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
('261703236', 'W11005766', 'W11005766', 'UTMH1', 'Clinical Consultants LLC', 'Christina', '', 'Jacketta', 'LCSW', 'Mental Health', 'Social Worker', '', NULL, 'O', '8541 S Redwood Rd Bld A', 'West Jordan', 'Salt Lake', 'UT', '84088', '8012338670', NULL, '8541 S Redwood Rd Bld A', 'West Jordan', 'Salt Lake', 'UT', '84088', '8012338670', '          ', 'UTMA', '', '', '0.00', '35.00', '0.00', 6, '2008-07-01', '2010-06-21', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1669646626', 0, 'N', 0, '2012-01-19', NULL, NULL, 0, 0, NULL, NULL),
('261703236', 'W11005767', 'W11005767', 'UTMH1', 'Clinical Consultants LLC', 'Frederick', 'T', 'King', 'LCSW', 'Mental Health', 'Social Worker', '', NULL, 'O', '8541 S Redwood Rd Bld A', 'West Jordan', 'Salt Lake', 'UT', '84088', '8012338670', NULL, '8541 S Redwood Rd Bld A', 'West Jordan', 'Salt Lake', 'UT', '84088', '8012338670', '          ', 'UTMA', '', '', '0.00', '35.00', '0.00', 6, '2008-07-01', '2011-11-30', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1518131622', 0, 'N', 0, '2012-01-03', NULL, NULL, 0, 0, NULL, NULL),
('261703236', 'W11005769', 'W11005769', 'UTMH1', 'Clinical Consultants LLC', 'Christopher', 'M', 'Lang', 'MD', 'Mental Health', 'Psychiatry', '', NULL, 'O', '8541 S Redwood Rd Bld A', 'West Jordan', 'Salt Lake', 'UT', '84088', '8012338670', NULL, '8541 S Redwood Rd Bld A', 'West Jordan', 'Salt Lake', 'UT', '84088', '8012338670', '          ', 'UTMD', '', '', '0.00', '35.00', '0.00', 6, '2008-07-01', '2010-06-22', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1174502546', 0, 'N', 0, '2013-02-27', NULL, NULL, 0, 0, NULL, NULL),
('261703236', 'W11005771', 'W11005771', 'UTMH1', 'Clinical Consultants LLC', 'Ruth', 'G', 'McKane', 'LCSW', 'Mental Health', 'Social Worker', '', NULL, 'O', '8541 S Redwood Rd Bld A', 'West Jordan', 'Salt Lake', 'UT', '84088', '8012338670', NULL, '8541 S Redwood Rd Bld A', 'West Jordan', 'Salt Lake', 'UT', '84088', '8012338670', '          ', 'UTMA', '', '', '0.00', '35.00', '0.00', 6, '2008-07-01', '2009-07-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1891960886', 0, 'N', 0, '2008-07-01', NULL, NULL, 0, 0, NULL, NULL),
('261703236', 'W11005768', 'W11005768', 'UTMH1', 'Clinical Consultants LLC', 'Janette', 'M', 'Luna', 'LCSW', 'Mental Health', 'Social Worker', '', NULL, 'O', '8541 S Redwood Rd Bld A', 'West Jordan', 'Salt Lake', 'UT', '84088', '8012338670', NULL, '8541 S Redwood Rd Bld A', 'West Jordan', 'Salt Lake', 'UT', '84088', '8012338670', '          ', 'UTMA', '', '', '0.00', '35.00', '0.00', 6, '2008-07-01', '2010-06-22', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1427223601', 0, 'N', 0, '2013-02-27', NULL, NULL, 0, 0, NULL, NULL),
