake City', 'Salt Lake', 'UT', '84124', '8012628486', '8012629752', 'WUSLORTH5', 'WUSTDHCPC5', NULL, '0.00', '35.00', '0.00', 3, '2006-04-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1346329042', 0, 'N', 0, '2013-01-14', NULL, NULL, 40.6871, -111.858, NULL, NULL),
('870616107', 'W11000755', 'W11000755', 'UT01', 'U of U Hospitals and Clinics', 'Kristen', 'L', 'Fails', 'PT', 'Physical Therapy', NULL, NULL, NULL, 'b', 'PO Box 510708', 'Salt Lake City', 'Salt Lake', 'UT', '84151', '8015876600', NULL, NULL, NULL, '', NULL, NULL, '', '', 'WISESTD', 'WUSTDHCPC5', NULL, '0.00', '35.00', NULL, 3, '2006-08-01', '2007-07-31', 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1306922877', 0, 'y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870616107', 'W11000756', 'W11000756', 'UT01', 'University Health Care', 'Kristen', 'L', 'Fails', 'PT', 'Physical Therapy', NULL, NULL, NULL, 'O', '1525 W 2100 S', 'Salt Lake City', 'Salt Lake', 'UT', '84119', '8012139900', NULL, NULL, NULL, '', NULL, NULL, '', '', 'WISESTD', 'WUSTDHCPC5', NULL, '0.00', '35.00', NULL, 3, '2006-08-01', '2007-07-31', 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1306922877', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870616107', 'W11000757', 'W11000757', 'UT01', 'University Health Care', 'Kristen', 'L', 'Fails', 'PT', 'Physical Therapy', NULL, NULL, NULL, 'O', '7495 S State St', 'Midvale', 'Salt Lake', 'UT', '84047', '8012139400', NULL, NULL, NULL, '', NULL, NULL, '', '', 'WISESTD', 'WUSTDHCPC5', NULL, '0.00', '35.00', NULL, 3, '2006-08-01', '2007-07-31', 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1306922877', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('876000525', 'W11000758', 'W11000758', 'UT01', 'University of Utah Hospital', 'Kristen', 'L', 'Fails', 'PT', 'Physical Therapy', NULL, NULL, NULL, 'B', 'PO Box 510721 ', 'Salt Lake City', 'Salt Lake', 'UT', '84151', '8015812121', NULL, '50 N Medical Dr', 'Salt Lake City', '', 'UT', '84132', '', '', NULL, NULL, '1', '0.00', NULL, NULL, 6, '2006-10-01', '2006-01-01', 1, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1306922877', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('876000525', 'W11000759', 'W11000759', 'UT01', 'University Health Care University Hospital', 'Kristen', 'L', 'Fails', 'PT', 'Physical Therapy', '', '', NULL, 'O', '50 N Medical Dr', 'Salt Lake City', 'Salt Lake', 'UT', '84132', '8015812121', NULL, '50 N Medical Dr', 'Salt Lake City', 'Salt Lake', 'UT', '84132', '8015812121', '          ', '', '', '1', '0.00', '0.00', '0.00', 6, '2006-10-01', '2012-09-25', 0, 0, 0, '', '', '', '', 'HCFA|', '1306922877', 0, 'N', 0, '2012-09-27', NULL, NULL, 0, 0, NULL, NULL),
('870442129', 'W11000760', 'W11000760', 'UT01', 'U of U Department of Anesthesiology', 'James', 'R', 'Harned', 'CRNA', 'Anesthesiology', NULL, NULL, NULL, 'B', 'Po Box 581053', 'Salt Lake City', 'Salt Lake', 'UT', '84158', '8012133800', NULL, NULL, NULL, '', NULL, NULL, '', '', NULL, NULL, '1000', '44.00', NULL, NULL, 3, '2006-08-01', '2007-07-31', 1, 12, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1548201841', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870442129', 'W11000761', 'W11000761', 'UT01', 'U of U Dept of Anesthesiology', 'James', 'R', 'Harned', 'CRNA', 'Anesthesiology', NULL, NULL, NULL, 'o', '50 N Medical Dr ', 'Salt Lake City', 'Salt Lake', 'UT', '84132', '8015816393', NULL, NULL, NULL, '', NULL, NULL, '', '', NULL, NULL, '1000', '44.00', NULL, NULL, 3, '2006-08-01', '2007-07-31', 1, 12, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1548201841', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('431859307', 'W11000762', 'W11000762', 'UT01', 'Choice Source Therapeutics', NULL, NULL, 'Choice Source Therapeutics', 'GROUP', 'Infusion Agency', NULL, NULL, NULL, 'O', 'Lock Box 27004', 'Chicago', 'Cook', 'IL', '60661', '8002372767', NULL, NULL, NULL, '', NULL, NULL, '', '', '', NULL, '1001', '0.00', '100.00', '0.00', 3, '2007-01-01', NULL, 1, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1720069628', 0, 'Y', 0, '2007-04-17', NULL, NULL, 0, 0, NULL, NULL),
('953382344', 'W11000763', 'W11000763', 'UT01', 'Choice Source Caremark', '', '', 'Choice Source Caremark', 'GROUP', 'Infusion Agency', 'Mail Order Pharmacy', 'Specialty Pharmacy', NULL, 'O', 'Dept 6175', 'Los Angeles', 'Los Angeles', 'CA', '90088', '8002372767', NULL, 'Dept 6175', 'Los Angeles', 'Los Angeles', 'CA', '90088', '8002372767', '', '', NULL, '1001', '0.00', '0.00', '0.00', 3, '2007-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1013998921', 0, 'Y', 0, '2012-09-24', NULL, NULL, 0, 0, NULL, NULL),
('522005869', 'W11000764', 'W11000764', 'UT01', 'TheraCom Inc', NULL, NULL, 'TheraCom Inc', 'GROUP', 'Infusion Agency', NULL, NULL, NULL, 'O', '9717 Key West Ave', 'Rockville', 'Montgomery', 'MD', '20850', '8002372767', NULL, NULL, NULL, '', NULL, NULL, '', '', '', NULL, '1001', '0.00', '100.00', '0.00', 3, '2007-01-01', NULL, 1, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1568443489', 0, 'Y', 0, '2007-04-17', NULL, NULL, 0, 0, NULL, NULL),
('953382344', 'W11000765', 'W11000765', 'UT01', 'Choice Source Caremark', '', '', 'Choice Source Caremark', 'GROUP', 'Infusion Agency', 'Mail Order Pharmacy', 'Specialty Pharmacy', NULL, 'O', '2211 Sanders Rd', 'Northbrook', 'Cook', 'IL', '60062', '8002372767', NULL, '2211 Sanders Rd', 'Northbrook', 'Cook', 'IL', '60062', '8002372767', '', '', NULL, '1001', '0.00', '0.00', '0.00', 3, '2007-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1013998921', 0, 'Y', 0, '2012-09-24', NULL, NULL, 0, 0, NULL, NULL),
('621795217', 'W11000766', 'W11000766', 'UT01', 'Rock Run Medical', 'Jeff', '', 'Anderson', 'PA', 'Family Practice', '', '', NULL, 'O', '5991 S 3500 W', 'Roy', 'Weber', 'UT', '84067', '8017732838', NULL, '5991 S 3500 W', 'Roy', 'Weber', 'UT', '84067', '8017732838', '', 'WUSTDINT5', 'WUSTDHCPC5', NULL, '0.00', '35.00', '0.00', 6, '2007-02-01', '2008-08-17', 0, 0, 0, 'Ogden Regional Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1255398921', 0, 'N', 0, '2011-03-24', NULL, NULL, 0, 0, NULL, NULL),
('621795217', 'W11000767', 'W11000767', 'UT01', 'Rock Run Medical', 'Jeff', '', 'Anderson', 'PA', 'Family Practice', '', '', NULL, 'B', 'PO Box 95970', 'South Jordan', 'Salt Lake', 'UT', '84095', '8013529500', NULL, 'PO Box 95970', 'South Jordan', 'Salt Lake', 'UT', '84095', '8013529500', '', 'WUSTDINT5', 'WUSTDHCPC5', NULL, '0.00', '35.00', '0.00', 6, '2007-02-01', '2008-08-17', 0, 0, 0, 'Ogden Regional Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1255398921', 0, 'Y', 0, '2011-03-24', NULL, NULL, 0, 0, NULL, NULL),
('870635889', 'W11000768', 'W11000768', 'UT01', 'Tooele Clinic Corp', 'Curt', 'R', 'Dustin', 'APRN', 'Family Practice', '', '', NULL, 'B', '330 Franklin Rd Ste 135A', 'Brentwood', 'Williamson', 'TN', '37027', '4358821697', '4358826304', '330 Franklin Rd Ste 135A', 'Brentwood', 'Williamson', 'TN', '37027', '4358821697', '4358826304', 'WiseSTD', 'WUSTDHCPC5', NULL, '0.00', '35.00', '0.00', 3, '2006-11-01', NULL, 0, 0, 0, 'Mountain West Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1821043548', 0, 'Y', 0, '2011-11-21', NULL, NULL, 0, 0, NULL, NULL),
('870635889', 'W11000769', 'W11000769', 'UT01', 'Mountain View Health Care', 'Curt', 'R', 'Dustin', 'APRN', 'Family Practice', '', '', NULL, 'O', '1959 N Aaron Dr Ste C', 'Tooele', 'Tooele', 'UT', '84074', '4358821644', '4358826304', '1959 N Aaron Dr Ste C', 'Tooele', 'Tooele', 'UT', '84074', '4358821644', '4358826304', 'WiseSTD', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 3, '2006-11-01', '2011-08-29', 0, 0, 0, 'Mountain West Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1821043548', 0, 'N', 0, '2011-11-21', NULL, NULL, 0, 0, NULL, NULL),
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('870281028', 'W11000828', 'W11000828', 'UT01', 'Central Utah Clinic', 'Yun', '', 'Ling', 'MD', 'Internal Medicine', '', '', NULL, 'O', '1175 E 50 S Ste 241', 'Payson', 'Utah', 'UT', '84004', '8014925999', '8013742615', '1175 E 50 S Ste 241', 'Payson', 'Utah', 'UT', '84004', '8014925999', '8013742615', 'WUUVPN10', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 6, '2006-06-01', '2010-07-14', 0, 0, 0, 'Timpanogos Regional Hospital', '', '', '', 'HCFA|UB|', '1063475341', 0, 'N', 0, '2013-09-23', 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
('870281028', 'W11000829', 'W11000829', 'UT01', 'Central Utah Clinic', 'Mark', NULL, 'Brown', 'MD', 'Internal Medicine', NULL, NULL, NULL, 'O', '1175 E 50 S Ste 241', 'Payson', 'Utah', 'UT', '84003', '8014925999', '8013742615', '1055 N 500 W', 'Provo', '', 'UT', '84604', '', '', 'WUUVPN10', 'WUSTDHCPC5', NULL, '0.00', '35.00', '0.00', 3, '2006-06-01', '2008-07-25', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '0000005447', 0, 'N', 0, '2006-10-19', NULL, NULL, 0, 0, NULL, NULL),
('870281028', 'W11000830', 'W11000830', 'UT01', 'Central Utah Clinic', 'Jason', '', 'Huddleston', 'DO', 'Internal Medicine', '', '', NULL, 'O', '1175 E 50 S Ste 241', 'Payson', 'Utah', 'UT', '84003', '8014925999', '8013742615', '1175 E 50 S Ste 241', 'Payson', 'Utah', 'UT', '84003', '8014925999', '8013742615', 'WUUVPN10', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 6, '2006-06-01', '2010-07-14', 0, 0, 0, 'Timpanogos Regional Hospital', '', '', '', 'HCFA|UB|', '1619908001', 0, 'N', 0, '2013-10-21', NULL, NULL, 0, 0, NULL, NULL),
('870281028', 'W11000831', 'W11000831', 'UT01', 'Central Utah Clinic', 'Troy', '', 'Lunceford', 'MD', 'Internal Medicine', '', '', NULL, 'O', '1120 E 100 N Ste 1', 'Payson', 'Utah', 'UT', '84651', '8014654813', '8013742615', '1120 E 100 N Ste 1', 'Payson', 'Utah', 'UT', '84651', '8014654813', '8013742615', 'WUUVPN10', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 6, '2006-06-01', '2010-07-14', 0, 0, 0, 'Mountain View Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1194842286', 0, 'N', 0, '2012-08-21', NULL, NULL, 0, 0, NULL, NULL),
('202785803', 'W11000832', 'W11000832', 'UT01', 'Color Country Pediatrics', 'Brian', 'C', 'McCune', 'MD', 'Pediatrics', '', '', NULL, 'O', '1333 N Main', 'Cedar City', 'Iron', 'UT', '84720', '4358650218', NULL, '1333 N Main', 'Cedar City', 'Iron', 'UT', '84720', '4358650218', '', 'WiseSTD', 'WUSTDHCPC5', NULL, '0.00', '35.00', '0.00', 3, '2007-07-01', '2008-12-31', 0, 0, 0, 'Timpanogos Regional Hospital', '', '', '', 'HCFA|UB|', '1790819241', 0, 'N', 0, '2011-09-30', NULL, NULL, 0, 0, NULL, NULL),
('870281028', 'W11000833', 'W11000833', 'UT01', 'Central Utah Clinic', 'Michael', 'C', 'Peterson', 'MD', 'Internal Medicine', '', '', NULL, 'O', '1055 N 500 W Ste 111 Bld C', 'Provo', 'Utah', 'UT', '84604', '8013748999', NULL, '1055 N 500 W Ste 111 Bld C', 'Provo', 'Utah', 'UT', '84604', '8013748999', '          ', 'WUUVPN10', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 6, '2006-01-01', '2010-07-14', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1902827322', 0, 'N', 0, '2011-04-08', NULL, NULL, 0, 0, NULL, NULL),
('870645895', 'W11000834', 'W11000834', 'UT01', 'U of U Pediatric Orthopedics', 'Annette', 'S', 'Brazell', 'MD', 'Pediatric Orthopedic Surgery', NULL, NULL, NULL, 'B', 'PO Box 58886', 'Salt Lake City', 'Salt Lake', 'UT', '84158', '8012133800', NULL, NULL, NULL, '', NULL, NULL, '', '', 'WUUPEDS', 'WUSTDHCPC5', NULL, '0.00', '15.00', '0.00', 3, '2006-08-01', '2008-02-21', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1235275611', 0, 'y', 0, '2007-02-07', NULL, NULL, 0, 0, NULL, NULL),
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('205050083', 'W11000876', 'W11000876', 'WY01', 'Wyoming Vision Center', 'F', 'John', 'Pembroke', 'OD', 'Optometry', '', '', NULL, 'B', 'PO Box 2250', 'Rock Springs', 'Sweetwater', 'WY', '82902', '3073824444', NULL, 'PO Box 2250', 'Rock Springs', 'Sweetwater', 'WY', '82902', '3073824444', '', 'WYSTD', 'wyhcpcs', NULL, '0.00', '35.00', '0.00', 3, '2007-05-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1578582573', 0, 'Y', 0, '2014-01-08', NULL, NULL, 0, 0, NULL, NULL),
('205050083', 'W11000877', 'W11000877', 'WY01', 'Wyoming Vision Center', 'F', 'John', 'Pembroke', 'OD', 'Optometry', '', '', NULL, 'O', '2820 Foothill Blvd', 'Rock Springs', 'Sweetwater', 'WY', '82901', '3073824444', NULL, '2820 Foothill Blvd', 'Rock Springs', 'Sweetwater', 'WY', '82901', '3073824444', '', 'WYSTD', 'wyhcpcs', NULL, '0.00', '35.00', '0.00', 3, '2007-05-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1578582573', 0, 'n', 0, '2014-01-08', NULL, NULL, 41.5832, -109.256, NULL, NULL),
('742058140', 'W11000878', 'W11000878', 'TX01', NULL, 'Martin', 'J', 'Wiesenthal', 'MD', 'Internal Medicine', '', '', NULL, 'O', '8038 Wurzbach Rd Ste 320', 'San Antonio', 'Bexar', 'TX', '78229', '2106143365', NULL, '8038 Wurzbach Rd Ste 320', 'San Antonio', 'Bexar', 'TX', '78229', '2106143365', '', 'TXINT', 'TXHCPCS', NULL, '0.00', '50.00', '0.00', 3, '2007-05-01', '2012-08-19', 0, 0, 0, 'St Lukes Baptist Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1770664732', 0, 'N', 0, '2013-02-01', NULL, NULL, 29.5144, -98.5772, NULL, NULL),
('742058140', 'W11000879', 'W11000879', 'TX01', NULL, 'Martin', 'J', 'Wiesenthal', 'MD', 'Internal Medicine', '', '', NULL, 'B', 'PO Box 66', 'San Antonio', 'Bexar', 'TX', '78229', '2106143365', NULL, 'PO Box 66', 'San Antonio', 'Bexar', 'TX', '78229', '2106143365', '', 'TXINT', 'TXHCPCS', NULL, '0.00', '50.00', '0.00', 3, '2007-05-01', '2012-08-19', 0, 0, 0, 'St Lukes Baptist Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1770664732', 0, 'Y', 0, '2013-02-01', NULL, NULL, 0, 0, NULL, NULL),
('870622942', 'W11000880', 'W11000880', 'UT01', 'Utah Imaging Associates ', '', '', 'Utah Imaging Associates LLC', 'GROUP', 'Imaging Center', 'Mammography', '', NULL, 'O', '596 W 750 S', 'Bountiful', 'Davis', 'UT', '84011', '8012962113', NULL, '596 W 750 S', 'Bountiful', 'Davis', 'UT', '84011', '8012962113', '', 'WUUTIMAGE5', NULL, NULL, '0.00', '35.00', '0.00', 3, '2006-04-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1629076229', 0, 'Y', 0, '2013-04-15', NULL, NULL, 40.8821, -111.893, NULL, NULL),
('836000295', 'W11000881', 'W11000881', 'WY01', 'Sweetwater Medical Group', 'Brandon', '', 'Meck', 'MD', 'Anesthesiology', '', '', NULL, 'O', '1200 College Dr', 'Rock Springs', 'Sweetwater', 'WY', '82901', '3073623711', NULL, '1200 College Dr', 'Rock Springs', 'Sweetwater', 'WY', '82901', '3073623711', '          ', '', '', '', '0.00', '5.00', '0.00', 3, '2006-12-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1639203664', 0, 'Y', 0, '2013-06-28', NULL, NULL, 41.5816, -109.236, NULL, NULL),
('836000295', 'W11000882', 'W11000882', 'WY01', 'Memorial Hospital of Sweetwater County', 'James', 'E', 'Pearl', 'MD', 'Internal Medicine', 'Pulmonary', 'Emergency Medicine', NULL, 'O', '1204 Hilltop Dr Ste 108', 'Rock Springs', 'Sweetwater', 'WY', '82901', '3073528125', NULL, '1204 Hilltop Dr Ste 108', 'Rock Springs', 'Sweetwater', 'WY', '82901', '3073528125', '', '', NULL, NULL, '0.00', '5.00', '0.00', 3, '2006-12-01', NULL, 0, 0, 0, 'Memorial Hospital of Sweetwater County', '', '', '', 'HCFA|UB|', '1417959206', 0, 'N', 0, '2011-12-19', NULL, NULL, 41.584, -109.232, NULL, NULL),