('261703236', 'W11005774', 'W11005774', 'UTMH1', 'Clinical Consultants ', 'Frederick', 'T', 'King', 'LCSW', 'Mental Health', 'Social Worker', '', NULL, 'O', '2351 Grant Ave Ste 100', 'Ogden', 'Weber', 'UT', '84401', '8016218670', NULL, '2351 Grant Ave Ste 100', 'Ogden', 'Weber', 'UT', '84401', '8016218670', '', 'UTMA', NULL, NULL, '0.00', '35.00', '0.00', 6, '2008-07-01', '2013-02-14', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1518131622', 0, 'n', 0, '2012-01-03', NULL, NULL, 0, 0, NULL, NULL),
('528705625', 'W11005780', 'W11005780', 'UTMH1', NULL, 'Steven', 'D', 'Brown', 'PHD', 'Mental Health', 'Psychology', '', NULL, 'B', '135 W 300 N', 'Ephraim', 'Sanpete', 'UT', '84627', '4352835559', NULL, '135 W 300 N', 'Ephraim', 'Sanpete', 'UT', '84627', '4352835559', '', 'PHD', NULL, NULL, '0.00', '35.00', '0.00', 3, '2008-07-01', '2013-02-14', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1982632600', 0, 'y', 0, '2012-01-03', NULL, NULL, 0, 0, NULL, NULL),
('528705625', 'W11005779', 'W11005779', 'UTMH1', NULL, 'Steven', 'D', 'Brown', 'PHD', 'Mental Health', 'Psychology', '', NULL, 'O', '96 So Main Ste 1', 'Ephraim', 'Sanpete', 'UT', '84627', '4352835559', NULL, '96 So Main Ste 1', 'Ephraim', 'Sanpete', 'UT', '84627', '4352835559', '', 'PHD', NULL, NULL, '0.00', '35.00', '0.00', 3, '2008-07-01', '2013-02-14', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1982632600', 0, 'n', 0, '2012-01-03', NULL, NULL, 0, 0, NULL, NULL),
('742768427', 'W11005790', 'W11005790', 'TX01', 'Institute for Womens Health', 'Jose', 'O', 'Vazquez-Vicente', 'DO', 'Obstetrics and Gynecology', NULL, NULL, NULL, 'B', '1210 Arion Pkwy', 'San Antonio', 'Bexar', 'TX', '78216', '2106563040', NULL, '1210 Arion Parkway', 'San Antonio', 'Bexar', 'TX', '78216', NULL, NULL, 'TXOBG', 'TXHCPCS', NULL, '0.00', '50.00', '0.00', 3, '2008-07-01', '2010-01-01', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1568520906', 0, 'y', 0, '2008-07-03', NULL, NULL, 0, 0, NULL, NULL),
('742768427', 'W11005789', 'W11005789', 'TX01', 'Institute for Womens Health', 'Jose', 'O', 'Vazquez-Vicente', 'DO', 'Obstetrics and Gynecology', NULL, NULL, NULL, 'O', '8715 Village Dr Ste 418', 'San Antonio', 'Bexar', 'TX', '78217', '2106563040', NULL, '1210 Arion Parkway', 'San Antonio', 'Bexar', 'TX', '78216', NULL, NULL, 'TXOBG', 'TXHCPCS', NULL, '0.00', '50.00', '0.00', 3, '2008-07-01', '2010-01-01', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1568520906', 0, 'N', 0, '2008-07-03', NULL, NULL, 29.5187, -98.4281, NULL, NULL),
('020789047', 'W11005784', 'W11005784', 'UTMH1', 'Acord Therapy', 'Gabrielle', '', 'Acord', 'LCSW', 'Mental Health', 'Social Worker', '', NULL, 'O', '505 S Main St ste 209', 'Bountiful', 'Davis', 'UT', '84010', '8019189058', NULL, '505 S Main St ste 209', 'Bountiful', 'Davis', 'UT', '84010', '8019189058', '', 'MA', NULL, NULL, '0.00', '35.00', '0.00', 3, '2008-07-01', '2013-02-14', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1417907650', 0, 'n', 0, '2013-02-27', NULL, NULL, 0, 0, NULL, NULL),