('836000295', 'W11000883', 'W11000883', 'WY01', 'Memorial Hospital of Sweetwater County', 'Terry', '', 'Donaldson', 'MD', 'Internal Medicine', '', '', NULL, 'O', '1204 Hilltop Dr Ste 108', 'Rock Springs', 'Sweetwater', 'WY', '82901', '3073528125', NULL, '1204 Hilltop Dr Ste 108', 'Rock Springs', 'Sweetwater', 'WY', '82901', '3073528125', '          ', '', '', '', '0.00', '5.00', '0.00', 3, '2006-12-01', '2011-09-30', 0, 0, 0, 'Memorial Hospital of Sweetwater County', '', '', '', 'HCFA|UB|', '1417903709', 0, 'N', 0, '2012-04-27', NULL, NULL, 0, 0, NULL, NULL),
('836000295', 'W11000884', 'W11000884', 'WY01', 'Sweetwater Medical Group', 'Brandon', '', 'Meck', 'MD', 'Anesthesiology', '', '', NULL, 'B', 'PO Box 1359', 'Rock Springs', 'Sweetwater', 'WY', '82902', '3073623711', NULL, 'PO Box 1359', 'Rock Springs', 'Sweetwater', 'WY', '82902', '3073623711', '          ', '', '', '', '0.00', '5.00', '0.00', 3, '2006-12-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1639203664', 0, 'N', 0, '2013-06-28', NULL, NULL, 0, 0, NULL, NULL),
('836000295', 'W11000885', 'W11000885', 'WY01', 'Memorial Hospital of Sweetwater County', 'Mohammad', '', 'Majeed', 'MD', 'Hospitalist', '', '', NULL, 'O', '1204 Hilltop Dr Ste 108', 'Rock Springs', 'Sweetwater', 'WY', '82901', '3073528125', NULL, '1204 Hilltop Dr Ste 108', 'Rock Springs', 'Sweetwater', 'WY', '82901', '3073528125', '          ', '', '', '', '0.00', '5.00', '0.00', 3, '2006-12-01', NULL, 0, 0, 0, 'Campbell County Memorial Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1598854671', 0, 'Y', 0, '2011-06-10', NULL, NULL, 41.584, -109.232, NULL, NULL),
('742743906', 'W11000886', 'W11000886', 'TX01', 'San Antonio Kidney Disease Center', 'James', 'W', 'Lin', 'MD', 'Nephrology', NULL, NULL, NULL, 'O', '2391 NE Loop 410 Ste 405', 'San Antonio', 'Bexar', 'TX', '78217', '2106547326', '2105908232', '7142 San Pedro Ave', 'San Antonio', '', 'TX', '78216', '', '', 'TXSTD', 'TXHCPCS', NULL, '0.00', '50.00', '0.00', 3, '2007-01-01', '2009-07-24', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1053310383', 0, 'N', 0, '2007-01-11', NULL, NULL, 29.5177, -98.4195, NULL, NULL),
('742743906', 'W11000887', 'W11000887', 'TX01', 'San Antonio Kidney Disease Center', 'John', 'E', 'Kobert', 'DO', 'Nephrology', '', '', NULL, 'O', '1008 Brooklyn Ave', 'San Antonio', 'Bexar', 'TX', '78215', '2102280743', '2102289749', '1008 Brooklyn Ave', 'San Antonio', 'Bexar', 'TX', '78215', '2102280743', '2102289749', 'TXSTD', 'TXHCPCS', NULL, '0.00', '50.00', '0.00', 3, '2007-01-01', '2012-08-19', 0, 0, 0, 'Mission Trail Baptist Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1376528810', 0, 'N', 0, '2013-05-07', NULL, NULL, 29.4382, -98.4887, NULL, NULL),
('742743906', 'W11000888', 'W11000888', 'TX01', 'San Antonio Kidney Disease Center', 'Nicolas', 'A', 'Forero', 'MD', 'Nephrology', NULL, NULL, NULL, 'O', '94 Briggs St Ste 500', 'San Antonio', 'Bexar', 'TX', '78224', '2104030765', '2105479270', '7142 San Pedro Ave', 'San Antonio', '', 'TX', '78216', '', '', 'TXSTD', 'TXHCPCS', NULL, '0.00', '50.00', '0.00', 3, '2007-01-01', '2009-07-24', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1740264365', 0, 'N', 0, '2007-01-11', NULL, NULL, 0, 0, NULL, NULL),
('742743906', 'W11000889', 'W11000889', 'TX01', 'San Antonio Kidney Disease Center', 'Steven', 'G', 'Rosenblatt', 'MD', 'Nephrology', '', '', NULL, 'O', '601 31st St', 'Hando', 'Medina', 'TX', '78861', '2106927228', NULL, '601 31st St', 'Hando', 'Medina', 'TX', '78861', '2106927228', '', 'TXSTD', 'TXHCPCS', NULL, '0.00', '50.00', '0.00', 3, '2007-01-01', '2012-08-19', 0, 0, 0, 'Baptist Medical Center', '', '', '', 'HCFA|UB|', '1710962279', 0, 'N', 0, '2013-05-06', NULL, NULL, 0, 0, NULL, NULL),
('870383107', 'W11000890', 'W11000890', 'UT01', NULL, 'Curtis', 'M', 'Campbell', 'MD', 'Urology', '', '', NULL, 'O', '4403 Harrison Blvd Ste 4400', 'Ogden', 'Weber', 'UT', '84403', '8013874550', '8013874565', '4403 Harrison Blvd Ste 4400', 'Ogden', 'Weber', 'UT', '84403', '8013874550', '8013874565', 'WISESTD', 'WUSTDHCPC5', NULL, '0.00', '35.00', '0.00', 3, '2007-05-01', NULL, 0, 0, 0, 'Ogden Regional Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1023059557', 0, 'n', 0, '2014-02-26', NULL, NULL, 41.1828, -111.949, NULL, NULL),
('841367175', 'W11000891', 'W11000891', 'UT01', 'Canyon View Medical Group', 'Miguel', 'L', 'Knochel', 'MD', 'Pediatrics', '', '', NULL, 'O', '325 W Ctr St', 'Spanish Fork', 'Utah', 'UT', '84660', '8017987301', NULL, '325 W Ctr St', 'Spanish Fork', 'Utah', 'UT', '84660', '8017987301', '          ', 'WUUVPN10', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 3, '2006-01-01', '2010-07-14', 0, 0, 0, 'Mountain View Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1730136243', 0, 'N', 0, '2013-09-09', NULL, NULL, 0, 0, NULL, NULL),
('841367175', 'W11000892', 'W11000892', 'UT01', 'Canyon View Medical Group', 'Miguel', 'L', 'Knochel', 'MD', 'Pediatrics', '', '', NULL, 'O', '15 S 1000 E Ste 100', 'Payson', 'Utah', 'UT', '84651', '8014659480', NULL, '15 S 1000 E Ste 100', 'Payson', 'Utah', 'UT', '84651', '8014659480', '          ', 'WUUVPN10', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 3, '2006-01-01', '2010-07-14', 0, 0, 0, 'Mountain View Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1730136243', 0, 'N', 0, '2013-09-09', NULL, NULL, 0, 0, NULL, NULL),
('043687810', 'W11000893', 'W11000893', 'UT01', 'Alpine Hospice Inc', NULL, NULL, 'Alpine Hospice Inc', 'GROUP', 'Hospice', NULL, NULL, NULL, 'B', 'PO Box 65788', 'Salt Lake City', 'Salt Lake', 'UT', '84165', '8017475500', NULL, 'PO Box 65788', 'Salt Lake City', '', 'UT', '84165', '', '', '', NULL, '3', '0.00', '35.00', '0.00', 3, '2006-10-01', NULL, 1, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1265430573', 0, 'y', 0, '2006-10-19', NULL, NULL, 0, 0, NULL, NULL),
('870547967', 'W11000894', 'W11000894', 'UT01', 'Alpine Home Health', NULL, NULL, 'Alpine Home Health', 'GROUP', 'Home Health Agency', NULL, NULL, NULL, 'B', 'PO Box 65788', 'Salt Lake City', 'Salt Lake', 'UT', '84165', '8017475500', NULL, 'PO Box 65788', 'Salt Lake City', '', 'UT', '84165', '', '', '', NULL, '4', '0.00', '100.00', '0.00', 3, '2006-10-01', NULL, 1, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1114932969', 0, 'y', 0, '2006-10-19', NULL, NULL, 0, 0, NULL, NULL),
('202616091', 'W11000895', 'W11000895', 'UT01', 'Sleepwell Partners', '', '', 'Sleepwell Partners', 'GROUP', 'Sleep Disorders', '', '', NULL, 'O', '10499 S Jordan Gateway', 'South Jordan', 'Salt Lake', 'UT', '84095', '8015237533', NULL, '10499 S Jordan Gateway', 'South Jordan', 'Salt Lake', 'UT', '84095', '8015237533', '', 'WCSTSWP5', NULL, NULL, '0.00', '100.00', '0.00', 3, '2006-11-01', '2008-05-01', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1942206370', 0, 'N', 0, '2013-06-27', NULL, NULL, 0, 0, NULL, NULL),
('870284475', 'W11000896', 'W11000896', 'UT01', 'Granger Medical Clinic', 'Sean', 'S', 'Harper', 'MD', 'Ear, Nose and Throat', NULL, NULL, NULL, 'O', '3725 W 4100 S', 'West Valley', 'Salt Lake', 'UT', '84120', '8019653484', '8019683605', '3725 W 4100 S', 'West Valley', '', 'UT', '84120', '', '', 'WUGRANGER5', 'WUSTDHCPC5', NULL, '0.00', '35.00', '0.00', 3, '2007-09-01', '2009-08-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1316068919', 0, 'N', 0, '2006-10-19', NULL, NULL, 0, 0, NULL, NULL),
('870284475', 'W11000897', 'W11000897', 'UT01', 'Granger Medical Clinic', 'Sean', 'S', 'Harper', 'MD', 'Ear, Nose and Throat', NULL, NULL, NULL, 'B', 'PO Box 70658', 'West Valley', 'Salt Lake', 'Ut', '84170', '8019653484', '8019683605', '3725 W 4100 S', 'West Valley', '', 'UT', '84120', '', '', 'WUGRANGER5', 'WUSTDHCPC5', NULL, '0.00', '35.00', '0.00', 3, '2007-09-01', '2009-08-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1316068919', 0, 'Y', 0, '2006-10-19', NULL, NULL, 0, 0, NULL, NULL),
('202785803', 'W11000898', 'W11000898', 'UT01', 'Color Country Pediatrics', 'Scott', 'B', 'Parker', 'APRN', 'Pediatrics', '', '', NULL, 'B', 'PO Box 3040', 'Cedar City', 'Iron', 'UT', '84721', '4358650218', NULL, 'PO Box 3040', 'Cedar City', 'Iron', 'UT', '84721', '4358650218', '', 'WiseSTD', 'WUSTDHCPC5', NULL, '0.00', '35.00', '0.00', 3, '2007-01-01', '2008-12-31', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1386626018', 0, 'Y', 0, '2014-04-02', NULL, NULL, 0, 0, NULL, NULL),
('202785803', 'W11000899', 'W11000899', 'UT01', 'Color Country Pediatrics', 'Scott', 'B', 'Parker', 'APRN', 'Pediatrics', '', '', NULL, 'O', '1333 N Main', 'Cedar City', 'Iron', 'UT', '84720', '4358650218', NULL, '1333 N Main', 'Cedar City', 'Iron', 'UT', '84720', '4358650218', '', 'WiseSTD', 'WUSTDHCPC5', NULL, '0.00', '35.00', '0.00', 3, '2007-01-01', '2008-12-31', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1386626018', 0, 'N', 0, '2014-04-02', NULL, NULL, 0, 0, NULL, NULL),
('876000525', 'W11000900', 'W11000900', 'UT01', 'University of Utah Hospital', 'Timothy', 'Alan', 'Henry', 'PT', 'Physical Therapy', NULL, NULL, NULL, 'B', 'PO Box 510721 ', 'Salt Lake City', 'Salt Lake', 'UT', '84151', '8015812121', NULL, '50 N Medical Dr', 'Salt Lake City', '', 'UT', '84132', '', '', NULL, NULL, '1', '0.00', NULL, NULL, 6, '2006-01-01', '2006-01-01', 1, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1891865960', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('876000525', 'W11000901', 'W11000901', 'UT01', 'University of Utah Hospital', 'Timothy', 'Alan', 'Henry', 'PT', 'Physical Therapy', NULL, NULL, NULL, 'O', '50 N Medical Dr', 'Salt Lake City', 'Salt Lake', 'UT', '84132', '8015812121', NULL, '50 N Medical Dr', 'Salt Lake City', '', 'UT', '84132', '', '', '', NULL, '1', '0.00', '0.00', '0.00', 6, '2006-01-01', NULL, 1, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|', '1891865960', 0, 'N', 0, '2006-12-27', NULL, NULL, 40.7685, -111.837, NULL, NULL),
('876000525', 'W11000902', 'W11000902', 'UT01', 'University of Utah Hospital', 'Tara', NULL, 'Jorgensen', 'SP', 'Speech Therapy', NULL, NULL, NULL, 'B', 'PO Box 510721 ', 'Salt Lake City', 'Salt Lake', 'UT', '84151', '8015812121', NULL, '50 N Medical Dr', 'Salt Lake City', '', 'UT', '84132', '', '', NULL, NULL, '1', '0.00', NULL, NULL, 6, '2006-01-01', '2006-01-01', 1, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1275749202', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('876000525', 'W11000903', 'W11000903', 'UT01', 'University of Utah Hospital', 'Tara', NULL, 'Jorgensen', 'SP', 'Speech Therapy', NULL, NULL, NULL, 'O', '50 N Medical Dr', 'Salt Lake City', 'Salt Lake', 'UT', '84132', '8015812121', NULL, '50 N Medical Dr', 'Salt Lake City', '', 'UT', '84132', '', '', '', NULL, '1', '0.00', '0.00', '0.00', 6, '2006-01-01', NULL, 1, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|', '1275749202', 0, 'N', 0, '2006-12-27', NULL, NULL, 40.7685, -111.837, NULL, NULL),
('870442129', 'W11000904', 'W11000904', 'UT01', 'U of U Dept of Anesthesiology', 'Lorrie', NULL, 'Belcher', 'CRNA', 'Anesthesiology', NULL, NULL, NULL, 'b', 'Po Box 581053', 'Salt Lake City', 'Salt Lake', 'UT', '84158', '8012133800', NULL, NULL, NULL, '', NULL, NULL, '', '', NULL, NULL, '1000', '44.00', NULL, NULL, 3, '2006-08-01', '2007-07-31', 1, 12, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1609981869', 0, 'y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870442129', 'W11000905', 'W11000905', 'UT01', 'U of U Dept of Anesthesiology', 'Lorrie', NULL, 'Belcher', 'CRNA', 'Anesthesiology', NULL, NULL, NULL, 'O', '50 N Medical Dr', 'Salt Lake City', 'Salt Lake', 'UT', '84132', '8015816393', NULL, NULL, NULL, '', NULL, NULL, '', '', NULL, NULL, '1000', '44.00', NULL, NULL, 3, '2006-08-01', '2007-07-31', 1, 12, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1609981869', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('876000525', 'W11000906', 'W11000906', 'UT01', 'University of Utah Hospital', 'Alan', NULL, 'Young', 'AUD', 'Audiology', NULL, NULL, NULL, 'B', 'PO Box 510721 ', 'Salt Lake City', 'Salt Lake', 'UT', '84151', '8015812121', NULL, '50 N Medical Dr', 'Salt Lake City', '', 'UT', '84132', '', '', NULL, NULL, '1', '0.00', NULL, NULL, 6, '2006-01-01', '2006-01-01', 1, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1588691380', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('876000525', 'W11000907', 'W11000907', 'UT01', 'University of Utah Hospital', 'Alan', '', 'Young', 'AUD', 'Audiology', NULL, NULL, NULL, 'O', '50 N Medical Dr', 'Salt Lake City', 'Salt Lake', 'UT', '84132', '8015812121', NULL, '50 N Medical Dr', 'Salt Lake City', 'Salt Lake', 'UT', '84132', '8015812121', '          ', '', '', '1', '0.00', '0.00', '0.00', 6, '2006-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|', '1588691380', 0, 'N', 0, '2013-11-15', NULL, NULL, 40.7685, -111.837, NULL, NULL),
('876000525', 'W11000908', 'W11000908', 'UT01', 'University of Utah Hospital', 'Nancy', NULL, 'Johns', 'OT', 'Physical Therapy', NULL, NULL, NULL, 'B', 'PO Box 510721 ', 'Salt Lake City', 'Salt Lake', 'UT', '84151', '8012382663', NULL, '50 N Medical Dr', 'Salt Lake City', '', 'UT', '84132', '', '', NULL, NULL, '1', '0.00', NULL, NULL, 6, '2006-01-01', '2006-01-01', 1, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1588870174', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('876000525', 'W11000909', 'W11000909', 'UT01', 'University of Utah Hospital', 'Nancy', NULL, 'Johns', 'OT', 'Physical Therapy', NULL, NULL, NULL, 'O', '50 N Medical Dr', 'Salt Lake City', 'Salt Lake', 'UT', '84132', '8015812121', NULL, '50 N Medical Dr', 'Salt Lake City', '', 'UT', '84132', '', '', '', NULL, '1', '0.00', '0.00', '0.00', 6, '2006-01-01', NULL, 1, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|', '1588870174', 0, 'N', 0, '2006-12-27', NULL, NULL, 40.7685, -111.837, NULL, NULL),
('870443046', 'W11000910', 'W11000910', 'UT01', 'U of U Medical Center - Psychiatry', 'Julia', 'G', 'McDougall', 'APRN', 'Mental Health', '', '', NULL, 'B', 'PO Box 413029', 'Salt Lake City', 'Salt Lake', 'UT', '84141', '8012133800', NULL, 'PO Box 413029', 'Salt Lake City', 'Salt Lake', 'UT', '84141', '8012133800', '          ', 'WUUUMG5', 'WUSTDHCPC5', '', '0.00', '25.00', '0.00', 3, '2006-08-01', '2012-08-20', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1003886599', 0, 'N', 0, '2012-08-21', NULL, NULL, 0, 0, NULL, NULL),
('870443046', 'W11000911', 'W11000911', 'UT01', 'University Health Care', 'Julia', 'G', 'McDougall', 'APRN', 'Mental Health', '', '', NULL, 'o', '50 N Medical Dr', 'Salt Lake City', 'Salt Lake', 'UT', '84132', '8015817951', NULL, '50 N Medical Dr', 'Salt Lake City', 'Salt Lake', 'UT', '84132', '8015817951', '          ', 'WUUUMG5', 'WUSTDHCPC5', '', '0.00', '25.00', '0.00', 3, '2006-08-01', '2012-08-20', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1003886599', 0, 'N', 0, '2012-08-21', NULL, NULL, 0, 0, NULL, NULL),
('870551055', 'W11000912', 'W11000912', 'UT01', 'Pediatric Cardiothoracic Surgeons', 'Arun', 'K', 'Singhal', 'MD', 'Cardiovascular Disease', NULL, NULL, NULL, 'B', 'PO Box 58049', 'Salt Lake City', 'Salt Lake', 'UT', '84158', '8012133800', NULL, NULL, NULL, '', NULL, NULL, '', '', 'WUUPEDS', 'WUSTDHCPC5', NULL, '0.00', '15.00', '0.00', 3, '2007-02-01', '2009-08-15', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1578551446', 0, 'Y', 0, '2007-02-07', NULL, NULL, 0, 0, NULL, NULL),