('020789047', 'W11005785', 'W11005785', 'UTMH1', NULL, 'Gabrielle', '', 'Acord', 'LCSW', 'Mental Health', 'Social Worker', '', NULL, 'B', 'PO Box 1176', 'Bountiful', 'Davis', 'UT', '84011', '8019189058', NULL, 'PO Box 1176', 'Bountiful', 'Davis', 'UT', '84011', '8019189058', '', 'MA', NULL, NULL, '0.00', '35.00', '0.00', 3, '2008-07-01', '2013-02-14', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1417907650', 0, 'y', 0, '2013-02-27', NULL, NULL, 0, 0, NULL, NULL),
('870410605', 'W11005786', 'W11005786', 'UTMH1', 'Family Support and Treatment Center', 'Joy', 'A', 'OBanion', 'LCSW', 'Mental Health', 'Social Worker', '', NULL, 'O', '1255 N 1200 W', 'Orem', 'Utah', 'UT', '84057', '8012291181', NULL, '1255 N 1200 W', 'Orem', 'Utah', 'UT', '84057', '8012291181', '', 'UTMA', '', '', '0.00', '35.00', '0.00', 3, '2008-07-01', '2013-02-14', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1235198763', 0, 'N', 0, '2014-04-24', NULL, NULL, 0, 0, NULL, NULL),
('870373083', 'W11005788', 'W11005788', 'UT01', 'Heart and Lung Institute', 'David', 'S', 'Massinople', 'MD', 'Cardiovascular Disease', '', '', NULL, 'O', '3570 W 9000 S Ste 110', 'West Jordan', 'Salt Lake', 'UT', '84088', '8012632370', '8012651200', '3570 W 9000 S Ste 110', 'West Jordan', 'Salt Lake', 'UT', '84088', '8012632370', '8012651200', 'WUSTDCARD5', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 3, '2008-07-01', '2014-04-30', 0, 0, 0, 'Jordan Valley Medical Center', 'Salt Lake Regional Medical Center', '', '', 'HCFA|UB|', '1255541785', 0, 'N', 0, '2014-06-23', NULL, NULL, 40.588, -111.975, NULL, NULL),
('870373083', 'W11005787', 'W11005787', 'UT01', 'Heart and Lung Institute', 'David', 'S', 'Massinople', 'MD', 'Cardiovascular Disease', '', '', NULL, 'O', '5979 S Fashion Blvd', 'Murray', 'Salt Lake', 'UT', '84107', '8012632370', '8012651200', '5979 S Fashion Blvd', 'Murray', 'Salt Lake', 'UT', '84107', '8012632370', '8012651200', 'WUSTDCARD5', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 3, '2008-07-01', '2014-04-30', 0, 0, 0, 'Jordan Valley Medical Center', 'Salt Lake Regional Medical Center', '', '', 'HCFA|UB|', '1255541785', 0, 'N', 0, '2014-06-23', NULL, NULL, 40.6415, -111.883, NULL, NULL),
('471541860', 'W11005782', 'W11005782', 'UTMH1', 'Cedarwood Counseling', 'Angel', 'M', 'Casey', 'PHD', 'Mental Health', 'Psychology', '', NULL, 'O', '324 N 200 E', 'Price', 'Carbon', 'UT', '84501', '4356375175', NULL, '324 N 200 E', 'Price', 'Carbon', 'UT', '84501', '4356375175', '', 'PHD', NULL, NULL, '0.00', '35.00', '0.00', 3, '2008-07-01', '2013-02-14', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1629056718', 0, 'N', 0, '2011-10-13', NULL, NULL, 0, 0, NULL, NULL),
('471541860', 'W11005783', 'W11005783', 'UTMH1', 'Cedarwood Counseling', 'Angel', 'M', 'Casey', 'PHD', 'Mental Health', 'Psychology', '', NULL, 'B', 'PO Box 5', 'Cleveland', 'Emery', 'UT', '84518', '4356375175', NULL, 'PO Box 5', 'Cleveland', 'Emery', 'UT', '84518', '4356375175', '', 'PHD', NULL, NULL, '0.00', '35.00', '0.00', 3, '2008-07-01', '2013-02-14', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1629056718', 0, 'y', 0, '2011-10-13', NULL, NULL, 0, 0, NULL, NULL),
('870644404', 'W11005781', 'W11005781', 'UTMH1', 'Sylvia Rios Davis Counseling ', 'Sylvia', 'R', 'Davis', 'LCSW', 'Mental Health', 'Social Worker', '', NULL, 'O', '14 N Main St', 'Springville', 'Utah', 'UT', '84663', '8014890124', NULL, '14 N Main St', 'Springville', 'Utah', 'UT', '84663', '8014890124', '', 'MA', NULL, NULL, '0.00', '35.00', '0.00', 3, '2008-07-01', '2013-02-14', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1609887215', 0, 'N', 0, '2011-09-29', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11005831', 'W11005831', 'WY01', 'Billings Clinic - Neurosurgery', 'Brian', NULL, 'Ragel', 'MD', 'Neurosurgery', NULL, NULL, NULL, 'O', '2825 8th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4062382501', '4062382469', 'PO Box 37000', 'Billings', 'Yellowstone', 'MT', '59107', NULL, NULL, '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2008-07-01', '2009-04-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1881725984', 0, 'N', 0, '2009-05-04', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11005832', 'W11005832', 'WY01', 'Billings Clinic', 'Brian', NULL, 'Ragel', 'MD', 'Neurosurgery', NULL, NULL, NULL, 'B', 'PO Box 35100', 'Billings', 'Yellowstone', 'MT', '59107', '4062382617', '4062382469', 'PO Box 35100', 'Billings', 'Yellowstone', 'MT', '59107', NULL, NULL, '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2008-07-01', '2009-04-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1881725984', 0, 'y', 0, '2009-05-04', NULL, NULL, 0, 0, NULL, NULL),
('742083988', 'W11005815', 'W11005815', 'TX01', 'Renal Associates', 'Jessica', 'L', 'Pierce', 'MD', 'Nephrology', '', '', NULL, 'O', '4499 Medical Dr Ste 102', 'San Antonio', 'Bexar', 'TX', '78229', '2109490469', NULL, '4499 Medical Dr Ste 102', 'San Antonio', 'Bexar', 'TX', '78229', '2109490469', '', 'TXSTD', 'TXHCPCS', NULL, '0.00', '50.00', '0.00', 3, '2008-07-07', '2012-08-19', 0, 0, 0, 'Baptist Medical Center', '', '', '', 'HCFA|UB|', '1831120344', 0, 'N', 0, '2013-05-06', NULL, NULL, 29.5105, -98.5737, NULL, NULL),
('742083988', 'W11005813', 'W11005813', 'TX01', 'Renal Associates', '', '', 'Renal Associates PA', 'GROUP', 'Nephrology', '', '', NULL, 'B', 'PO Box 701008', 'San Antonio', 'Bexar', 'TX', '78232', '2106141231', NULL, 'PO Box 701008', 'San Antonio', 'Bexar', 'TX', '78232', '2106141231', '', 'TXSTD', 'TXHCPCS', NULL, '0.00', '50.00', '0.00', 3, '2008-02-01', '2012-08-19', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '0000008357', 0, 'y', 0, '2013-05-06', NULL, NULL, 0, 0, NULL, NULL),