('870551055', 'W11000913', 'W11000913', 'UT01', 'University Health Care', 'Arun', 'K', 'Singhal', 'MD', 'Cardiovascular Disease', NULL, NULL, NULL, 'O', '100 N Mario Capecchi Dr Ste 2800', 'Salt Lake City', 'Salt Lake', 'UT', '84113', '8016625566', NULL, NULL, NULL, '', NULL, NULL, '', '', 'WUUPEDS', 'WUSTDHCPC5', NULL, '0.00', '15.00', '0.00', 3, '2007-02-01', '2009-08-15', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1578551446', 0, 'N', 0, '2007-02-07', NULL, NULL, 0, 0, NULL, NULL),
('562349471', 'W11000914', 'W11000914', 'UT01', 'New Horizon Health Care', 'Lawrence', 'G', 'Nelson', 'MD', 'Family Practice', NULL, NULL, NULL, 'O', '1675 N Freedom Blvd Ste 3', 'Provo', 'Utah', 'UT', '84604', '8013741010', NULL, '1055 N 300 W', 'Provo', '', 'UT', '84604', '', '', 'WiseSTD', 'WUSTDHCPC5', NULL, '0.00', '35.00', '0.00', 3, '2006-12-01', '2010-02-17', NULL, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1316085996', 0, 'N', 0, '2006-11-09', NULL, NULL, 0, 0, NULL, NULL),
('562349471', 'W11000915', 'W11000915', 'UT01', 'New Horizon Health Care', 'Lawrence', 'G', 'Nelson', 'MD', 'Family Practice', NULL, NULL, NULL, 'B', 'PO Box 50745', 'South Jordan', 'Salt Lake', 'UT', '84095', '8013529500', NULL, '1055 N 300 W', 'Provo', '', 'UT', '84604', '', '', 'WiseSTD', 'WUSTDHCPC5', NULL, '0.00', '35.00', '0.00', 3, '2006-12-01', '2010-02-17', NULL, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1316085996', 0, 'Y', 0, '2006-11-09', NULL, NULL, 0, 0, NULL, NULL),
('205851690', 'W11000916', 'W11000916', 'UT01', 'Coral Desert Imaging Center', '', '', 'Coral Desert Imaging Center', 'GROUP', 'Imaging Center', 'Radiology', '', NULL, 'O', '1490 E Foremaster Dr Bldg C', 'St George', 'Washington', 'UT', '84790', '4359862238', '4359862237', '1490 E Foremaster Dr Bldg C', 'St George', 'Washington', 'UT', '84790', '4359862238', '4359862237', 'WiseSTD', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 3, '2007-05-01', '2010-11-09', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1174642102', 0, 'Y', 0, '2010-11-09', NULL, NULL, 0, 0, NULL, NULL),
('870616177', 'W11000917', 'W11000917', 'UT01', 'Salt Lake Orthopaedic Clinic', 'Scott', 'W', 'Russell', 'PHD', 'Mental Health', 'Psychology', '', NULL, 'O', '1160 E 3900 S Ste 5000', 'Salt Lake City', 'Salt Lake', 'UT', '84124', '8012628486', NULL, '1160 E 3900 S Ste 5000', 'Salt Lake City', 'Salt Lake', 'UT', '84124', '8012628486', '          ', 'WUSLORTH5', 'wUSTDHCPC5', '', '0.00', '35.00', '0.00', 3, '2006-04-01', '2014-01-28', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1407858988', 0, 'N', 0, '2014-02-10', NULL, NULL, 0, 0, NULL, NULL),
('830330554', 'W11000918', 'W11000918', 'WY01', 'Evanston Clinic', 'Karrie', '', 'Knopf', 'PAC', 'Family Practice', '', '', NULL, 'O', '196 Arrowhead Dr Ste 1', 'Evanston', 'Uinta', 'WY', '82930', '3077838136', '3077838254', '196 Arrowhead Dr Ste 1', 'Evanston', 'Uinta', 'WY', '82930', '3077838136', '3077838254', 'wystd', 'wyhcpcs', '', '0.00', '35.00', '0.00', 3, '2006-12-01', NULL, 0, 0, 0, 'Evanston Regional Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1487659371', 0, 'N', 0, '2013-06-28', NULL, NULL, 41.2435, -110.998, NULL, NULL),
('830330554', 'W11000919', 'W11000919', 'WY01', 'Evanston Regional Hospital', 'Tracy', NULL, 'Potter', 'PAC', 'Family Practice', '', '', NULL, 'O', '107 N Main St', 'Lyman', 'Uinta', 'WY', '82937', '3077873313', NULL, '107 N Main St', 'Lyman', 'Uinta', 'WY', '82937', '3077873313', '          ', 'wystd', 'wyhcpcs', '', '0.00', '35.00', '0.00', 3, '2006-12-01', '2010-08-01', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1326043225', 0, 'N', 0, '2007-01-11', NULL, NULL, 0, 0, NULL, NULL),
('830330554', 'W11000920', 'W11000920', 'WY01', 'Evanston Regional Hospital', 'Kirk', '', 'Bellow', 'PAC', 'Family Practice', '', '', NULL, 'O', '107 N Main St', 'Lyman', 'Uinta', 'WY', '82937', '3077873312', NULL, '107 N Main St', 'Lyman', 'Uinta', 'WY', '82937', '3077873312', '          ', 'wystd', 'wyhcpcs', '', '0.00', '35.00', '0.00', 3, '2006-12-01', '2010-09-22', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1235134131', 0, 'N', 0, '2010-09-22', NULL, NULL, 0, 0, NULL, NULL),
('743003947', 'W11000921', 'W11000921', 'TX01', 'The San Antonio Orthopaedic Group', 'Phyllis', 'K', 'Monroe', 'OT', 'Physical Therapy', '', '', NULL, 'B', 'PO Box 2516', 'San Antonio', 'Bexar', 'TX', '78258', '8004454263', '          ', 'PO Box 2516', 'San Antonio', 'Bexar', 'TX', '78258', '8004454263', '          ', 'TXORTHO', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2007-01-01', '2014-07-16', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1598978314', 0, 'Y', 0, '2014-07-18', NULL, NULL, 0, 0, NULL, NULL),
('870281299', 'W11000922', 'W11000922', 'UT01', 'American Fork Clinic', 'Mark', '', 'Hafen', 'DO', 'Family Practice', '', '', NULL, 'O', '226 N 1100 E Ste A', 'American Fork', 'Utah', 'UT', '84003', '8018553843', NULL, '226 N 1100 E Ste A', 'American Fork', 'Utah', 'UT', '84003', '8018553843', '          ', 'WUUVPN10', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 3, '2007-07-01', '2010-07-14', 0, 0, 0, 'Timpanogos Regional Hospital', '', '', '', 'HCFA|UB|', '1306952056', 0, 'N', 0, '2013-10-25', NULL, NULL, 0, 0, NULL, NULL),
('876000525', 'W11000923', 'W11000923', 'UT01', 'University of Utah Hospital', 'Brooke', NULL, 'Hammond', 'SP', 'Audiology', NULL, NULL, NULL, 'O', '50 N Medical Dr', 'Salt Lake City', 'Salt Lake', 'UT', '84132', '8015812121', NULL, '50 N Medical Dr', 'Salt Lake City', '', 'UT', '84132', '', '', '', NULL, '1', '0.00', '0.00', '0.00', 6, '2006-01-01', NULL, 1, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|', '1548344492', 0, 'N', 0, '2006-12-27', NULL, NULL, 40.7685, -111.837, NULL, NULL),
('876000525', 'W11000924', 'W11000924', 'UT01', 'University of Utah Hospital', 'Daniel', 'R', 'Houtz', 'SP', 'Speech Therapy', NULL, NULL, NULL, 'O', '50 N Medical Dr', 'Salt Lake City', 'Salt Lake', 'UT', '84132', '8015812121', NULL, '50 N Medical Dr', 'Salt Lake City', '', 'UT', '84132', '', '', '', NULL, '1', '0.00', '0.00', '0.00', 6, '2006-01-01', NULL, 1, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|', '1073729679', 0, 'N', 0, '2006-12-27', NULL, NULL, 40.7685, -111.837, NULL, NULL),
('876000525', 'W11000925', 'W11000925', 'UT01', 'University of Utah Hospital', 'Karen', NULL, 'Straw', 'SP', 'Speech Therapy', NULL, NULL, NULL, 'O', '50 N Medical Dr', 'Salt Lake City', 'Salt Lake', 'UT', '84132', '8015812121', NULL, '50 N Medical Dr', 'Salt Lake City', '', 'UT', '84132', '', '', '', NULL, '1', '0.00', '0.00', '0.00', 6, '2006-01-01', NULL, 1, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|', '0000008936', 0, 'N', 0, '2006-12-27', NULL, NULL, 40.7685, -111.837, 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
('876000525', 'W11000926', 'W11000926', 'UT01', 'University of Utah Hospital', 'Catherine', NULL, 'Howard', 'PT', 'Physical Therapy', NULL, NULL, NULL, 'O', '50 N Medical Dr', 'Salt Lake City', 'Salt Lake', 'UT', '84132', '8015812121', NULL, '50 N Medical Dr', 'Salt Lake City', '', 'UT', '84132', '', '', '', NULL, '1', '0.00', '0.00', '0.00', 6, '2006-01-01', NULL, 1, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|', '1982807947', 0, 'N', 0, '2006-12-27', NULL, NULL, 40.7685, -111.837, NULL, NULL),
('876000525', 'W11000927', 'W11000927', 'UT01', 'University of Utah Hospital', 'Catherine', NULL, 'Howard', 'PT', 'Physical Therapy', NULL, NULL, NULL, 'B', 'PO Box 510721 ', 'Salt Lake City', 'Salt Lake', 'UT', '84151', '8015812121', NULL, '50 N Medical Dr', 'Salt Lake City', '', 'UT', '84132', '', '', NULL, NULL, '1', '0.00', NULL, NULL, 6, '2006-01-01', '2006-01-01', 1, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1982807947', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('876000525', 'W11000928', 'W11000928', 'UT01', 'University of Utah Hospital', 'Brooke', NULL, 'Hammond', 'SP', 'Audiology', NULL, NULL, NULL, 'B', 'PO Box 510721 ', 'Salt Lake City', 'Salt Lake', 'UT', '84151', '8015812121', NULL, '50 N Medical Dr', 'Salt Lake City', '', 'UT', '84132', '', '', NULL, NULL, '1', '0.00', NULL, NULL, 6, '2006-01-01', '2006-01-01', 1, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1548344492', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('876000525', 'W11000929', 'W11000929', 'UT01', 'University of Utah Hospital', 'Karen', NULL, 'Straw', 'SP', 'Speech Therapy', NULL, NULL, NULL, 'B', 'PO Box 510721 ', 'Salt Lake City', 'Salt Lake', 'UT', '84151', '8015812121', NULL, '50 N Medical Dr', 'Salt Lake City', '', 'UT', '84132', '', '', NULL, NULL, '1', '0.00', NULL, NULL, 6, '2006-01-01', '2006-01-01', 1, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '8936', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('876000525', 'W11000930', 'W11000930', 'UT01', 'University of Utah Hospital', 'Daniel', NULL, 'Straw', 'SP', 'Speech Therapy', NULL, NULL, NULL, 'B', 'PO Box 510721 ', 'Salt Lake City', 'Salt Lake', 'UT', '84151', '8015812121', NULL, '50 N Medical Dr', 'Salt Lake City', '', 'UT', '84132', '', '', NULL, NULL, '1', '0.00', NULL, NULL, 6, '2006-01-01', '2006-01-01', 1, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', NULL, 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('876000525', 'W11000931', 'W11000931', 'UT01', 'University of Utah Hospital', 'Elaine', 'Lovell', 'Lake', 'SP', 'Speech Therapy', NULL, NULL, NULL, 'B', 'PO Box 510721 ', 'Salt Lake City', 'Salt Lake', 'UT', '84151', '8015812121', NULL, '50 N Medical Dr', 'Salt Lake City', '', 'UT', '84132', '', '', NULL, NULL, '1', '0.00', NULL, NULL, 6, '2006-01-01', '2006-01-01', 1, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1558566026', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('876000525', 'W11000932', 'W11000932', 'UT01', 'University of Utah Hospital', 'Elaine', 'Lovell', 'Lake', 'SP', 'Speech Therapy', NULL, NULL, NULL, 'O', '50 N Medical Dr', 'Salt Lake City', 'Salt Lake', 'UT', '84132', '8015812121', NULL, '50 N Medical Dr', 'Salt Lake City', '', 'UT', '84132', '', '', '', NULL, '1', '0.00', '0.00', '0.00', 6, '2006-01-01', NULL, 1, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|', '1558566026', 0, 'N', 0, '2006-12-27', NULL, NULL, 40.7685, -111.837, NULL, NULL),
('742712740', 'W11000933', 'W11000933', 'TX01', 'San Antonia Pediatrics', 'Rosalia', '', 'Jalomo', 'MD', 'Pediatrics', NULL, NULL, NULL, 'O', '315 N San Saba Ste 1075', 'San Antonio', 'Bexar', 'TX', '78207', '2102233543', NULL, NULL, NULL, '', NULL, NULL, '', '', 'TXPED', 'TXHCPCS', NULL, '0.00', '50.00', '0.00', 3, '2007-06-01', '2009-09-15', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1801857644', 0, 'n', 0, '2007-06-06', NULL, NULL, 29.4279, -98.5002, NULL, NULL),
('742712740', 'W11000934', 'W11000934', 'TX01', 'San Antonia Pediatrics', 'Rosalia', '', 'Jalomo', 'MD', 'Pediatrics', NULL, NULL, NULL, 'B', 'PO Box 120427', 'San Antonio', 'Bexar', 'TX', '78212', '2102233543', NULL, 'PO Box 120427', 'San Antonio', '', 'TX', '78212', '', '', 'TXPED', 'TXHCPCS', NULL, '0.00', '50.00', '0.00', 3, '2007-06-01', '2009-09-15', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1801857644', 0, 'Y', 0, '2007-06-06', NULL, NULL, 0, 0, NULL, NULL),
('742482411', 'W11000935', 'W11000935', 'TX01', NULL, 'Averess', 'Vicki', 'Rickerson', 'MD', 'Internal Medicine', '', '', NULL, 'O', '8601 Village Dr Ste 100', 'San Antonio', 'Bexar', 'TX', '78217', '2106467227', NULL, '8601 Village Dr Ste 100', 'San Antonio', 'Bexar', 'TX', '78217', '2106467227', '', 'TXINT', 'TXHCPCS', NULL, '0.00', '50.00', '0.00', 3, '2007-06-01', '2012-08-19', 0, 0, 0, 'North East Baptist Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1821018763', 0, 'N', 0, '2013-09-12', NULL, NULL, 29.5178, -98.4283, NULL, NULL),
('364288180', 'W11000936', 'W11000936', 'UT01', 'Gateway Medical', 'Hal', 'Gene', 'Astle', 'MD', 'Neurology', NULL, NULL, NULL, 'O', '2380 N 400 E Ste A', 'North Logan', 'Cache', 'UT', '84341', '4357879600', NULL, '2380 N 400 E', 'N Logan', '', 'UT', '84341', '', '', 'WiseSTD', 'WUSTDHCPC5', NULL, '0.00', '35.00', '0.00', 8, '2007-03-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1336131234', 0, 'N', 0, '2007-03-02', NULL, NULL, 41.775, -111.823, NULL, NULL),
('364288180', 'W11000937', 'W11000937', 'UT01', 'Gateway Medical', 'Hal', 'Gene', 'Astle', 'MD', 'Neurology', NULL, NULL, NULL, 'B', 'PO Box 6157', 'North Logan', 'Cache', 'UT', '84341', '4357879600', NULL, '2380 N 400 E', 'N Logan', '', 'UT', '84341', '', '', 'WiseSTD', 'WUSTDHCPC5', NULL, '0.00', '35.00', '0.00', 8, '2007-03-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1336131234', 0, 'Y', 0, '2007-03-02', NULL, NULL, 0, 0, NULL, NULL),
('870665661', 'W11000938', 'W11000938', 'UT01', 'Pioneer Comprehensive Medical', 'Hugo', 'E', 'Rodier', 'MD', 'Family Practice', 'Nutrition', '', NULL, 'O', '12433 Fort St', 'Draper', 'Salt Lake', 'UT', '84020', '8015761086', NULL, '12433 Fort St', 'Draper', 'Salt Lake', 'UT', '84020', '8015761086', '          ', 'WISESTD', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 3, '2007-05-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1871577031', 0, 'N', 0, '2013-09-12', NULL, NULL, 40.5243, -111.864, NULL, NULL),
('752358801', 'W11000939', 'W11000939', 'TX01', 'Childrens Heart Network', 'Patrick', 'F', 'Glasow', 'MD', '', '', '', NULL, 'O', '1901 Babcock Rd Ste 301', 'San Antonio', 'Bexar', 'TX', '78229', '2103417722', NULL, '1901 Babcock Rd Ste 301', 'San Antonio', 'Bexar', 'TX', '78229', '2103417722', '', 'TXORTHO', 'TXHCPCS', NULL, '0.00', '50.00', '0.00', 3, '2006-07-01', '2009-02-06', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1568468791', 0, 'n', 0, '2011-07-14', NULL, NULL, 0, 0, NULL, NULL),
('752358801', 'W11000940', 'W11000940', 'TX01', 'Childrens Heart Network', 'Elaine', 'M', 'Maldonado', 'MD', '', '', '', NULL, 'O', '1901 Babcock Rd Ste 301', 'San Antonio', 'Bexar', 'TX', '78229', '2103417722', NULL, '1901 Babcock Rd Ste 301', 'San Antonio', 'Bexar', 'TX', '78229', '2103417722', '', 'TXORTHO', 'TXHCPCS', NULL, '0.00', '50.00', '0.00', 3, '2006-07-01', '2009-02-06', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1902897341', 0, 'n', 0, '2011-07-14', NULL, NULL, 0, 0, NULL, NULL),
('752358801', 'W11000941', 'W11000941', 'TX01', 'Childrens Heart Network', 'James', 'H', 'Rogers', 'MD', '', '', '', NULL, 'O', '1901 Babcock Rd Ste 301', 'San Antonio', 'Bexar', 'TX', '78229', '2103417722', NULL, '1901 Babcock Rd Ste 301', 'San Antonio', 'Bexar', 'TX', '78229', '2103417722', '', 'TXORTHO', 'TXHCPCS', NULL, '0.00', '50.00', '0.00', 3, '2006-07-01', '2009-02-06', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1275530347', 0, 'n', 0, '2011-07-14', NULL, NULL, 0, 0, NULL, NULL),
('752358801', 'W11000942', 'W11000942', 'TX01', 'Childrens Heart Network', 'James', 'H', 'Rogers', 'MD', '', '', '', NULL, 'B', 'PO Box 2137', 'San Antonio', 'Bexar', 'TX', '78297', '2103417722', NULL, 'PO Box 2137', 'San Antonio', 'Bexar', 'TX', '78297', '2103417722', '', 'TXORTHO', 'TXHCPCS', NULL, '0.00', '50.00', '0.00', 3, '2006-07-01', '2009-02-06', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1275530347', 0, 'Y', 0, '2011-07-14', NULL, NULL, 0, 0, NULL, NULL),
('752358801', 'W11000943', 'W11000943', 'TX01', 'Childrens Heart Network', 'Elaine', 'M', 'Maldonado', 'MD', '', '', '', NULL, 'B', 'PO Box 2137', 'San Antonio', 'Bexar', 'TX', '78297', '2103417722', NULL, 'PO Box 2137', 'San Antonio', 'Bexar', 'TX', '78297', '2103417722', '', 'TXORTHO', 'TXHCPCS', NULL, '0.00', '50.00', '0.00', 3, '2006-07-01', '2009-02-06', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1902897341', 0, 'Y', 0, '2011-07-14', NULL, NULL, 0, 0, NULL, NULL),
('752358801', 'W11000944', 'W11000944', 'TX01', 'Childrens Heart Network', 'Patrick', 'F', 'Glasow', 'MD', '', '', '', NULL, 'B', 'PO Box 2137', 'San Antonio', 'Bexar', 'TX', '78297', '2103417722', NULL, 'PO Box 2137', 'San Antonio', 'Bexar', 'TX', '78297', '2103417722', '', 'TXORTHO', 'TXHCPCS', NULL, '0.00', '50.00', '0.00', 3, '2006-07-01', '2009-02-06', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1568468791', 0, 'Y', 0, '2011-07-14', NULL, NULL, 0, 0, NULL, NULL),
('522488481', 'W11000945', 'W11000945', 'UT01', '', 'Larry', 'D', 'Weber', 'MS', 'Audiology', '', '', NULL, 'O', '2510 Washington Blvd Ste 100', 'Ogden', 'Weber', 'UT', '84401', '8016273001', '8016273001', '2510 Washington Blvd Ste 100', 'Ogden', 'Weber', 'UT', '84401', '8016273001', '8016273001', 'WiseSTD', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 3, '2006-12-01', '2010-09-30', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1174550800', 0, 'N', 0, '2012-08-27', NULL, NULL, 0, 0, NULL, NULL),
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('010724468', 'W11000983', 'W11000983', 'TX01', 'Lone Star Cancer', 'Jayasree', 'N', 'Rao', 'MD', 'Hematology and Oncology', NULL, NULL, NULL, 'O', '9102 Floyd Curl Dr', 'San Antonio', 'Bexar', 'TX', '78240', '2102470920', NULL, 'PO Box 781905', 'San Antonio', '', 'TX', '78240', '', '', 'TXONCOL', 'TXHCPCS', NULL, '0.00', '50.00', '0.00', 3, '2007-01-01', '2009-07-21', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1285662510', 0, 'N', 0, '2008-08-17', NULL, NULL, 29.5287, -98.5918, NULL, NULL),
('010724468', 'W11000984', 'W11000984', 'TX01', 'Lone Star Cancer', 'Jayasree', 'N', 'Rao', 'MD', 'Hematology and Oncology', NULL, NULL, NULL, 'O', '925 San Pedro Ave', 'San Antonio', 'Bexar', 'TX', '78212', '2102276156', NULL, 'PO Box 781905', 'San Antonio', '', 'TX', '78240', '', '', 'TXONCOL', 'TXHCPCS', NULL, '0.00', '50.00', '0.00', 3, '2007-01-01', '2009-07-21', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1285662510', 0, 'N', 0, '2008-08-17', NULL, NULL, 29.4423, -98.4998, NULL, NULL),
('010724468', 'W11000985', 'W11000985', 'TX01', 'Lone Star Cancer', 'Devendra', 'Kumar', 'Bhachawat', 'MD', 'Hematology and Oncology', 'Oncology', '', NULL, 'O', '925 San Pedro Ave', 'San Antonio', 'Bexar', 'TX', '78212', '2102276156', NULL, '925 San Pedro Ave', 'San Antonio', 'Bexar', 'TX', '78212', '2102276156', '', 'TXONCOL', 'TXHCPCS', NULL, '0.00', '50.00', '0.00', 3, '2007-01-01', '2009-01-01', 0, 0, 0, 'Baptist Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1053338731', 0, 'N', 0, '2013-04-05', NULL, NULL, 29.4423, -98.4998, NULL, NULL),
('743002424', 'W11000986', 'W11000986', 'TX01', 'Leon Springs Pediatrics', 'Leah', '', 'Garguena-Bacuta', 'MD', 'Pediatrics', '', '', NULL, 'O', '24165 IH 10 W Ste 114', 'San Antonio', 'Bexar', 'TX', '78257', '2106871543', NULL, '24165 IH 10 W Ste 114', 'San Antonio', 'Bexar', 'TX', '78257', '2106871543', '', 'TXPED', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2007-06-01', '2012-08-19', 0, 0, 0, 'North Central Baptist Hospital', '', '', '', 'HCFA|UB|', '1679575708', 0, 'N', 0, '2014-06-04', NULL, NULL, 29.6657, -98.6322, NULL, NULL),
('743002424', 'W11000987', 'W11000987', 'TX01', 'Leon Springs Pediatrics', 'David', 'W', 'Popp', 'MD', 'Pediatrics', '', '', NULL, 'O', '24165 IH 10 W Ste 114', 'San Antonio', 'Bexar', 'TX', '78257', '2106871543', NULL, '24165 IH 10 W Ste 114', 'San Antonio', 'Bexar', 'TX', '78257', '2106871543', '', 'TXPED', 'TXHCPCS', NULL, '0.00', '50.00', '0.00', 3, '2007-06-01', '2012-08-19', 0, 0, 0, 'North Central Baptist Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1417941048', 0, 'n', 0, '2013-07-09', NULL, NULL, 29.6657, -98.6322, NULL, NULL),
('743002424', 'W11000988', 'W11000988', 'TX01', 'Leon Springs Pediatrics', 'David', 'W', 'Popp', 'MD', 'Pediatrics', '', '', NULL, 'B', 'PO Box 1937', 'San Antonio', 'Bexar', 'TX', '78257', '2106871543', NULL, 'PO Box 1937', 'San Antonio', 'Bexar', 'TX', '78257', '2106871543', '', 'TXPED', 'TXHCPCS', NULL, '0.00', '50.00', '0.00', 3, '2007-06-01', '2012-08-19', 0, 0, 0, 'North Central Baptist Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1417941048', 0, 'Y', 0, '2013-07-09', NULL, NULL, 0, 0, NULL, NULL),
('743002424', 'W11000989', 'W11000989', 'TX01', 'Leon Springs Pediatrics', 'Leah', '', 'Garguena-Bacuta', 'MD', 'Pediatrics', '', '', NULL, 'B', 'PO Box 1937', 'San Antonio', 'Bexar', 'TX', '78257', '2106871543', NULL, 'PO Box 1937', 'San Antonio', 'Bexar', 'TX', '78257', '2106871543', '', 'TXPED', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2007-06-01', '2012-08-19', 0, 0, 0, 'North Central Baptist Hospital', '', '', '', 'HCFA|UB|', '1679575708', 0, 'Y', 0, '2014-06-04', NULL, NULL, 0, 0, NULL, NULL),
('742974353', 'W11000990', 'W11000990', 'TX01', NULL, 'Robert', 'G', 'Nobles', 'MD', 'Internal Medicine', '', '', NULL, 'O', '5979 Babcock Rd', 'San Antonio', 'Bexar', 'TX', '78249', '2106905511', NULL, '5979 Babcock Rd', 'San Antonio', 'Bexar', 'TX', '78249', '2106905511', '', 'TXINT', 'TXHCPCS', NULL, '0.00', '50.00', '0.00', 3, '2007-06-01', '2012-08-19', 0, 0, 0, 'Baptist Medical Center', '', '', '', 'HCFA|UB|', '1467457937', 0, 'n', 0, '2013-08-15', NULL, NULL, 29.5302, -98.6034, NULL, NULL),
('742974353', 'W11000991', 'W11000991', 'TX01', NULL, 'Robert', 'G', 'Nobles', 'MD', 'Internal Medicine', '', '', NULL, 'B', 'PO Box 690547', 'San Antonio', 'Bexar', 'TX', '78249', '2106905511', NULL, 'PO Box 690547', 'San Antonio', 'Bexar', 'TX', '78249', '2106905511', '', 'TXINT', 'TXHCPCS', NULL, '0.00', '50.00', '0.00', 3, '2007-06-01', '2012-08-19', 0, 0, 0, 'Baptist Medical Center', '', '', '', 'HCFA|UB|', '1467457937', 0, 'Y', 0, '2013-08-15', NULL, NULL, 0, 0, NULL, NULL),
('742957980', 'W11000992', 'W11000992', 'TX01', NULL, 'Lawrence', 'A', 'Alder', 'MD', 'Internal Medicine', '', '', NULL, 'O', '19260 Stone Oak Pkwy Ste 105', 'San Antonio', 'Bexar', 'TX', '78258', '2104023456', NULL, '19260 Stone Oak Pkwy Ste 105', 'San Antonio', 'Bexar', 'TX', '78258', '2104023456', '', 'TXINTB', 'TXHCPCS', NULL, '0.00', '50.00', '0.00', 3, '2007-05-01', '2012-08-19', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1023027182', 0, 'n', 0, '2013-04-24', NULL, NULL, 0, 0, NULL, NULL),
('742825112', 'W11000993', 'W11000993', 'TX01', NULL, 'Patrick', 'H', 'Peters', 'MD', 'Internal Medicine', '', '', NULL, 'O', '6547 Bandera Rd Ste C', 'San Antonio', 'Bexar', 'TX', '78238', '2105217676', NULL, '6547 Bandera Rd Ste C', 'San Antonio', 'Bexar', 'TX', '78238', '2105217676', '', 'TXINTB', 'TXHCPCS', NULL, '0.00', '50.00', '0.00', 3, '2007-05-01', '2012-08-19', 0, 0, 0, 'Baptist Medical Center', '', '', '', 'HCFA|UB|', '1578505731', 0, 'n', 0, '2013-04-11', NULL, NULL, 29.4915, -98.6132, NULL, NULL),
('841399721', 'W11000994', 'W11000994', 'WY01', 'Frontier Audiology', 'Lori', 'L', 'Archie', 'AUD', 'Audiology', '', '', NULL, 'O', '222 S 5th St', 'Douglas', 'Converse', 'WY', '82633', '3073388300', NULL, '222 S 5th St', 'Douglas', 'Converse', 'WY', '82633', '3073388300', '', 'WISEWYSTD', 'wyhcpcs', NULL, '0.00', '35.00', '0.00', 3, '2007-07-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1710072681', 0, 'n', 0, '2014-04-24', NULL, NULL, 42.7578, -105.381, NULL, NULL),
('841399721', 'W11000995', 'W11000995', 'WY01', 'Frontier Audiology', 'Lori', 'L', 'Archie', 'AUD', 'Audiology', '', '', NULL, 'O', '407 S Medical Arts Ct Ste F', 'Gillette', 'Campbell', 'WY', '82716', '3076823399', NULL, '407 S Medical Arts Ct Ste F', 'Gillette', 'Campbell', 'WY', '82716', '3076823399', '', 'WISEWYSTD', 'wyhcpcs', NULL, '0.00', '35.00', '0.00', 3, '2007-07-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1710072681', 0, 'n', 0, '2014-04-24', NULL, NULL, 44.29, -105.521, NULL, NULL),
('841399721', 'W11000996', 'W11000996', 'WY01', 'Frontier Audiology', 'Lori', 'L', 'Archie', 'AUD', 'Audiology', '', '', NULL, 'B', '968 Gilchirst', 'Wheatland', 'Platte', 'WY', '82201', '3076823399', NULL, '968 Gilchirst', 'Wheatland', 'Platte', 'WY', '82201', '3076823399', '', 'WISEWYSTD', 'wyhcpcs', NULL, '0.00', '35.00', '0.00', 3, '2007-07-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1710072681', 0, 'Y', 0, '2014-04-24', NULL, NULL, 0, 0, NULL, NULL),
('043681691', 'W11000997', 'W11000997', 'WY01', '', 'Clinton', 'F', 'Merrill', 'MD', 'Hematology and Oncology', 'Oncology', '', NULL, 'O', '255 N 30th St', 'Laramie', 'Albany', 'WY', '82072', '3077427586', NULL, '255 N 30th St', 'Laramie', 'Albany', 'WY', '82072', '3077427586', '          ', 'wisewystd', 'wyhcpcs', '', '0.00', '35.00', '0.00', 3, '2007-07-01', '2011-05-18', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1992707285', 0, 'N', 0, '2011-05-18', NULL, NULL, 0, 0, NULL, NULL),
('043681691', 'W11000998', 'W11000998', 'WY01', '', 'Clinton', 'F', 'Merrill', 'MD', 'Hematology and Oncology', 'Oncology', '', NULL, 'B', 'PO Box 1005', 'Laramie', 'Albany', 'WY', '82070', '3077427586', NULL, 'PO Box 1005', 'Laramie', 'Albany', 'WY', '82070', '3077427586', '          ', 'wisewystd', 'wyhcpcs', '', '0.00', '35.00', '0.00', 3, '2007-07-01', '2011-05-18', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1992707285', 0, 'Y', 0, '2011-05-18', NULL, NULL, 0, 0, NULL, NULL),
('455885458', 'W11000999', 'W11000999', 'WY01', 'Wind River Hearing Services', 'Celesta', '', 'Komrs', 'MS', 'Audiology', '', '', NULL, 'O', '269 Garfield St', 'Lander', 'Fremont', 'WY', '82520', '3073320284', NULL, '269 Garfield St', 'Lander', 'Fremont', 'WY', '82520', '3073320284', '          ', 'WiseWYSTD', 'wyhcpcs', '', '0.00', '35.00', '0.00', 3, '2007-07-01', '2011-05-25', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1578649042', 0, 'N', 0, '2011-05-25', NULL, NULL, 0, 0, NULL, NULL),
('455885458', 'W11001000', 'W11001000', 'WY01', 'Memorial Hospital of Carbon', 'Celesta', '', 'Komrs', 'MS', 'Audiology', '', '', NULL, 'O', '2221 W Elm St', 'Rawlins', 'Carbon', 'WY', '82301', '8663320284', NULL, '2221 W Elm St', 'Rawlins', 'Carbon', 'WY', '82301', '8663320284', '          ', 'WiseWYSTD', 'wyhcpcs', '', '0.00', '35.00', '0.00', 3, '2007-07-01', '2011-05-25', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1578649042', 0, 'N', 0, '2011-05-25', NULL, NULL, 0, 0, NULL, NULL),
('455885458', 'W11001001', 'W11001001', 'WY01', 'Red Desert Clinic', 'Celesta', '', 'Komrs', 'MS', 'Audiology', '', '', NULL, 'O', '2761 Commercial Way', 'Rock Springs', 'Sweetwater', 'WY', '82901', '8663320284', NULL, '2761 Commercial Way', 'Rock Springs', 'Sweetwater', 'WY', '82901', '8663320284', '          ', 'WiseWYSTD', 'wyhcpcs', '', '0.00', '35.00', '0.00', 3, '2007-07-01', '2011-05-25', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1578649042', 0, 'N', 0, '2011-05-25', NULL, NULL, 0, 0, NULL, NULL),
('830308330', 'W11001002', 'W11001002', 'WY01', 'Strong Tree Clinic', 'Joseph', '', 'Baumstarck', 'MD', 'Family Practice', '', '', NULL, 'O', '342 East main', 'Lovell', 'Big Horn', 'WY', '82431', '3075486289', NULL, '342 East main', 'Lovell', 'Big Horn', 'WY', '82431', '3075486289', '          ', 'WiseWYSTD', 'wyhcpcs', '', '0.00', '35.00', '0.00', 3, '2007-07-01', '2010-06-23', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1538121025', 0, 'Y', 0, '2010-06-23', NULL, NULL, 0, 0, NULL, NULL),
('830308330', 'W11001003', 'W11001003', 'WY01', 'Strong Tree Clinic', 'Griffyth', '', 'Richard', 'PA', 'Family Practice', '', '', NULL, 'O', '342 East main', 'Lovell', 'Big Horn', 'WY', '82431', '3075486289', NULL, '342 East main', 'Lovell', 'Big Horn', 'WY', '82431', '3075486289', '          ', 'WiseWYSTD', 'wyhcpcs', '', '0.00', '35.00', '0.00', 3, '2007-07-01', '2010-06-23', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '0000008379', 0, 'N', 0, '2010-06-23', NULL, NULL, 0, 0, NULL, NULL),
('830306295', 'W11001004', 'W11001004', 'WY01', 'Family Vision Clinic', 'Richard', 'D', 'Jones', 'OD', 'Optometry', NULL, NULL, NULL, 'O', '426 Nevada Ave', 'Lovell', 'Big Horn', 'WY', '82431', '3075487450', NULL, 'PO Box 785', 'Lovell', '', 'WY', '82431', '', '', 'WiseWYSTD', 'wyhcpcs', NULL, '0.00', '35.00', NULL, 3, '2007-07-01', '2007-11-15', 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1477544161', 0, 'n', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('830306295', 'W11001005', 'W11001005', 'WY01', 'Family Vision Clinic', 'Richard', 'D', 'Jones', 'OD', 'Optometry', NULL, NULL, NULL, 'O', '1708 Stampede Ave', 'CODY', 'Park', 'WY', '82414', '3075872404', NULL, 'PO Box 785', 'Lovell', '', 'WY', '82431', '', '', 'WiseWYSTD', 'wyhcpcs', NULL, '0.00', '35.00', NULL, 3, '2007-07-01', '2007-11-15', 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1477544161', 0, 'n', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('830306295', 'W11001006', 'W11001006', 'WY01', 'Family Vision Clinic', 'Richard', 'D', 'Jones', 'OD', 'Optometry', NULL, NULL, NULL, 'B', 'PO Box 785', 'Lovell', 'Big Horn', 'WY', '82431', '3075487450', NULL, 'PO Box 785', 'Lovell', '', 'WY', '82431', '', '', 'WiseWYSTD', 'wyhcpcs', NULL, '0.00', '35.00', NULL, 3, '2007-07-01', '2007-11-15', 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1477544161', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870436209', 'W11001007', 'W11001007', 'UT01', 'The Avenues Womens Clinic', 'Hannele', '', 'Laine', 'MD', 'Obstetrics and Gynecology', '', '', NULL, 'O', '455 E S Temple Ste 202', 'Salt Lake City', 'Salt Lake', 'UT', '84111', '8013559951', NULL, '455 E S Temple Ste 202', 'Salt Lake City', 'Salt Lake', 'UT', '84111', '8013559951', '          ', 'WUSTDOBG5', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 3, '2006-12-01', '2010-09-01', 0, 0, 0, 'Salt Lake Regional Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1083817449', 0, 'N', 0, '2012-02-22', NULL, NULL, 0, 0, NULL, NULL),
('870470731', 'W11001008', 'W11001008', 'UT01', 'Ungricht Eye Associates', 'Paul', 'W', 'Wyatt', 'MD', 'Ophthalmology', NULL, NULL, NULL, 'O', '5770 S 250 E Ste 410', 'Salt Lake City', 'Salt Lake', 'UT', '84107', '8013144420', NULL, '5770 S 250 E', 'Salt Lake City', '', 'UT', '84107', '', '', 'WiseSTD', 'WUSTDHCPC5', NULL, '0.00', '35.00', NULL, 6, '2006-10-01', '2007-10-01', 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1700082104', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870306646', 'W11001009', 'W11001009', 'UT01', 'Emergency Physicians Group', 'Marc', 'Paul', 'Hyde', 'MD', 'Emergency Medicine', '', '', NULL, 'B', 'PO Box 95970', 'South Jordan', 'Salt Lake', 'UT', '84095', '8013529500', NULL, 'PO Box 95970', 'South Jordan', 'Salt Lake', 'UT', '84095', '8013529500', '', 'WiseSTD', 'WUSTDHCPC5', NULL, '0.00', '35.00', '0.00', 3, '2007-01-01', NULL, 0, 0, 0, 'University Health Care University Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1962594879', 0, 'Y', 0, '2011-07-19', NULL, NULL, 0, 0, NULL, NULL),
('870306646', 'W11001010', 'W11001010', 'UT01', 'Emergency Physicians Group', 'Marc', 'Paul', 'Hyde', 'MD', 'Emergency Medicine', '', '', NULL, 'O', '1200 E 3900 S', 'Salt Lake City', 'Salt Lake', 'UT', '84124', '8013529500', NULL, '1200 E 3900 S', 'Salt Lake City', 'Salt Lake', 'UT', '84124', '8013529500', '          ', 'WiseSTD', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 3, '2007-01-01', NULL, 0, 0, 0, 'University Health Care University Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1962594879', 0, 'Y', 0, '2011-07-19', NULL, NULL, 40.6871, -111.856, NULL, NULL),