('742083988', 'W11005811', 'W11005811', 'TX01', 'Renal Associates', '', '', 'Renal Associates PA', 'GROUP', 'Nephrology', '', '', NULL, 'B', '16620 US Hwy 281 N Ste 300', 'San Antonio', 'Bexar', 'TX', '78232', '2106141231', NULL, '16620 US Hwy 281 N Ste 300', 'San Antonio', 'Bexar', 'TX', '78232', '2106141231', '', 'TXSTD', 'TXHCPCS', NULL, '0.00', '50.00', '0.00', 3, '2008-02-01', '2012-08-19', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '0000008357', 0, 'y', 0, '2013-05-06', NULL, NULL, 0, 0, NULL, NULL),
('742083988', 'W11005814', 'W11005814', 'TX01', 'Renal Associates', 'Brijesh', '', 'Kapoor', 'MD', 'Nephrology', '', '', NULL, 'O', '11481 Toepperwein Ste 1202', 'San Antonio', 'Bexar', 'TX', '78233', '2106558470', NULL, '11481 Toepperwein Ste 1202', 'San Antonio', 'Bexar', 'TX', '78233', '2106558470', '', 'TXSTD', 'TXHCPCS', NULL, '0.00', '50.00', '0.00', 3, '2008-07-07', '2012-08-19', 0, 0, 0, 'Baptist Medical Center', 'North East Baptist Hospital', 'North Central Baptist Hospital', NULL, 'HCFA|UB|', '1518988104', 0, 'N', 0, '2012-06-28', NULL, NULL, 29.5418, -98.34, NULL, NULL),
('200079821', 'W11005829', 'W11005829', 'ID01', 'CPAP Now Inc', '', '', 'CPAP Now Inc', 'GROUP', 'Durable Medical Equipment', '', '', NULL, 'O', '526-C Shoup Ave W', 'Twin Falls', 'Twin Falls', 'ID', '83301', '2084552400', '          ', '526-C Shoup Ave W', 'Twin Falls', 'Twin Falls', 'ID', '83301', '2084552400', '          ', 'DME80', '', '', '0.00', '35.00', '0.00', 3, '2008-07-01', '2014-03-31', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1518066414', 0, 'N', 0, '2014-05-13', NULL, NULL, 0, 0, NULL, NULL),
('200079821', 'W11005828', 'W11005828', 'ID01', 'CPAP Now Inc', '', '', 'CPAP Now Inc', 'GROUP', 'Durable Medical Equipment', '', '', NULL, 'O', '2423 S Georgia', 'Caldwell', 'Canyon', 'ID', '83605', '2084558801', '          ', '2423 S Georgia', 'Caldwell', 'Canyon', 'ID', '83605', '2084558801', '          ', 'DME80', '', '', '0.00', '35.00', '0.00', 3, '2008-07-01', '2014-03-31', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1518066414', 0, 'N', 0, '2014-05-13', NULL, NULL, 0, 0, NULL, NULL),
('820333564', 'W11005800', 'W11005800', 'ID01', NULL, 'Richard', 'F', 'Starkey', 'MD', 'Family Practice', '', '', NULL, 'B', 'PO Box 427', 'Mountain Home', 'Elmore', 'ID', '83647', '2085879736', NULL, 'PO Box 427', 'Mountain Home', 'Elmore', 'ID', '83647', '2085879736', '', 'IDSTD', 'WUSTDHCPC5', NULL, '0.00', '30.00', '0.00', 3, '2008-07-07', '2012-08-19', 0, 0, 0, 'Elmore Medical Center', '', '', '', 'HCFA|UB|', '1831206135', 0, 'y', 0, '2013-01-17', NULL, NULL, 0, 0, NULL, NULL),
('820333564', 'W11005803', 'W11005803', 'ID01', NULL, 'Linda', 'G', 'Shaw', 'FNP', 'Family Practice', '', '', NULL, 'B', 'PO Box 427', 'Mountain Home', 'Elmore', 'ID', '83647', '2085879736', NULL, 'PO Box 427', 'Mountain Home', 'Elmore', 'ID', '83647', '2085879736', '', 'IDSTD', 'WUSTDHCPC5', NULL, '0.00', '30.00', '0.00', 3, '2008-07-07', '2012-08-19', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1669561049', 0, 'Y', 0, '2013-03-28', NULL, NULL, 0, 0, NULL, NULL),