('870283830', 'W11001011', 'W11001011', 'UT01', 'Intermountain Allergy', 'Gregory', 'M', 'Wickern', 'MD', 'Allergy and Immunology', '', '', NULL, 'O', '150 S 1000 E', 'Salt Lake City', 'Salt Lake', 'UT', '84102', '8013634071', NULL, '150 S 1000 E', 'Salt Lake City', 'Salt Lake', 'UT', '84102', '8013634071', '', 'WiseSTD6A', 'WUSTDHCPC5', NULL, '0.00', '35.00', '0.00', 3, '2006-09-01', '2008-11-30', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1972578672', 0, 'N', 0, '2011-01-19', NULL, NULL, 0, 0, NULL, NULL),
('870395551', 'W11001012', 'W11001012', 'UT01', NULL, 'Michael', 'L', 'Massengale', 'DC', 'Chiropractic', NULL, NULL, NULL, 'B', '9135 S Monroe St Ste B', 'Sandy', 'Salt Lake', 'UT', '84070', '8013527270', '8013527024', '9135 S Monroe', 'Sandy', '', 'UT', '84070', '', '', 'WLABRAD', 'WUSTDHCPC5', NULL, '0.00', NULL, '55.46', 3, '2007-04-09', '2007-12-31', 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1962507848', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870395551', 'W11001013', 'W11001013', 'UT01', NULL, 'J', 'Adam', 'Cleverley', 'DC', 'Chiropractic', NULL, NULL, NULL, 'B', '9135 S Monroe St Ste B', 'Sandy', 'Salt Lake', 'UT', '84070', '8013527270', '8013527024', '9135 S Monroe', 'Sandy', '', 'UT', '84070', '', '', 'WLABRAD', 'WUSTDHCPC5', NULL, '0.00', NULL, '55.46', 3, '2007-04-09', '2007-12-31', 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '5736', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870395551', 'W11001014', 'W11001014', 'UT01', NULL, 'Paul', 'R', 'Cassista', 'DC', 'Chiropractic', NULL, NULL, NULL, 'B', '9135 S Monroe St Ste B', 'Sandy', 'Salt Lake', 'UT', '84070', '8013527270', '8013527024', '9135 S Monroe', 'Sandy', '', 'UT', '84070', '', '', 'WLABRAD', 'WUSTDHCPC5', NULL, '0.00', NULL, '55.46', 3, '2007-04-09', '2007-12-31', 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1548272552', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870395551', 'W11001015', 'W11001015', 'UT01', NULL, 'Ronald', NULL, 'Beutler', 'DC', 'Chiropractic', NULL, NULL, NULL, 'B', '9135 S Monroe St Ste B', 'Sandy', 'Salt Lake', 'UT', '84070', '8013527270', '8013527024', '9135 S Monroe', 'Sandy', '', 'UT', '84070', '', '', 'WLABRAD', 'WUSTDHCPC5', NULL, '0.00', NULL, '55.46', 3, '2007-04-09', '2007-12-31', 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1649344490', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870395551', 'W11001016', 'W11001016', 'UT01', NULL, 'Richard', NULL, 'Salois', 'DC', 'Chiropractic', NULL, NULL, NULL, 'B', '9135 S Monroe St Ste B', 'Sandy', 'Salt Lake', 'UT', '84070', '8013527270', '8013527024', '9135 S Monroe', 'Sandy', '', 'UT', '84070', '', '', 'WLABRAD', 'WUSTDHCPC5', NULL, '0.00', NULL, '55.46', 3, '2007-04-09', '2007-12-31', 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1023184207', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870395551', 'W11001017', 'W11001017', 'UT01', NULL, 'Adam', NULL, 'Murie', 'DC', 'Chiropractic', NULL, NULL, NULL, 'B', '9135 S Monroe St Ste B', 'Sandy', 'Salt Lake', 'UT', '84070', '8013527270', '8013527024', '9135 S Monroe', 'Sandy', '', 'UT', '84070', '', '', 'WLABRAD', 'WUSTDHCPC5', NULL, '0.00', NULL, '55.46', 3, '2007-04-09', '2007-12-31', 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1629274840', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870395551', 'W11001018', 'W11001018', 'UT01', NULL, 'Trevor', NULL, 'Lowry', 'DC', 'Chiropractic', NULL, NULL, NULL, 'B', '9135 S Monroe St Ste B', 'Sandy', 'Salt Lake', 'UT', '84070', '8013527270', '8013527024', '9135 S Monroe', 'Sandy', '', 'UT', '84070', '', '', 'WLABRAD', 'WUSTDHCPC5', NULL, '0.00', NULL, '55.46', 3, '2007-04-09', '2007-12-31', 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1104837848', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870395551', 'W11001019', 'W11001019', 'UT01', '', 'Michael', 'Loren', 'Massengale', 'DC', 'Chiropractic', '', '', NULL, 'O', '1951 W 4700 S Ste 2', 'Salt Lake City', 'Salt Lake', 'UT', '84118', '8019694700', '8019697217', '1951 W 4700 S Ste 2', 'Salt Lake City', 'Salt Lake', 'UT', '84118', '8019694700', '8019697217', 'WLABRAD', 'WUSTDHCPC5', '', '0.00', '0.00', '55.46', 3, '2007-04-09', '2010-10-31', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1962507848', 0, 'N', 0, '2013-12-30', NULL, NULL, 0, 0, NULL, NULL),
('870395551', 'W11001020', 'W11001020', 'UT01', NULL, 'J', 'Adam', 'Cleverley', 'DC', 'Chiropractic', NULL, NULL, NULL, 'O', '3360 S 15 E', 'Idaho Falls', 'Bonneville', 'ID', '83404', '2085246412', '2085246097', '867 E 9400 S', 'Sandy', '', 'UT', '84094', '', '', 'WLABRAD', 'WUSTDHCPC5', NULL, '0.00', '0.00', '55.46', 3, '2007-04-09', '2010-10-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '0000005736', 0, 'N', 0, '2006-08-31', NULL, NULL, 0, 0, NULL, NULL),
('870395551', 'W11001021', 'W11001021', 'UT01', '', 'Paul', 'R', 'Cassista', 'DC', 'Chiropractic', NULL, NULL, NULL, 'O', '1019 E Lincoln Way', 'Cheyenne', 'Laramie', 'WY', '82001', '3076357727', '8013527024', '1019 E Lincoln Way', 'Cheyenne', 'Laramie', 'WY', '82001', '3076357727', '8013527024', 'WLABRAD', 'WUSTDHCPC5', '', '0.00', '0.00', '55.46', 3, '2007-04-09', '2010-10-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1548272552', 0, 'N', 0, '2006-08-31', 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
('870395551', 'W11001022', 'W11001022', 'UT01', NULL, 'Ronald', NULL, 'Beutler', 'DC', 'Chiropractic', NULL, NULL, NULL, 'O', '1275 S 800 E', 'Orem', 'Utah', 'UT', '84097', '8012359977', '8012350949', '867 E 9400 S', 'Sandy', '', 'UT', '84094', '', '', 'WLABRAD', 'WUSTDHCPC5', NULL, '0.00', '0.00', '55.46', 3, '2007-04-09', '2010-10-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1649344490', 0, 'N', 0, '2006-08-31', NULL, NULL, 0, 0, NULL, NULL),
('870395551', 'W11001023', 'W11001023', 'UT01', NULL, 'Richard', NULL, 'Salois', 'DC', 'Chiropractic', NULL, NULL, NULL, 'O', '1275 S 800 E', 'Orem', 'Utah', 'UT', '84097', '8012359977', '8012350949', '867 E 9400 S', 'Sandy', '', 'UT', '84094', '', '', 'WLABRAD', 'WUSTDHCPC5', NULL, '0.00', '0.00', '55.46', 3, '2007-04-09', '2010-10-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1023184207', 0, 'N', 0, '2006-08-31', NULL, NULL, 0, 0, NULL, NULL),
('870395551', 'W11001024', 'W11001024', 'UT01', NULL, 'Adam', NULL, 'Murie', 'DC', 'Chiropractic', NULL, NULL, NULL, 'O', '1180 S Sage St Ste E', 'Cedar City', 'Iron', 'UT', '84720', '4358676354', '4358671472', '867 E 9400 S', 'Sandy', '', 'UT', '84094', '', '', 'WLABRAD', 'WUSTDHCPC5', NULL, '0.00', '0.00', '55.46', 3, '2007-04-09', '2010-10-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1629274840', 0, 'N', 0, '2008-05-14', NULL, NULL, 0, 0, NULL, NULL),
('870395551', 'W11001025', 'W11001025', 'UT01', NULL, 'Trevor', NULL, 'Lowry', 'DC', 'Chiropractic', NULL, NULL, NULL, 'O', '1104 E Ashton St', 'Salt Lake City', 'Salt Lake', 'UT', '84106', '8015210471', NULL, '867 E 9400 S', 'Sandy', '', 'UT', '84094', '', '', 'WLABRAD', 'WUSTDHCPC5', NULL, '0.00', '0.00', '55.46', 3, '2007-04-09', '2009-05-01', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1104837848', 0, 'N', 0, '2006-08-31', NULL, NULL, 0, 0, NULL, NULL),
('621795215', 'W11001026', 'W11001026', 'UT01', 'Center for Orthopedic & Rehabilitation Excellence', 'Leslie', 'J', 'Harris', 'MD', 'Orthopedic Surgery', '', '', NULL, 'O', '3584 W 9000 S Ste 405', 'West Jordan', 'Salt Lake', 'UT', '84088', '8015683480', NULL, '3584 W 9000 S Ste 405', 'West Jordan', 'Salt Lake', 'UT', '84088', '8015683480', '', 'WUSTDSURG5', 'WUSTDHCPC5', NULL, '0.00', '35.00', '0.00', 6, '2007-02-01', NULL, 0, 0, 0, 'Jordan Valley Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1679587687', 0, 'N', 0, '2012-07-19', NULL, NULL, 40.5879, -111.976, NULL, NULL),
('621795215', 'W11001027', 'W11001027', 'UT01', 'Center for Orthopedic & Rehabilitation Excellence', 'Armen', '', 'Khachatryan', 'MD', 'Orthopedic Surgery', '', '', NULL, 'O', '3584 W 9000 S Ste 405', 'West Jordan', 'Salt Lake', 'UT', '84088', '8015683480', NULL, '3584 W 9000 S Ste 405', 'West Jordan', 'Salt Lake', 'UT', '84088', '8015683480', '', 'WUSTDSURG5', 'WUSTDHCPC5', NULL, '0.00', '35.00', '0.00', 6, '2007-02-01', NULL, 0, 0, 0, 'Jordan Valley Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1114930781', 0, 'N', 0, '2011-10-10', NULL, NULL, 40.5879, -111.976, NULL, NULL),
('621795215', 'W11001028', 'W11001028', 'UT01', 'Center for Orthopedic & Rehabilitation Excellence', 'Michael', 'G', 'Henderson', 'PA-C', 'Emergency Medicine', 'Physician Assistant', 'Neurosurgery', NULL, 'O', '3584 W 9000 S Ste 405', 'West Jordan', 'Salt Lake', 'UT', '84088', '8015683480', NULL, '3584 W 9000 S Ste 405', 'West Jordan', 'Salt Lake', 'UT', '84088', '8015683480', '', 'WUSTDSURG5', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 6, '2007-02-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1265423594', 0, 'N', 0, '2014-05-27', NULL, NULL, 40.5879, -111.976, NULL, NULL),
('621795215', 'W11001029', 'W11001029', 'UT01', 'Center of Orthopedic and Rehab', 'Robert', 'W', 'Townsley', 'PA-C', 'Orthopedic Surgery', '', '', NULL, 'O', '3584 W 9000 S Ste 405', 'West Jordan', 'Salt Lake', 'UT', '84088', '8015683480', NULL, '3584 W 9000 S Ste 405', 'West Jordan', 'Salt Lake', 'UT', '84088', '8015683480', '          ', 'WUSTDSURG5', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 6, '2007-02-01', NULL, 0, 0, 0, 'Jordan Valley Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1770635245', 0, 'N', 0, '2011-10-11', NULL, NULL, 40.5879, -111.976, NULL, NULL),
('870306646', 'W11001030', 'W11001030', 'UT01', 'Emergency Physicians Group', 'Jonathan', 'D', 'Apfelbaum', 'MD', 'Emergency Medicine', '', '', NULL, 'B', 'PO Box 95970', 'South Jordan', 'Salt Lake', 'UT', '84095', '8013529500', NULL, 'PO Box 95970', 'South Jordan', 'Salt Lake', 'UT', '84095', '8013529500', '', 'WISESTD', 'WUSTDHCPC5', NULL, '0.00', '35.00', '0.00', 3, '2007-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1790745867', 0, 'Y', 0, '2011-07-19', NULL, NULL, 0, 0, NULL, NULL),
('870306646', 'W11001031', 'W11001031', 'UT01', 'Emergency Physicians Group', 'Jonathan', 'D', 'Apfelbaum', 'MD', 'Emergency Medicine', '', '', NULL, 'O', '1200 E 3900 S', 'Salt Lake City', 'Salt Lake', 'UT', '84124', '8013529500', NULL, '1200 E 3900 S', 'Salt Lake City', 'Salt Lake', 'UT', '84124', '8013529500', '          ', 'WISESTD', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 3, '2007-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1790745867', 0, 'Y', 0, '2011-07-19', NULL, NULL, 40.6871, -111.856, NULL, NULL),
('205486699', 'W11001032', 'W11001032', 'UT01', 'Sorensen Cardiovascular Group', 'Sherman', 'G', 'Sorensen', 'MD', 'Cardiovascular Disease', NULL, NULL, NULL, 'O', '5169 S Cottonwood St Ste 610', 'Murray', 'Salt Lake', 'UT', '84107', '8015073656', NULL, '5169 S Cottonwood St Ste 610', 'Murray', 'Salt Lake', 'UT', '84107', '8015073656', '          ', 'WUSTDCARD5', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 3, '2007-07-01', '2012-10-22', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1164490280', 0, 'N', 0, '2012-10-25', NULL, NULL, 0, 0, NULL, NULL),
('161630573', 'W11001033', 'W11001033', 'TX01', 'Priority Pediatrics', 'Jeanne', '', 'Lovett', 'MD', 'Pediatrics', '', '', NULL, 'O', '2235 Thousand Oaks Ste119', 'San Antonio', 'Bexar', 'TX', '78232', '2104907334', NULL, '2235 Thousand Oaks Ste119', 'San Antonio', 'Bexar', 'TX', '78232', '2104907334', '', 'TXPED', 'TXHCPCS', NULL, '0.00', '50.00', '0.00', 3, '2007-07-01', '2012-08-19', 0, 0, 0, 'North East Baptist Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1750477386', 0, 'n', 0, '2011-08-22', NULL, NULL, 29.5873, -98.4514, NULL, NULL),
('161630573', 'W11001034', 'W11001034', 'TX01', 'Priority Pediatrics', 'Win', NULL, 'Kyu', 'MD', 'Pediatrics', NULL, NULL, NULL, 'O', '2235 Thousand Oaks Ste119', 'San Antonio', 'Bexar', 'TX', '78232', '2104907334', NULL, '2235 Thousand Oaks', 'San Antonio', '', 'TX', '78232', '', '', 'TXPED', 'TXHCPCS', NULL, '0.00', '50.00', '0.00', 3, '2007-07-01', '2009-07-27', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1699835421', 0, 'n', 0, '2007-06-29', NULL, NULL, 29.5873, -98.4514, NULL, NULL),
('202785803', 'W11001035', 'W11001035', 'UT01', 'Color Country Pediatrics', 'Brian', 'N', 'Burrows', 'MD', 'Pediatrics', '', '', NULL, 'O', '2 E Center St', 'Milford', 'Beaver', 'UT', '84751', '4353872880', NULL, '2 E Center St', 'Milford', 'Beaver', 'UT', '84751', '4353872880', '', 'WiseSTD', 'WUSTDHCPC5', NULL, '0.00', '35.00', '0.00', 3, '2007-01-01', '2008-12-31', 0, 0, 0, 'Valley View Medical Center', '', '', '', 'HCFA|UB|', '1063440782', 0, 'N', 0, '2014-04-17', NULL, NULL, 0, 0, NULL, NULL),
('202785803', 'W11001036', 'W11001036', 'UT01', 'Color Country Pediatrics', 'Brian', 'C', 'McCune', 'MD', 'Pediatrics', '', '', NULL, 'O', '2 E Center St', 'Milford', 'Beaver', 'UT', '84751', '4353872880', NULL, '2 E Center St', 'Milford', 'Beaver', 'UT', '84751', '4353872880', '', 'WiseSTD', 'WUSTDHCPC5', NULL, '0.00', '35.00', '0.00', 3, '2007-01-01', '2008-12-31', 0, 0, 0, 'Timpanogos Regional Hospital', '', '', '', 'HCFA|UB|', '1790819241', 0, 'N', 0, '2011-09-30', NULL, NULL, 0, 0, NULL, NULL),
('202785803', 'W11001037', 'W11001037', 'UT01', 'Color Country Pediatrics', 'Scott', 'B', 'Parker', 'APRN', 'Pediatrics', '', '', NULL, 'O', '2 E Center St', 'Milford', 'Beaver', 'UT', '84751', '4353872880', NULL, '2 E Center St', 'Milford', 'Beaver', 'UT', '84751', '4353872880', '', 'WiseSTD', 'WUSTDHCPC5', NULL, '0.00', '35.00', '0.00', 3, '2007-01-01', '2008-12-31', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1386626018', 0, 'N', 0, '2014-04-02', NULL, NULL, 0, 0, NULL, NULL),
('205977241', 'W11001038', 'W11001038', 'TX01', 'Toyota Family Health Center', 'Steven', 'Thomas', 'Elliott', 'PTA', 'Physical Therapy', NULL, NULL, NULL, 'O', '1 Lone Star Pass Bldg 46', 'San Antonio', 'Bexar', 'TX', '78264', '2102635700', NULL, '1 Lone Star Pass Bldg 46', 'San Antonio', '', 'TX', '78264', '', '', 'TXFHCTR', 'TXHCPCS', NULL, '0.00', '50.00', NULL, 3, '2007-01-01', '2007-06-30', 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1851421424', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('205977241', 'W11001039', 'W11001039', 'TX01', 'Toyota Family Health Center', 'James', 'E', 'Calhoun', 'PTA', 'Physical Therapy', NULL, NULL, NULL, 'O', '1 Lone Star Pass Bldg 46', 'San Antonio', 'Bexar', 'TX', '78264', '2102635700', NULL, '1 Lone Star Pass Bldg 46', 'San Antonio', '', 'TX', '78264', '', '', 'TXFHCTR', 'TXHCPCS', NULL, '0.00', '50.00', NULL, 3, '2007-01-01', '2007-06-30', 0, NULL, 0, '', NULL, NULL, NULL, 'HCFA|UB|', '1437292497', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('205977241', 'W11001040', 'W11001040', 'TX01', 'Toyota Family Health Center', 'Stuart', 'Alfred', 'Saunders', 'PTA', 'Physical Therapy', NULL, NULL, NULL, 'O', '1 Lone Star Pass Bldg 46', 'San Antonio', 'Bexar', 'TX', '78264', '2102635700', NULL, '1 Lone Star Pass Bldg 46', 'San Antonio', '', 'TX', '78264', '', '', 'TXFHCTR', 'TXHCPCS', NULL, '0.00', '50.00', NULL, 3, '2007-01-01', '2007-06-30', 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1245359793', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('161751617', 'W11001041', 'W11001041', 'TX01', 'Rheumatology Associates of South Texas', 'Thomas', '', 'Rennie', 'MD', 'Rheumatology', '', '', NULL, 'B', 'Po Box 823', 'San Antonio', 'Bexar', 'TX', '78293', '2106563926', NULL, 'Po Box 823', 'San Antonio', 'Bexar', 'TX', '78293', '2106563926', '', 'TXSTD', 'TXHCPCS', NULL, '0.00', '50.00', '0.00', 3, '2007-01-01', '2012-08-19', 0, 0, 0, 'North East Baptist Hospital', NULL, NULL, NULL, 'HCFA|UB|', '0000008358', 0, 'Y', 0, '2013-04-24', NULL, NULL, 0, 0, NULL, NULL),