('820333564', 'W11005801', 'W11005801', 'ID01', NULL, 'Richard', 'F', 'Starkey', 'MD', 'Family Practice', '', '', NULL, 'o', '805 N 6th E', 'Mountain Home', 'Elmore', 'ID', '83647', '2085879736', NULL, '805 N 6th E', 'Mountain Home', 'Elmore', 'ID', '83647', '2085879736', '', 'IDSTD', 'WUSTDHCPC5', NULL, '0.00', '30.00', '0.00', 3, '2008-07-07', '2012-08-19', 0, 0, 0, 'Elmore Medical Center', '', '', '', 'HCFA|UB|', '1831206135', 0, 'N', 0, '2013-01-17', NULL, NULL, 43.1376, -115.693, NULL, NULL),
('820333564', 'W11005802', 'W11005802', 'ID01', NULL, 'Linda', 'G', 'Shaw', 'FNP', 'Family Practice', '', '', NULL, 'o', '805 N 6th E', 'Mountain Home', 'Elmore', 'ID', '83647', '2085879736', NULL, '805 N 6th E', 'Mountain Home', 'Elmore', 'ID', '83647', '2085879736', '', 'IDSTD', 'WUSTDHCPC5', NULL, '0.00', '30.00', '0.00', 3, '2008-07-07', '2012-08-19', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1669561049', 0, 'N', 0, '2013-03-28', NULL, NULL, 43.1376, -115.693, NULL, NULL),
('200079821', 'W11005830', 'W11005830', 'ID01', 'CPAP Now Inc', '', '', 'CPAP Now Inc', 'GROUP', 'Durable Medical Equipment', '', '', NULL, 'O', '6128 Fairview Ste 1A', 'Boise', 'Ada', 'ID', '83704', '2082871733', '          ', '6128 Fairview Ste 1A', 'Boise', 'Ada', 'ID', '83704', '2082871733', '          ', 'DME80', '', '', '0.00', '35.00', '0.00', 3, '2008-07-01', '2014-03-31', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1518066414', 0, 'N', 0, '2014-05-13', NULL, NULL, 0, 0, NULL, NULL),
('820392395', 'W11005806', 'W11005806', 'ID01', NULL, 'Edward', 'H', 'Newcombe', 'MD', 'Internal Medicine', 'Family Practice', '', NULL, 'O', '2036 N Cole Rd', 'Boise', 'Ada', 'ID', '83704', '2083750722', NULL, '2036 N Cole Rd', 'Boise', 'Ada', 'ID', '83704', '2083750722', '', 'IDSTD', 'WUSTDHCPC5', NULL, '0.00', '30.00', '0.00', 3, '2008-07-07', '2012-08-19', 0, 0, 0, 'Saint Alphonsus Medical Center Nampa', NULL, '', '', 'HCFA|UB|', '1063441343', 0, 'n', 0, '2013-10-30', NULL, NULL, 43.6238, -116.273, NULL, NULL),
('262653132', 'W11005817', 'W11005817', 'UT01', 'Alpine Family Medicine', 'Daniel', 'W', 'Egan', 'MD', 'Family Practice', '', '', NULL, 'O', '155 W Canyon Crest Rd Ste 200', 'Alpine', 'Utah', 'UT', '84004', '8017639851', '8017639852', '155 W Canyon Crest Rd Ste 200', 'Alpine', 'Utah', 'UT', '84004', '8017639851', '8017639852', 'WUUVPN10', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 3, '2008-07-01', '2010-07-14', 0, 0, 0, 'Timpanogos Regional Hospital', '', '', '', 'HCFA|UB|', '1417066564', 0, 'N', 0, '2013-08-13', NULL, NULL, 0, 0, NULL, NULL),