('161751617', 'W11001042', 'W11001042', 'TX01', 'Rheumatology Associates of South Texas', 'Kevin', NULL, 'Kempf', 'MD', 'Rheumatology', NULL, NULL, NULL, 'B', 'Po Box 823', 'San Antonio', 'Bexar', 'TX', '78293', '2106563926', NULL, '19272 Stone Oak Pkwy', 'San Antonio', '', 'TX', '78258', '', '', 'TXSTD', 'TXHCPCS', NULL, '0.00', '50.00', '0.00', 3, '2007-01-01', '2012-08-19', 0, 0, 0, 'North East Baptist Hospital', NULL, NULL, NULL, 'HCFA|UB|', '0000007065', 0, 'Y', 0, '2007-01-11', NULL, NULL, 0, 0, NULL, NULL),
('161751617', 'W11001043', 'W11001043', 'TX01', 'Rheumatology Associates of South Texas', 'Everett', '', 'Allen', 'MD', 'Rheumatology', '', '', NULL, 'B', 'Po Box 823', 'San Antonio', 'Bexar', 'TX', '78293', '2106563926', NULL, 'Po Box 823', 'San Antonio', 'Bexar', 'TX', '78293', '2106563926', '', 'TXSTD', 'TXHCPCS', NULL, '0.00', '50.00', '0.00', 3, '2007-01-01', '2012-08-19', 0, 0, 0, 'North East Baptist Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1609846641', 0, 'Y', 0, '2012-01-03', NULL, NULL, 0, 0, NULL, NULL),
('435707144', 'W11001044', 'W11001044', 'WY01', '', 'Robert', 'D', 'Schaffarzick', 'OD', 'Optometry', '', '', NULL, 'O', '816 Klondyke St', 'Kemmerer', 'Lincoln', 'WY', '83101', '3078779250', '          ', '816 Klondyke St', 'Kemmerer', 'Lincoln', 'WY', '83101', '3078779250', '          ', 'WisewySTD', 'wyhcpcs', '', '0.00', '35.00', '0.00', 3, '2007-07-01', '2014-07-21', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1235107954', 0, 'N', 0, '2014-07-24', NULL, NULL, 41.7941, -110.536, NULL, NULL),
('830238944', 'W11001045', 'W11001045', 'WY01', 'Solutions for Life', 'Peggy', 'Colleen', 'Wiley', 'MS', 'Mental Health', '', '', NULL, 'O', '1841 Madora Ave', 'Douglas', 'Converse', 'WY', '82633', '3073582846', NULL, '1841 Madora Ave', 'Douglas', 'Converse', 'WY', '82633', '3073582846', '          ', 'WiseWYSTD', 'wyhcpcs', '', '0.00', '35.00', '0.00', 3, '2007-07-01', '2011-05-25', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1376610881', 0, 'N', 0, '2011-05-25', NULL, NULL, 0, 0, NULL, NULL),
('830324127', 'W11001046', 'W11001046', 'WY01', 'Platte Valley Medical Clinic', 'Diane', 'L', 'Noton', 'MD', 'Family Practice', '', '', NULL, 'O', '1208 S River St', 'Saratoga', 'Carbon', 'WY', '82331', '3073268381', NULL, '1208 S River St', 'Saratoga', 'Carbon', 'WY', '82331', '3073268381', '          ', 'WiseWYSTD', 'Wyhcpcs', '', '0.00', '35.00', '0.00', 3, '2007-07-01', '2010-10-15', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1588656136', 0, 'N', 0, '2010-10-15', NULL, NULL, 0, 0, NULL, NULL),
('830324127', 'W11001047', 'W11001047', 'WY01', 'Platte Valley Medical Clinic', 'Jacob', 'I', 'Blazzard', 'PA', 'Family Practice', '', '', NULL, 'O', '1208 S River St', 'Saratoga', 'Carbon', 'WY', '82331', '3073268381', NULL, '1208 S River St', 'Saratoga', 'Carbon', 'WY', '82331', '3073268381', '          ', 'WiseWYSTD', 'Wyhcpcs', '', '0.00', '35.00', '0.00', 3, '2007-07-01', '2010-10-15', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1326125485', 0, 'N', 0, '2010-10-15', NULL, NULL, 0, 0, NULL, NULL),
('830324127', 'W11001048', 'W11001048', 'WY01', 'Platte Valley Medical Clinic', 'Jacob', 'I', 'Blazzard', 'PA', 'Family Practice', '', '', NULL, 'B', 'PO Box 650', 'Saratoga', 'Carbon', 'WY', '82331', '3073268381', NULL, 'PO Box 650', 'Saratoga', 'Carbon', 'WY', '82331', '3073268381', '          ', 'WiseWYSTD', 'Wyhcpcs', '', '0.00', '35.00', '0.00', 3, '2007-07-01', '2010-10-15', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1326125485', 0, 'Y', 0, '2010-10-15', NULL, NULL, 0, 0, NULL, NULL),
('830324127', 'W11001049', 'W11001049', 'WY01', 'Platte Valley Medical Clinic', 'Diane', 'L', 'Noton', 'MD', 'Family Practice', '', '', NULL, 'B', 'PO Box 650', 'Saratoga', 'Carbon', 'WY', '82331', '3073268381', NULL, 'PO Box 650', 'Saratoga', 'Carbon', 'WY', '82331', '3073268381', '          ', 'WiseWYSTD', 'Wyhcpcs', '', '0.00', '35.00', '0.00', 3, '2007-07-01', '2010-10-15', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1588656136', 0, 'Y', 0, '2010-10-15', NULL, NULL, 0, 0, NULL, NULL),
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INSERT INTO `providers_new` (`Provider_Tax_ID`, `Provider_Suffix`, `Provider_Network_ID`, `Provider_Region`, `Provider_Name`, `Provider_Doctor_First_Name`, `Provider_Doctor_Middle_Name`, `Provider_Doctor_Last_Name`, `Provider_Doctor_Degree`, `Provider_Specialty_1`, `Provider_Specialty_2`, `Provider_Specialty_3`, `Provider_Specialty_4`, `Provider_Address_Type`, `Provider_Address`, `Provider_City`, `Provider_County`, `Provider_State`, `Provider_Zip`, `Provider_Phone`, `Provider_Fax`, `Provider_Mailing_Address`, `Provider_Mailing_City`, `Provider_Mailing_County`, `Provider_Mailing_State`, `Provider_Mailing_Zip`, `Provider_Mailing_Phone`, `Provider_Mailing_Fax`, `Provider_Primary_Schedule`, `Provider_Secondary_Schedule`, `Provider_Rate_Sheet`, `Provider_Anes_Rate`, `Provider_Default_Rate`, `Provider_Max_DOS`, `Provider_Min_Match_Value`, `Provider_Effective_Date`, `Provider_Term_Date`, `Provider_Pend`, `Provider_Anes_Minutes`, `Provider_PPO`, `Provider_Hospital_1`, `Provider_Hospital_2`, `Provider_Hospital_3`, `Provider_Hospital_4`, `Provider_Type`, `Provider_NPI`, `Provider_Check_Override`, `Exclude_Dir`, `Audit_Status`, `Last_Change_Date`, `Medicare_ID`, `Provider_Lang`, `Provider_Latitude`, `Provider_Longitude`, `Provider_school`, `Provider_cert`) VALUES
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('743134264', 'W11001118', 'W11001118', 'UT01', 'Pediatric Pulmonology-Department of University of Utah', 'Ameet', 'S', 'Daftary', 'MD', 'Pediatric Pulmonology', 'Pediatrics', '', NULL, 'B', 'PO Box 413021', 'Salt Lake City', 'Salt Lake', 'UT', '84141', '8012133800', '8015853655', 'PO Box 413021', 'Salt Lake City', 'Salt Lake', 'UT', '84141', '8012133800', '8015853655', 'WUUPEDS', 'WUSTDHCPC5', '', '0.00', '15.00', '0.00', 3, '2006-08-01', '2012-07-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1891889119', 0, 'N', 0, '2012-07-31', NULL, NULL, 0, 0, NULL, NULL),
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('870637304', 'W11001273', 'W11001273', 'UT01', '', 'Joanne', 'H', 'Abegglen', 'APRN', 'Pain Management', 'Family Practice', '', NULL, 'O', '301 N 200 E Ste 2A', 'St George', 'Washington', 'UT', '84770', '4356887246', NULL, '301 N 200 E Ste 2A', 'St George', 'Washington', 'UT', '84770', '4356887246', '', 'WUSTDPAIN5', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 3, '2007-03-01', NULL, 0, 0, 0, 'Valley View Medical Center', '', '', '', 'HCFA|UB|', '1104909878', 0, 'N', 0, '2014-05-16', NULL, NULL, 37.1081, -113.566, NULL, NULL),
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('562627040', 'W11001287', 'W11001287', 'UT01', 'U of U Maternal Fetal Medicine', 'Heather', 'D', 'Major', 'MD', 'Maternal Fetal Medicine', 'Obstetrics and Gynecology', '', NULL, 'B', 'PO Box 413028', 'Salt Lake City', 'Salt Lake', 'UT', '84141', '8012133800', NULL, 'PO Box 413028', 'Salt Lake City', 'Salt Lake', 'UT', '84141', '8012133800', '          ', 'WUUUMG5', 'WUSTDHCPC5', '', '0.00', '25.00', '0.00', 3, '2007-07-01', '2012-08-20', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1700860350', 0, 'Y', 0, '2012-08-20', NULL, NULL, 0, 0, NULL, NULL),
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('870648457', 'W11001290', 'W11001290', 'UT01', 'University Health Care', 'Colleen', 'L', 'Milroy', 'MD', 'Maternal Fetal Medicine', 'Endocrinology', '', NULL, 'o', '50 N Medical Dr', 'Salt Lake City', 'Salt Lake', 'UT', '84132', '8015879500', NULL, '50 N Medical Dr', 'Salt Lake City', 'Salt Lake', 'UT', '84132', '8015879500', '          ', 'WUUUMG5', 'WUSTDHCPC5', '', '0.00', '25.00', '0.00', 3, '2006-08-01', '2012-08-21', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1730302175', 0, 'N', 0, '2012-08-22', NULL, NULL, 0, 0, NULL, NULL),
('870648457', 'W11001291', 'W11001291', 'UT01', 'U of U OB Care Now', 'Colleen', 'L', 'Milroy', 'MD', 'Maternal Fetal Medicine', 'Endocrinology', '', NULL, 'B', 'PO Box 1674', 'Salt Lake City', 'Salt Lake', 'UT', '84110', '8015876600', NULL, 'PO Box 1674', 'Salt Lake City', 'Salt Lake', 'UT', '84110', '8015876600', '          ', 'WUUUMG5', 'WUSTDHCPC5', '', '0.00', '25.00', '0.00', 3, '2006-08-01', '2012-08-21', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1730302175', 0, 'N', 0, '2012-08-22', NULL, NULL, 0, 0, NULL, NULL),
('870337363', 'W11001292', 'W11001292', 'UT01', 'Gastroenterology Associates', 'R', 'Hill', 'Harris', 'MD', 'Gastroenterology', NULL, NULL, NULL, 'O', '1250 E 3900 S Ste 360', 'Salt Lake City', 'Salt Lake', 'UT', '84124', '8012633041', '8012638485', '1250 E 3900 S', 'Salt Lake City', '', 'UT', '841241362', '', '', 'WiseSTD20', 'WUSTDHCPC5', NULL, '0.00', '35.00', '0.00', 3, '2006-11-01', '2008-08-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1659463453', 0, 'N', 0, '2006-10-27', NULL, NULL, 0, 0, NULL, NULL),
('870627216', 'W11001293', 'W11001293', 'UT01', '', 'Heidi', 'A', 'Heras', 'MD', 'Ear, Nose and Throat', NULL, NULL, NULL, 'O', '482 W 50 N Ste 14', 'American Fork', 'Utah', 'UT', '84003', '8014927662', NULL, '482 W 50 N Ste 14', 'American Fork', 'Utah', 'UT', '84003', '8014927662', '          ', 'WUUVPN10', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 3, '2007-07-01', '2010-07-14', 0, 0, 0, 'Timpanogos Regional Hospital', '', '', '', 'HCFA|UB|', '1619910684', 0, 'N', 0, '2013-08-27', NULL, NULL, 0, 0, NULL, NULL),
('742719352', 'W11001294', 'W11001294', 'TX01', 'Urology of San Antonio', 'Kenneth', 'J', 'Stallman', 'MD', 'Urology', '', '', NULL, 'O', '7909 Fredericksburg Rd Ste 125', 'San Antonio', 'Bexar', 'TX', '78229', '2106144544', '2106174104', '7909 Fredericksburg Rd Ste 125', 'San Antonio', 'Bexar', 'TX', '78229', '2106144544', '2106174104', 'TXSTD', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2007-08-01', '2012-08-19', 0, 0, 0, 'St Lukes Baptist Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1871575100', 0, 'N', 0, '2014-01-24', NULL, NULL, 29.5113, -98.5683, NULL, NULL),
('742719352', 'W11001295', 'W11001295', 'TX01', 'Urology of San Antonio', 'William', 'P', 'Fitch', 'MD', 'Urology', NULL, NULL, NULL, 'O', '7909 Fredericksburg Rd Ste 135', 'San Antonio', 'Bexar', 'TX', '78229', '2106144544', '2105825552', '7909 Fredericksburg Rd Ste 135', 'San Antonio', 'Bexar', 'TX', '78229', '2106144544', '2105825552', 'TXSTD', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2007-08-01', '2009-10-09', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1174528442', 0, 'N', 0, '2014-01-24', NULL, NULL, 29.5113, -98.5683, NULL, NULL),
('742719352', 'W11001296', 'W11001296', 'TX01', 'Urology of San Antonio', 'Kurt', 'G', 'Meissner', 'MD', 'Urology', '', '', NULL, 'O', '7909 Fredericksburg Rd Ste 120', 'San Antonio', 'Bexar', 'TX', '78229', '2106144544', '2106174104', '7909 Fredericksburg Rd Ste 120', 'San Antonio', 'Bexar', 'TX', '78229', '2106144544', '2106174104', 'TXSTD', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2007-08-01', '2012-08-19', 0, 0, 0, 'St Lukes Baptist Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1164427449', 0, 'N', 0, '2014-01-24', NULL, NULL, 29.5113, -98.5683, NULL, NULL),
('870519691', 'W11001297', 'W11001297', 'UT01', 'Utah Cancer Specialists', 'Launce', '', 'Gie-Chuan Gouw', 'MD', 'Hematology and Oncology', 'Oncology', 'Internal Medicine', NULL, 'O', '3838 S 700 E Ste 100', 'Salt Lake City', 'Salt Lake', 'UT', '84106', '8012690231', '8012690304', '1121 S 3900 E', 'Salt Lake City', '', 'UT', '84124', '', '', 'WUSTDONC5', 'WUSTDHCPC5', NULL, '0.00', '35.00', '0.00', 3, '2006-11-01', '2010-03-23', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1689788325', 0, 'N', 0, '2009-06-01', NULL, NULL, 0, 0, NULL, NULL),
('870519691', 'W11001298', 'W11001298', 'UT01', 'Utah Cancer Specialists', 'Launce', '', 'Gie-Chuan Gouw', 'MD', 'Hematology and Oncology', 'Oncology', 'Internal Medicine', NULL, 'B', '1121 S 3900 E Ste C 240', 'Salt Lake City', 'Salt Lake', 'UT', '84124', '8012660878', NULL, '1121 S 3900 E', 'Salt Lake City', '', 'UT', '84124', '', '', 'WUSTDONC5', 'WUSTDHCPC5', NULL, '0.00', '35.00', '0.00', 3, '2006-11-01', '2010-03-23', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1689788325', 0, 'y', 0, '2009-06-01', NULL, NULL, 0, 0, NULL, NULL),
('043642369', 'W11001299', 'W11001299', 'UT01', 'Oquirrh Mountain Womens Center', 'Daniel', 'R', 'Ferguson', 'MD', 'Obstetrics and Gynecology', '', '', NULL, 'O', '984 S Medical Dr', 'Brigham City', 'Box Elder', 'UT', '84302', '4356952273', '4358339888', '984 S Medical Dr', 'Brigham City', 'Box Elder', 'UT', '84302', '4356952273', '4358339888', 'WiseSTD', 'WUSTDHCPC5', NULL, '0.00', '35.00', '0.00', 3, '2006-11-01', '2009-02-19', 0, 0, 0, 'Brigham City Community Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1194802991', 0, 'N', 0, '2012-06-25', NULL, NULL, 0, 0, NULL, NULL),
('870290108', 'W11001300', 'W11001300', 'UT01', 'Medical Associates of St George', NULL, NULL, 'Medical Associates Of St George', 'GROUP', 'Family Practice', NULL, NULL, NULL, 'O', '736 S 900 E Ste 203', 'St George', 'Washington', 'UT', '84790', '4356746065', '4356738557', '736 S 900 E', 'St George', '', 'UT', '847907000', '', '', 'WUSTGEIPA', 'WUSTDHCPC', NULL, '0.00', '25.00', '0.00', 3, '2007-07-01', '2010-02-01', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '0000007545', 0, 'N', 0, '2007-01-05', NULL, NULL, 0, 0, NULL, NULL),
('870290108', 'W11001301', 'W11001301', 'UT01', 'Medical Associates of St George', 'Nancy', 'R', 'Davis', 'NP', 'Family Practice', '', '', NULL, 'O', '736 S 900 E Ste 203', 'St George', 'Washington', 'UT', '84790', '4356746065', '4356738557', '736 S 900 E Ste 203', 'St George', 'Washington', 'UT', '84790', '4356746065', '4356738557', 'WUSTGEIPA', 'WUSTDHCPC', NULL, '0.00', '25.00', '0.00', 3, '2007-07-01', '2010-02-01', 0, 0, 0, 'Dixie Regional Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1821101288', 0, 'N', 0, '2011-12-20', NULL, NULL, 0, 0, NULL, NULL),
('870290108', 'W11001302', 'W11001302', 'UT01', 'Medical Associates of St George', 'Norman', 'H', 'Fawson', 'MD', 'Family Practice', NULL, NULL, NULL, 'O', '736 S 900 E Ste 203', 'St George', 'Washington', 'UT', '84790', '4356746065', '4356738557', '736 S 900 E', 'St George', '', 'UT', '847907000', '', '', 'WUSTGEIPA', 'WUSTDHCPC', NULL, '0.00', '25.00', '0.00', 3, '2007-07-01', '2008-10-01', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1144375155', 0, 'N', 0, '2007-01-05', NULL, NULL, 0, 0, NULL, NULL),
('870290108', 'W11001303', 'W11001303', 'UT01', 'Medical Associates of St George', 'Gus', 'C', 'Pendleton', 'MD', 'Family Practice', '', '', NULL, 'O', '736 S 900 E Ste 203', 'St George', 'Washington', 'UT', '84790', '4356746065', '4356738557', '736 S 900 E Ste 203', 'St George', 'Washington', 'UT', '84790', '4356746065', '4356738557', 'WUSTGEIPA', 'WUSTDHCPC', NULL, '0.00', '25.00', '0.00', 3, '2007-07-01', '2010-02-01', 0, 0, 0, 'Dixie Regional Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1649361874', 0, 'N', 0, '2013-10-16', NULL, NULL, 0, 0, NULL, NULL),
('870290108', 'W11001304', 'W11001304', 'UT01', 'Medical Associates of St George', 'Clark', 'J', 'Staheli', 'MD', 'Family Practice', '', '', NULL, 'O', '736 S 900 E Ste 203', 'St George', 'Washington', 'UT', '84790', '4356746065', '4356738557', '736 S 900 E Ste 203', 'St George', 'Washington', 'UT', '84790', '4356746065', '4356738557', 'WUSTGEIPA', 'WUSTDHCPC', NULL, '0.00', '25.00', '0.00', 3, '2007-07-01', '2010-02-01', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1568505691', 0, 'N', 0, '2013-10-30', NULL, NULL, 0, 0, NULL, NULL),
('870290108', 'W11001305', 'W11001305', 'UT01', 'Medical Associates of St George', 'C', 'K', 'Stratford', 'MD', 'Family Practice', '', '', NULL, 'O', '736 S 900 E Ste 203', 'St George', 'Washington', 'UT', '84790', '4356746065', '4356738557', '736 S 900 E Ste 203', 'St George', 'Washington', 'UT', '84790', '4356746065', '4356738557', 'WUSTGEIPA', 'WUSTDHCPC', NULL, '0.00', '25.00', '0.00', 3, '2007-07-01', '2010-02-01', 0, 0, 0, 'Dixie Regional Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1275688228', 0, 'N', 0, '2013-09-20', NULL, NULL, 0, 0, NULL, NULL),
('870290108', 'W11001306', 'W11001306', 'UT01', 'Medical Associates of St George', 'Howard', 'L', 'Chamberlain', 'MD', 'Family Practice', '', '', NULL, 'O', '736 S 900 E Ste 203', 'St George', 'Washington', 'UT', '84790', '4356746065', '4356738557', '736 S 900 E Ste 203', 'St George', 'Washington', 'UT', '84790', '4356746065', '4356738557', 'WUSTGEIPA', 'WUSTDHCPC', NULL, '0.00', '25.00', '0.00', 3, '2007-07-01', '2010-02-01', 0, 0, 0, 'Dixie Regional Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1306951504', 0, 'N', 0, '2014-01-17', NULL, NULL, 0, 0, NULL, NULL),
('870290108', 'W11001307', 'W11001307', 'UT01', 'Medical Associates of St George', 'Scott', 'D', 'Barton', 'MD', 'Family Practice', '', '', NULL, 'O', '736 S 900 E Ste 203', 'St George', 'Washington', 'UT', '84790', '4356746065', '4356738557', '736 S 900 E Ste 203', 'St George', 'Washington', 'UT', '84790', '4356746065', '4356738557', 'WUSTGEIPA', 'WUSTDHCPC', NULL, '0.00', '25.00', '0.00', 3, '2007-07-01', '2010-02-01', 0, 0, 0, 'Dixie Regional Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1376690180', 0, 'N', 0, '2013-10-08', NULL, NULL, 0, 0, NULL, NULL),
('870290108', 'W11001308', 'W11001308', 'UT01', 'Medical Associates of St George', 'Mckay', 'D', 'Christian', 'MD', 'Family Practice', '', '', NULL, 'O', '736 S 900 E Ste 203', 'St George', 'Washington', 'UT', '84790', '4356746065', '4356738557', '736 S 900 E Ste 203', 'St George', 'Washington', 'UT', '84790', '4356746065', '4356738557', 'WUSTGEIPA', 'WUSTDHCPC', NULL, '0.00', '25.00', '0.00', 3, '2007-07-01', '2010-02-01', 0, 0, 0, 'Dixie Regional Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1760528897', 0, 'N', 0, '2011-12-20', NULL, NULL, 0, 0, NULL, NULL),
('870657311', 'W11001309', 'W11001309', 'UT01', 'Callahan Clinic', 'Thomas', 'D', 'Callahan', 'MD', 'Family Practice', '', '', NULL, 'O', '1240 E 100 S Ste 15A', 'St George', 'Washington', 'UT', '84790', '4356565323', NULL, '1240 E 100 S Ste 15A', 'St George', 'Washington', 'UT', '84790', '4356565323', '', 'WUSTGEIPA', 'WUSTDHCPC', '', '0.00', '25.00', '0.00', 3, '2007-07-01', NULL, 0, 0, 0, 'Dixie Regional Medical Center', '', '', '', 'HCFA|UB|', '1043328123', 0, 'N', 0, '2014-06-04', NULL, NULL, 37.079, -113.56, 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
('870657311', 'W11001310', 'W11001310', 'UT01', 'Callahan Clinic', 'Douglas', 'D', 'Callahan', 'DO', 'Family Practice', '', '', NULL, 'O', '1240 E 100 S Ste 15A', 'St George', 'Washington', 'UT', '84790', '4356565323', NULL, '1240 E 100 S Ste 15A', 'St George', 'Washington', 'UT', '84790', '4356565323', '', 'WUSTGEIPA', 'WUSTDHCPC', '', '0.00', '25.00', '0.00', 3, '2007-07-01', NULL, 0, 0, 0, 'Dixie Regional Medical Center', '', '', '', 'HCFA|UB|', '1265540355', 0, 'N', 0, '2014-06-20', NULL, NULL, 37.079, -113.56, NULL, NULL),
('870376618', 'W11001311', 'W11001311', 'UT01', NULL, 'William', 'T', 'Graff', 'MD', 'Family Practice', NULL, NULL, NULL, 'O', '630 S 400 E Ste 101', 'St George', 'Washington', 'UT', '84770', '4356739653', NULL, '630 S 400 E', 'St George', '', 'UT', '847703765', '', '', 'WUSTGEIPA', 'WUSTDHCPC', NULL, '0.00', '25.00', '0.00', 3, '2007-07-01', NULL, 0, 0, 0, 'Dixie Regional Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1487667473', 0, 'N', 0, '2007-04-09', NULL, NULL, 37.0977, -113.575, NULL, NULL),
('870570100', 'W11001312', 'W11001312', 'UT01', NULL, 'Raymond', 'K', 'Hinton', 'MD', 'Family Practice', NULL, NULL, NULL, 'O', '195 W Telegraph St', 'Washington', 'Washington', 'UT', '84780', '4356284444', NULL, '195 W Telegraph St', 'Washington', '', 'UT', '847801675', '', '', 'WUSTGEIPA', 'WUSTDHCPC', NULL, '0.00', '25.00', '0.00', 3, '2007-07-01', '2009-02-18', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1609978345', 0, 'N', 0, '2010-01-12', NULL, NULL, 0, 0, NULL, NULL),
('870424089', 'W11001313', 'W11001313', 'UT01', '', 'Richard', 'W', 'Wintch', 'MD', 'General Surgery', NULL, NULL, NULL, 'O', '515 S 300 E Ste 102', 'St George', 'Washington', 'UT', '84770', '4356284489', NULL, '515 S 300 E Ste 102', 'St George', 'Washington', 'UT', '84770', '4356284489', '          ', 'WUSTGEIPA', 'WUSTDHCPC', '', '0.00', '25.00', '0.00', 3, '2007-07-01', NULL, 0, 0, 0, 'Dixie Regional Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1619992807', 0, 'N', 0, '2013-08-28', NULL, NULL, 37.0994, -113.577, NULL, NULL),
('870628665', 'W11001314', 'W11001314', 'UT01', 'Southern Utah Ear Nose & Throat', 'Steven', 'P', 'Chase', 'MD', 'Ear, Nose and Throat', '', '', NULL, 'O', '1490 E Foremaster Dr Ste 350', 'St George', 'Washington', 'UT', '84790', '4356283334', '4356283375', '1490 E Foremaster Dr Ste 350', 'St George', 'Washington', 'UT', '84790', '4356283334', '4356283375', 'WUSTGEIPA', 'WUSTDHCPC', NULL, '0.00', '25.00', '0.00', 3, '2007-07-01', NULL, 0, 0, 0, 'Dixie Regional Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1831108042', 0, 'N', 0, '2013-08-21', NULL, NULL, 37.0959, -113.551, NULL, NULL),
('870628665', 'W11001315', 'W11001315', 'UT01', 'Southern Utah Ear Nose & Throat', 'Kent', 'E', 'Gardner', 'MD', 'Ear, Nose and Throat', '', '', NULL, 'O', '1490 E Foremaster Dr Ste 350', 'St George', 'Washington', 'UT', '84790', '4356283334', '4356283375', '1490 E Foremaster Dr Ste 350', 'St George', 'Washington', 'UT', '84790', '4356283334', '4356283375', 'WUSTGEIPA', 'WUSTDHCPC', NULL, '0.00', '25.00', '0.00', 3, '2007-07-01', '2009-02-15', 0, 0, 0, 'Dixie Regional Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1881702355', 0, 'N', 0, '2013-08-28', NULL, NULL, 0, 0, NULL, NULL),
('530320541', 'W11001316', 'W11001316', 'UT01', NULL, 'Robert', 'P', 'Rignell', 'MD', 'Internal Medicine', '', '', NULL, 'O', '515 S 300 E Ste 105', 'St George', 'Washington', 'UT', '84770', '4356283651', NULL, '515 S 300 E Ste 105', 'St George', 'Washington', 'UT', '84770', '4356283651', '', 'WUSTGEIPA', 'WUSTDHCPC', NULL, '0.00', '25.00', '0.00', 3, '2007-07-01', NULL, 0, 0, 0, 'Dixie Regional Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1326034737', 0, 'N', 0, '2014-03-18', NULL, NULL, 37.0994, -113.577, NULL, NULL),
('870398281', 'W11001317', 'W11001317', 'UT01', 'Canyonland Pediatrics', 'Christian', 'Y', 'Herrera', 'MD', 'Pediatrics', '', '', NULL, 'O', '1490 E Foremaster Dr Ste 130', 'St George', 'Washington', 'UT', '84790', '4356340055', NULL, '1490 E Foremaster Dr Ste 130', 'St George', 'Washington', 'UT', '84790', '4356340055', '          ', 'WUSTGEIPA', 'WUSTDHCPC', '', '0.00', '25.00', '0.00', 3, '2007-07-01', '2011-11-29', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '0000831282', 0, 'N', 0, '2011-11-30', NULL, NULL, 0, 0, NULL, NULL),
('870398281', 'W11001318', 'W11001318', 'UT01', 'Canyonland Pediatrics', 'Wendell', 'T', 'Nilson', 'MD', 'Pediatrics', NULL, NULL, NULL, 'O', '1490 E Foremaster Dr Ste 130', 'St George', 'Washington', 'UT', '84790', '4356340055', NULL, '1490 E Foremaster', 'St George', '', 'UT', '84790', '', '', 'WUSTGEIPA', 'WUSTDHCPC', NULL, '0.00', '25.00', '0.00', 3, '2007-07-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1205883576', 0, 'N', 0, '2006-12-20', NULL, NULL, 37.0959, -113.551, NULL, NULL),
('870290108', 'W11001319', 'W11001319', 'UT01', 'St George Clinic', '', '', 'St George Clinic', 'GROUP', 'Urgent Care', '', '', NULL, 'B', '736 S 900 E Ste 203', 'St George', 'Washington', 'UT', '84790', '4356736131', '4356738557', '736 S 900 E Ste 203', 'St George', 'Washington', 'UT', '84790', '4356736131', '4356738557', 'WUSTGEIPA', 'WUSTDHCPC', NULL, '0.00', '25.00', '0.00', 3, '2007-07-01', '2010-02-01', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1295829281', 0, 'Y', 0, '2012-03-20', NULL, NULL, 0, 0, NULL, NULL),
('870622005', 'W11001320', 'W11001320', 'UT01', 'Night Light Pediatrics', 'Jerry', 'D', 'Twiggs', 'MD', 'Pediatrics', 'Pediatrics', NULL, NULL, 'O', '1240 E 100 S Ste 14', 'St George', 'Washington', 'UT', '84790', '4356288232', NULL, '1240 E 100 S Ste 14', 'St George', 'Washington', 'UT', '84790', '4356288232', '', 'WUSTGEIPA', 'WUSTDHCPC', NULL, '0.00', '25.00', '0.00', 3, '2007-07-01', NULL, 0, 0, 0, 'Dixie Regional Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1972583680', 0, 'N', 0, '2011-05-20', NULL, NULL, 37.079, -113.56, NULL, NULL),
('870622005', 'W11001321', 'W11001321', 'UT01', 'Night Light Pediatrics', NULL, NULL, 'Night Light Pediatrics', 'GROUP', 'Urgent Care', NULL, NULL, NULL, 'B', '1240 E 100 S Ste 14', 'St George', 'Washington', 'UT', '84790', '4356288232', NULL, NULL, 'Ste 14', '', 'UT', '84790', '', '', 'WUSTGEIPA', 'WUSTDHCPC', NULL, '0.00', '25.00', NULL, 3, '2000-01-01', '2000-01-01', 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1295855914', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870622005', 'W11001322', 'W11001322', 'UT01', 'Night Light Pediatrics M-Sun 6pm-10pm', '', '', 'Night Light Pediatrics', 'GROUP', 'Urgent Care', NULL, NULL, NULL, 'O', '1240 E 100 S Ste 14', 'St George', 'Washington', 'UT', '84790', '4356288232', NULL, '1240 E 100 S Ste 14', 'St George', 'Washington', 'UT', '84790', '4356288232', '          ', 'WUSTGEIPA', 'WUSTDHCPC', '', '0.00', '25.00', '0.00', 3, '2007-07-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1295855914', 0, 'N', 0, '2013-06-12', NULL, NULL, 37.079, -113.56, NULL, NULL),
('870494537', 'W11001323', 'W11001323', 'UT01', 'Dixie Pediatrics', 'Jerry', 'D', 'Twiggs', 'MD', 'Pediatrics', 'Pediatrics', NULL, NULL, 'O', '1240 E 100 S Ste 14', 'St George', 'Washington', 'UT', '84790', '4356288232', NULL, '1240 E 100 S Ste 14', 'St George', 'Washington', 'UT', '84790', '4356288232', '', 'WUSTGEIPA', 'WUSTDHCPC', NULL, '0.00', '25.00', '0.00', 3, '2007-07-01', NULL, 0, 0, 0, 'Dixie Regional Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1972583680', 0, 'N', 0, '2011-05-20', NULL, NULL, 37.079, -113.56, NULL, NULL),
('870494537', 'W11001324', 'W11001324', 'UT01', 'Dixie Pediatrics', 'Karl', 'T', 'McMullin', 'MD', 'Pediatrics', NULL, NULL, NULL, 'O', '1240 E 100 S Ste 14', 'St George', 'Washington', 'UT', '84790', '4356288232', NULL, NULL, 'Ste 14', '', 'St G', 'UT', '', '', 'WUSTGEIPA', 'WUSTDHCPC', NULL, '0.00', '25.00', '0.00', 3, '2007-07-01', NULL, 0, 0, 0, 'Dixie Regional Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '0000007531', 0, 'N', 0, '2007-02-07', NULL, NULL, 37.079, -113.56, NULL, NULL),
('870494537', 'W11001325', 'W11001325', 'UT01', 'Dixie Pediatrics', 'Bryan', 'B', 'Hofheins', 'PA', 'Pediatrics', '', '', NULL, 'O', '1240 E 100 S Ste 14', 'St George', 'Washington', 'UT', '84790', '4356288232', NULL, '1240 E 100 S Ste 14', 'St George', 'Washington', 'UT', '84790', '4356288232', '', 'WUSTGEIPA', 'WUSTDHCPC', '', '0.00', '25.00', '0.00', 3, '2007-07-01', NULL, 0, 0, 0, 'Dixie Regional Medical Center', '', '', '', 'HCFA|UB|', '1326147034', 0, 'N', 0, '2014-06-17', NULL, NULL, 37.079, -113.56, NULL, NULL),
('870494537', 'W11001326', 'W11001326', 'UT01', 'Dixie Pediatrics', '', '', 'Dixie Pediatrics', 'MD', 'Pediatrics', '', '', NULL, 'O', '1240 E 100 S Ste 14', 'St George', 'Washington', 'UT', '84790', '4356288232', NULL, '1240 E 100 S Ste 14', 'St George', 'Washington', 'UT', '84790', '4356288232', '', 'WUSTGEIPA', 'WUSTDHCPC', NULL, '0.00', '25.00', '0.00', 3, '2007-07-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '0000005987', 0, 'N', 0, '2011-07-18', NULL, NULL, 37.079, -113.56, NULL, NULL),
('870442129', 'W11001327', 'W11001327', 'UT01', '+240 = 10 mins unit U of U Dept of Anesthesiology', '', '', '+240 = 10 mins unit U of U Dept of Anesthesiology +240 = 10 mins unit', 'GROUP', 'Anesthesiology', '', '', NULL, 'o', '50 N Medical Dr', 'Salt Lake City', 'Salt Lake', 'UT', '84132', '8015816393', NULL, '50 N Medical Dr', 'Salt Lake City', 'Salt Lake', 'UT', '84132', '8015816393', '          ', '', '', '1000', '47.52', '0.00', '0.00', 3, '2007-08-01', '2008-12-31', 1, 12, 0, '', '', '', '', 'HCFA|UB|', '1134158322', 0, 'Y', 0, '2014-01-07', NULL, NULL, 0, 0, NULL, NULL),
('870442129', 'W11001328', 'W11001328', 'UT01', '+240 = 10 mins unit U of U Dept of Anesthesiology', '', '', '+240 = 10 mins unit U of U Dept of Anesthesiology +240 = 10 mins unit', 'GROUP', 'Anesthesiology', '', '', NULL, 'B', 'PO Box 581053', 'Salt Lake City', 'Salt Lake', 'UT', '84158', '8012133800', NULL, 'PO Box 581053', 'Salt Lake City', 'Salt Lake', 'UT', '84158', '8012133800', '          ', '', '', '1000', '47.52', '0.00', '0.00', 3, '2007-08-01', '2008-12-31', 1, 12, 0, '', '', '', '', 'HCFA|UB|', '1134158322', 0, 'N', 0, '2014-01-07', NULL, NULL, 0, 0, NULL, NULL),
('061787631', 'W11001329', 'W11001329', 'UT01', 'Lone Peak General Surgery', 'Ian', 'R', 'Cavin', 'DO', 'General Surgery', '', '', NULL, 'B', 'PO Box 100253', 'Atlanta', 'Fulton', 'GA', '30384', '8006613365', NULL, 'PO Box 100253', 'Atlanta', 'Fulton', 'GA', '30384', '8006613365', '', 'WUUVPN10', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 3, '2007-08-01', '2010-08-31', 0, 0, 0, 'St Marks Hospital', '', '', '', 'HCFA|UB|', '1184647315', 0, 'Y', 0, '2014-05-15', NULL, NULL, 0, 0, NULL, NULL),
('061787631', 'W11001330', 'W11001330', 'UT01', 'Lone Peak General Surgery', 'Charles', 'R', 'Davis', 'MD', 'General Surgery', '', '', NULL, 'B', 'PO Box 100253', 'Atlanta', 'Fulton', 'GA', '30384', '8015663062', NULL, 'PO Box 100253', 'Atlanta', 'Fulton', 'GA', '30384', '8015663062', '', 'WUUVPN10', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 3, '2007-08-01', '2010-08-31', 0, 0, 0, 'St Marks Hospital', '', '', '', 'HCFA|UB|', '1326136565', 0, 'Y', 0, '2014-05-15', NULL, NULL, 0, 0, NULL, NULL),
('061787631', 'W11001331', 'W11001331', 'UT01', 'Lone Peak General Surgery', 'Ian', 'R', 'Cavin', 'DO', 'General Surgery', '', '', NULL, 'O', '10011 Centennial Pkwy Ste 150', 'Sandy', 'Salt Lake', 'UT', '84070', '8015663062', NULL, '10011 Centennial Pkwy Ste 150', 'Sandy', 'Salt Lake', 'UT', '84070', '8015663062', '', 'WUUVPN10', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 3, '2007-08-01', '2010-06-01', 0, 0, 0, 'St Marks Hospital', '', '', '', 'HCFA|UB|', '1184647315', 0, 'N', 0, '2014-05-15', NULL, NULL, 0, 0, NULL, NULL),