('262653132', 'W11005816', 'W11005816', 'UT01', 'Alpine Family Medicine', 'Peter', 'V', 'Sundwall', 'MD', 'Family Practice', '', '', NULL, 'O', '155 W Canyon Crest Rd Ste 200', 'Alpine', 'Utah', 'UT', '84004', '8017639851', '8017639852', '155 W Canyon Crest Rd Ste 200', 'Alpine', 'Utah', 'UT', '84004', '8017639851', '8017639852', 'WUUVPN10', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 3, '2008-07-01', '2010-07-14', 0, 0, 0, 'Timpanogos Regional Hospital', '', '', '', 'HCFA|UB|', '1558470641', 0, 'N', 0, '2013-09-23', NULL, NULL, 0, 0, NULL, NULL),
('870395551', 'W11005825', 'W11005825', 'UT01', '', 'James Bradley', '', 'Young', 'DC', 'Chiropractic', '', '', NULL, 'O', '1410 N Hill Field Rd Ste 4', 'Layton', 'Davis', 'UT', '84041', '8017740555', NULL, '1410 N Hill Field Rd Ste 4', 'Layton', 'Davis', 'UT', '84041', '8017740555', '          ', 'WLABRAD', 'WUSTDHCPC5', '', '0.00', '0.00', '55.46', 3, '2008-07-01', '2010-10-31', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1861580888', 0, 'N', 0, '2010-11-09', NULL, NULL, 0, 0, NULL, NULL),
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('528767277', 'W11005824', 'W11005824', 'UTMH1', NULL, 'Linda', '', 'Gurrister', 'LCSW', 'Mental Health', 'Social Worker', '', NULL, 'O', '4190 S Highland Dr Ste 210', 'Salt Lake City', 'Salt Lake', 'UT', '84124', '8012788492', NULL, '4190 S Highland Dr Ste 210', 'Salt Lake City', 'Salt Lake', 'UT', '84124', '8012788492', '', 'UTMA', NULL, NULL, '0.00', '35.00', '0.00', 3, '2008-07-07', '2013-02-14', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1396873279', 0, 'n', 0, '2013-02-27', NULL, NULL, 0, 0, NULL, NULL),
('870306646', 'W11005796', 'W11005796', 'UT01', 'Emergency Physicians Group', 'Steven', 'R', 'Mooth', 'MD', 'Emergency Medicine', '', '', NULL, 'O', '1200 E 3900 S', 'Salt Lake City', 'Salt Lake', 'UT', '84124', '8012687975', NULL, '1200 E 3900 S', 'Salt Lake City', 'Salt Lake', 'UT', '84124', '8012687975', '          ', 'WISESTD', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 3, '2008-07-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1063695542', 0, 'Y', 0, '2011-07-19', NULL, NULL, 40.6871, -111.856, NULL, NULL),
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('711001492', 'W11005820', 'W11005820', 'UTMH1', 'Ogden Center for Counseling', 'Lawrence', 'A', 'Carcelli', 'PHD', 'Mental Health', 'Psychology', '', NULL, 'O', '4699 Harrison Blvd Ste 300', 'Ogden', 'Weber', 'UT', '84403', '8014798286', NULL, '4699 Harrison Blvd Ste 300', 'Ogden', 'Weber', 'UT', '84403', '8014798286', '', 'PHD', NULL, NULL, '0.00', '35.00', '0.00', 3, '2008-07-07', '2013-02-14', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1639236367', 0, 'n', 0, '2011-12-19', NULL, NULL, 0, 0, NULL, NULL),