('061787631', 'W11001332', 'W11001332', 'UT01', 'Lone Peak General Surgery', 'Charles', 'R', 'Davis', 'MD', 'General Surgery', '', '', NULL, 'O', '10011 Centennial Pkwy Ste 150', 'Sandy', 'Salt Lake', 'UT', '84070', '8015663062', NULL, '10011 Centennial Pkwy Ste 150', 'Sandy', 'Salt Lake', 'UT', '84070', '8015663062', '', 'WUUVPN10', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 3, '2007-08-01', '2010-06-01', 0, 0, 0, 'St Marks Hospital', '', '', '', 'HCFA|UB|', '1326136565', 0, 'N', 0, '2014-05-15', NULL, NULL, 0, 0, NULL, NULL),
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('830246056', 'W11001336', 'W11001336', 'WY01', '', 'V', 'Raja', 'Chandra', 'MD', 'Family Practice', 'Urgent Care', '', NULL, 'B', 'PO Box 1768', 'Rawlins', 'Carbon', 'WY', '82301', '3073242294', NULL, 'PO Box 1768', 'Rawlins', 'Carbon', 'WY', '82301', '3073242294', '          ', 'WYSINCLAIR', 'WYHCPCS', '', '0.00', '35.00', '0.00', 3, '2007-08-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1073667317', 0, 'Y', 0, '2013-08-30', NULL, NULL, 0, 0, NULL, NULL),
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('870616107', 'W11001404', 'W11001404', 'UT01', 'University Health Care', 'Lynn', NULL, 'Falkner', 'PA', 'Family Practice', NULL, NULL, NULL, 'o', '220 Millpond Rd Ste 100', 'Stansbury Park', 'Tooele', 'UT', '84074', '8012139400', NULL, '220 Millpond Rd Ste 100', 'Stansbury Park', 'Tooele', 'UT', '84074', '8012139400', '          ', 'WISESTDU', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 6, '2007-08-01', '2012-09-16', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1225128820', 0, 'N', 0, '2012-09-17', NULL, NULL, 0, 0, NULL, NULL);
INSERT INTO `providers_new` (`Provider_Tax_ID`, `Provider_Suffix`, `Provider_Network_ID`, `Provider_Region`, `Provider_Name`, `Provider_Doctor_First_Name`, `Provider_Doctor_Middle_Name`, `Provider_Doctor_Last_Name`, `Provider_Doctor_Degree`, `Provider_Specialty_1`, `Provider_Specialty_2`, `Provider_Specialty_3`, `Provider_Specialty_4`, `Provider_Address_Type`, `Provider_Address`, `Provider_City`, `Provider_County`, `Provider_State`, `Provider_Zip`, `Provider_Phone`, `Provider_Fax`, `Provider_Mailing_Address`, `Provider_Mailing_City`, `Provider_Mailing_County`, `Provider_Mailing_State`, `Provider_Mailing_Zip`, `Provider_Mailing_Phone`, `Provider_Mailing_Fax`, `Provider_Primary_Schedule`, `Provider_Secondary_Schedule`, `Provider_Rate_Sheet`, `Provider_Anes_Rate`, `Provider_Default_Rate`, `Provider_Max_DOS`, `Provider_Min_Match_Value`, `Provider_Effective_Date`, `Provider_Term_Date`, `Provider_Pend`, `Provider_Anes_Minutes`, `Provider_PPO`, `Provider_Hospital_1`, `Provider_Hospital_2`, `Provider_Hospital_3`, `Provider_Hospital_4`, `Provider_Type`, `Provider_NPI`, `Provider_Check_Override`, `Exclude_Dir`, `Audit_Status`, `Last_Change_Date`, `Medicare_ID`, `Provider_Lang`, `Provider_Latitude`, `Provider_Longitude`, `Provider_school`, `Provider_cert`) VALUES
('870616107', 'W11001405', 'W11001405', 'UT01', 'University Health Care', 'Ryan', 'T', 'Rushton', 'DPM', 'Podiatry', NULL, NULL, NULL, 'o', '220 Millpond Rd Ste 100', 'Stansbury Park', 'Tooele', 'UT', '84074', '8012139400', NULL, '220 Millpond Rd Ste 100', 'Stansbury Park', 'Tooele', 'UT', '84074', '8012139400', '          ', 'WISESTDU', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 6, '2007-08-01', '2012-09-16', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1013007632', 0, 'N', 0, '2012-09-18', NULL, NULL, 0, 0, NULL, NULL),
('870616107', 'W11001406', 'W11001406', 'UT01', 'University Health Care', 'Hilary', 'S', 'Seibert', 'DO', 'Family Practice', NULL, NULL, NULL, 'o', '220 Millpond Rd Ste 100', 'Stansbury Park', 'Tooele', 'UT', '84074', '8012139400', NULL, '220 Millpond Rd Ste 100', 'Stansbury Park', 'Tooele', 'UT', '84074', '8012139400', '          ', 'WISESTDU', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 6, '2007-08-01', '2012-09-16', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1275623894', 0, 'N', 0, '2013-01-21', NULL, NULL, 0, 0, NULL, NULL),
('870616107', 'W11001407', 'W11001407', 'UT01', 'University Health Care', 'Elizabeth', 'R', 'Smith', 'MD', 'Pediatrics', 'Family Practice', 'Pediatric Internal Medicine', NULL, 'o', '220 Millpond Rd Ste 100', 'Stansbury Park', 'Tooele', 'UT', '84074', '8012139400', NULL, '220 Millpond Rd Ste 100', 'Stansbury Park', 'Tooele', 'UT', '84074', '8012139400', '          ', 'WISESTDU', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 6, '2007-08-01', '2011-07-01', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1336239961', 0, 'N', 0, '2013-01-22', NULL, NULL, 0, 0, NULL, NULL),
('870616107', 'W11001408', 'W11001408', 'UT01', 'University Health Care', 'Christina', NULL, 'Vokt', 'MD', 'Family Practice', NULL, NULL, NULL, 'o', '220 Millpond Rd Ste 100', 'Stansbury Park', 'Tooele', 'UT', '84074', '8012139400', NULL, '220 Millpond Rd Ste 100', 'Stansbury Park', 'Tooele', 'UT', '84074', '8012139400', '          ', 'WISESTDU', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 6, '2007-08-01', '2012-09-16', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1568480895', 0, 'N', 0, '2012-09-18', NULL, NULL, 0, 0, NULL, NULL),
('870616107', 'W11001409', 'W11001409', 'UT01', 'University Health Care', 'Brian', NULL, 'Whisenant', 'MD', 'Internal Medicine', '', '', NULL, 'o', '220 Millpond Rd Ste 100', 'Stansbury Park', 'Tooele', 'UT', '84074', '8012139400', NULL, '220 Millpond Rd Ste 100', 'Stansbury Park', 'Tooele', 'UT', '84074', '8012139400', '          ', 'WISESTDU', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 6, '2007-08-01', '2012-09-16', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '0000009594', 0, 'N', 0, '2012-09-18', NULL, NULL, 0, 0, NULL, NULL),
('870616107', 'W11001410', 'W11001410', 'UT01', 'University Health Care', 'Ellie', NULL, 'Brownstein', 'MD', 'Pediatrics', NULL, NULL, NULL, 'o', '7495 S State St', 'Midvale', 'Salt Lake', 'UT', '84047', '8012139400', NULL, '7495 S State St', 'Midvale', 'Salt Lake', 'UT', '84047', '8012139400', '          ', 'WISESTDU', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 6, '2007-08-01', '2012-09-16', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1760572341', 0, 'N', 0, '2012-09-17', NULL, NULL, 0, 0, NULL, NULL),
('870616107', 'W11001411', 'W11001411', 'UT01', 'University Health Care', 'Julie', 'S', 'Day', 'MD', 'Family Practice', '', '', NULL, 'o', '1525 W 2100 S', 'Salt Lake City', 'Salt Lake', 'UT', '84119', '8018872499', NULL, '1525 W 2100 S', 'Salt Lake City', 'Salt Lake', 'UT', '84119', '8018872499', '          ', 'WISESTDU', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 6, '2007-08-01', '2012-09-16', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1831274521', 0, 'N', 0, '2012-09-17', NULL, NULL, 0, 0, NULL, NULL),
('870616107', 'W11001412', 'W11001412', 'UT01', 'University Health Care', 'Peggy', 'H', 'Fujimura', 'MD', 'Family Practice', '', '', NULL, 'o', '145 W University Pkwy', 'Orem', 'Utah', 'UT', '84058', '8012348600', NULL, '145 W University Pkwy', 'Orem', 'Utah', 'UT', '84058', '8012348600', '          ', 'WISESTDU', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 6, '2007-08-01', '2012-09-16', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '0000006332', 0, 'N', 0, '2012-09-17', NULL, NULL, 0, 0, NULL, NULL),
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('870616107', 'W11001414', 'W11001414', 'UT01', 'University Health Care', 'Jessica', 'L', 'Greenwood', 'MD', 'Family Practice', NULL, NULL, NULL, 'o', '1525 W 2100 S', 'Salt Lake City', 'Salt Lake', 'UT', '84119', '8018872499', NULL, '1525 W 2100 S', 'Salt Lake City', 'Salt Lake', 'UT', '84119', '8018872499', '          ', 'WISESTDU', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 6, '2007-08-01', '2012-09-16', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1982638250', 0, 'N', 0, '2012-09-17', NULL, NULL, 0, 0, NULL, NULL),
('870616107', 'W11001415', 'W11001415', 'UT01', 'University Health Care', 'Sumati', 'V', 'Gupta', 'MD', 'Internal Medicine', 'Geriatric Medicine', '', NULL, 'o', '7495 S State St', 'Midvale', 'Salt Lake', 'UT', '84047', '8012139400', '8012139443', '7495 S State St', 'Midvale', 'Salt Lake', 'UT', '84047', '8012139400', '8012139443', 'WISESTDU', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 6, '2006-08-01', '2012-09-16', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1003906603', 0, 'N', 0, '2012-09-17', NULL, NULL, 0, 0, NULL, NULL),
('870616107', 'W11001416', 'W11001416', 'UT01', 'University Health Care', 'Phil', 'S', 'Haggerty', 'DO', 'Family Practice', NULL, NULL, NULL, 'o', '145 W University Pkwy ', 'Orem', 'Utah', 'UT', '84058', '8012348600', NULL, NULL, NULL, '', NULL, NULL, '', '', 'WISESTDU', 'WUSTDHCPC5', NULL, '0.00', '35.00', NULL, 6, '2007-08-01', '2007-10-01', 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', NULL, 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870616107', 'W11001417', 'W11001417', 'UT01', 'University Health Care', 'Phil', 'S', 'Haggerty', 'DO', 'Family Practice', NULL, NULL, NULL, 'o', '1525 W 2100 S ', 'Salt Lake City', 'Salt Lake', 'UT', '84119', '8018872400', NULL, NULL, NULL, '', NULL, NULL, '', '', 'WISESTDU', 'WUSTDHCPC5', NULL, '0.00', '35.00', NULL, 6, '2007-08-01', '2007-10-01', 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', NULL, 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870616107', 'W11001418', 'W11001418', 'UT01', 'University Health Care', 'David', 'R', 'Hillam', 'MD', 'Family Practice', NULL, NULL, NULL, 'o', '145 W University Pkwy', 'Orem', 'Utah', 'UT', '84058', '8012348600', NULL, '145 W University Pkwy', 'Orem', 'Utah', 'UT', '84058', '8012348600', '          ', 'WISESTDU', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 6, '2007-08-01', '2012-09-16', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1275623878', 0, 'N', 0, '2012-09-25', NULL, NULL, 0, 0, NULL, NULL),
('870616107', 'W11001419', 'W11001419', 'UT01', 'University Health Care', 'Rina', 'M', 'Hooper', 'MD', 'Family Practice', NULL, NULL, NULL, 'o', '3730 W 4700 S', 'West Valley', 'Salt Lake', 'UT', '84118', '8012139200', NULL, '3730 W 4700 S', 'West Valley', 'Salt Lake', 'UT', '84118', '8012139200', '', 'WISESTDU', 'WUSTDHCPC5', NULL, '0.00', '35.00', '0.00', 6, '2007-08-01', '2008-03-01', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1538259130', 0, 'N', 0, '2013-07-29', NULL, NULL, 0, 0, NULL, NULL),
('870616107', 'W11001420', 'W11001420', 'UT01', 'University Health Care', 'Thomas', 'A', 'Hyatt', 'DO', 'Family Practice', NULL, NULL, NULL, 'o', '145 W University Pkwy', 'Orem', 'Utah', 'UT', '84058', '8012348600', NULL, NULL, NULL, '', NULL, NULL, '', '', 'WISESTDU', 'WUSTDHCPC5', NULL, '0.00', '35.00', '0.00', 6, '2007-08-01', '2010-02-15', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1346330941', 0, 'N', 0, '2007-08-01', NULL, NULL, 0, 0, NULL, NULL),
('870616107', 'W11001421', 'W11001421', 'UT01', 'University Health Care', 'Christopher', 'R', 'Johnson', 'DO', 'Family Practice', NULL, NULL, NULL, 'o', '145 W University Pkwy', 'Orem', 'Utah', 'UT', '84058', '8012348600', NULL, '145 W University Pkwy', 'Orem', 'Utah', 'UT', '84058', '8012348600', '          ', 'WISESTDU', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 6, '2007-08-01', '2012-09-16', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '0000006960', 0, 'N', 0, '2012-09-18', NULL, NULL, 0, 0, NULL, NULL),
('870616107', 'W11001422', 'W11001422', 'UT01', 'University Health Care', 'Michael', 'S', 'Kennedy', 'MD', 'Family Practice', '', '', NULL, 'o', '145 W University Pkwy', 'Orem', 'Utah', 'UT', '84058', '8012348600', NULL, '145 W University Pkwy', 'Orem', 'Utah', 'UT', '84058', '8012348600', '          ', 'WISESTDU', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 6, '2007-08-01', '2012-09-16', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1417047010', 0, 'N', 0, '2012-09-18', NULL, NULL, 0, 0, NULL, NULL),
('870616107', 'W11001423', 'W11001423', 'UT01', 'University Health Care', 'Thomas', 'J', 'Kottarathil', 'MD', 'Gastroenterology', NULL, NULL, NULL, 'o', '1525 W 2100 S', 'Salt Lake City', 'Salt Lake', 'UT', '84119', '8018872400', NULL, '1525 W 2100 S', 'Salt Lake City', 'Salt Lake', 'UT', '84119', '8018872400', '          ', 'WISESTDU', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 6, '2007-08-01', '2012-09-16', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1205911997', 0, 'N', 0, '2012-09-18', NULL, NULL, 0, 0, NULL, NULL),
('870616107', 'W11001424', 'W11001424', 'UT01', 'University Health Care', 'Scott', 'A', 'Larson', 'MD', 'Pediatric Ophthalmology', 'Ophthalmology', NULL, NULL, 'o', '145 W University Pkwy', 'Orem', 'Utah', 'UT', '84058', '8012348600', NULL, '145 W University Pkwy', 'Orem', 'Utah', 'UT', '84058', '8012348600', '          ', 'WISESTDU', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 6, '2007-08-01', '2012-09-16', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1992757991', 0, 'N', 0, '2012-09-18', NULL, NULL, 0, 0, NULL, NULL),
('870616107', 'W11001425', 'W11001425', 'UT01', 'University Health Care', 'Rixt', 'A', 'Luikenaar', 'MD', 'Obstetrics and Gynecology', '', '', NULL, 'O', '7495 S State St', 'Midvale', 'Salt Lake', 'UT', '84047', '8012139400', NULL, '7495 S State St', 'Midvale', 'Salt Lake', 'UT', '84047', '8012139400', '', 'WISESTDU', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 6, '2007-08-01', '2012-09-16', 0, 0, 0, 'St Marks Hospital', '', '', '', 'HCFA|UB|', '1285688101', 0, 'N', 0, '2014-05-12', NULL, NULL, 0, 0, NULL, NULL),
('870616107', 'W11001426', 'W11001426', 'UT01', 'University Health Care', 'Wendy', NULL, 'Macey', 'PA', 'Family Practice', NULL, NULL, NULL, 'o', '7495 S State St', 'Midvale', 'Salt Lake', 'UT', '84047', '8012139400', NULL, '7495 S State St', 'Midvale', 'Salt Lake', 'UT', '84047', '8012139400', '          ', 'WISESTDU', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 6, '2007-08-01', '2012-09-16', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1295825800', 0, 'N', 0, '2012-09-18', NULL, NULL, 0, 0, NULL, NULL),
('870616107', 'W11001427', 'W11001427', 'UT01', 'University Health Care', 'Wendy', NULL, 'Macey', 'PA', 'Family Practice', NULL, NULL, NULL, 'o', '1525 W 2100 S', 'Salt Lake City', 'Salt Lake', 'UT', '84119', '8018872400', NULL, '1525 W 2100 S', 'Salt Lake City', 'Salt Lake', 'UT', '84119', '8018872400', '          ', 'WISESTDU', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 6, '2007-08-01', '2012-09-16', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1295825800', 0, 'N', 0, '2012-09-18', NULL, NULL, 0, 0, NULL, NULL),
('870616107', 'W11001428', 'W11001428', 'UT01', 'University Health Care', 'Michael', 'K', 'Magill', 'MD', 'Family Practice', NULL, NULL, NULL, 'o', '1525 W 2100 S', 'Salt Lake City', 'Salt Lake', 'UT', '84119', '8018872400', NULL, '1525 W 2100 S', 'Salt Lake City', 'Salt Lake', 'UT', '84119', '8018872400', '          ', 'WISESTDU', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 6, '2007-08-01', '2012-09-16', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1215976386', 0, 'N', 0, '2012-09-18', NULL, NULL, 0, 0, NULL, NULL),
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