('711001492', 'W11005821', 'W11005821', 'UTMH1', NULL, 'Lawrence', 'A', 'Carcelli', 'PHD', 'Mental Health', 'Psychology', '', NULL, 'B', 'PO Box 150307', 'Ogden', 'Weber', 'UT', '84403', '8014798286', NULL, 'PO Box 150307', 'Ogden', 'Weber', 'UT', '84403', '8014798286', '', 'PHD', NULL, NULL, '0.00', '35.00', '0.00', 3, '2008-07-07', '2013-02-14', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1639236367', 0, 'y', 0, '2011-12-19', NULL, NULL, 0, 0, NULL, NULL),
('200985749', 'W11005823', 'W11005823', 'UTMH1', '', 'Tamara', 'A', 'Little', 'LCSW', 'Mental Health', 'Social Worker', '', NULL, 'B', '946 S 2300 E', 'Springville', 'Utah', 'UT', '84663', '8015920885', NULL, '946 S 2300 E', 'Springville', 'Utah', 'UT', '84663', '8015920885', '          ', 'MA', '', '', '0.00', '35.00', '0.00', 3, '2008-07-07', '2013-02-14', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1639348576', 0, 'Y', 0, '2012-01-03', NULL, NULL, 0, 0, NULL, NULL),
('200985749', 'W11005822', 'W11005822', 'UTMH1', 'Center for Growth & Healing', 'Tamara', 'A', 'Little', 'LCSW', 'Mental Health', 'Social Worker', '', NULL, 'O', '143 E 200 S', 'Springville', 'Utah', 'UT', '84663', '8015920885', NULL, '143 E 200 S', 'Springville', 'Utah', 'UT', '84663', '8015920885', '', 'MA', NULL, NULL, '0.00', '35.00', '0.00', 3, '2008-07-07', '2013-02-14', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1639348576', 0, 'n', 0, '2012-01-03', NULL, NULL, 0, 0, NULL, NULL),
('522725896', 'W11005878', 'W11005878', 'UTPEHP', 'Alpha Center', 'Saul', 'D', 'Tompkins', 'PHD', 'Mental Health', 'Psychology', '', NULL, 'O', '1170 Colorado Ave', 'Grand Junction', 'Mesa', 'CO', '81501', '9702412948', NULL, '1170 Colorado Ave', 'Grand Junction', 'Mesa', 'CO', '81501', '9702412948', '', 'COSTD', 'WUSTDHCPC5', NULL, '0.00', '35.00', '0.00', 3, '2008-08-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1477658763', 0, 'n', 0, '2011-11-29', NULL, NULL, 0, 0, NULL, NULL),
('870276435', 'W11005875', 'W11005875', 'UT01', 'Home Health Equipment & Supplies', NULL, NULL, 'Home Health Equipment & Supplies', 'GROUP', 'Durable Medical Equipment', NULL, NULL, NULL, 'O', '26 W 200 N Ste 78-15', 'Roosevelt', 'Duchesne', 'UT', '84066', '4357222418', '4357226187', '250 W 300 N', 'Roosevelt', 'Duchesne', 'UT', '84066', NULL, NULL, '', NULL, NULL, '0.00', '4.00', '0.00', 3, '2006-11-01', '2009-10-15', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '0185135711', 0, 'N', 0, '2009-10-27', NULL, NULL, 0, 0, NULL, NULL),
('260762942', 'W11005834', 'W11005834', 'UTMH1', '', 'John', 'L', 'Kluthe', 'PHD', 'Mental Health', 'Psychology', '', NULL, 'B', 'PO Box 1569', 'Hooper', 'Weber', 'UT', '84315', '8014798286', NULL, 'PO Box 1569', 'Hooper', 'Weber', 'UT', '84315', '8014798286', '          ', 'PHD', '', '', '0.00', '35.00', '0.00', 3, '2008-08-01', '2013-02-14', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1427192087', 0, 'N', 0, '2013-02-27', NULL, NULL, 0, 0, NULL, NULL),
('528866261', 'W11005836', 'W11005836', 'UTMH1', '', 'Patrick', 'D', 'Gilmore', 'LCSW', 'Mental Health', 'Social Worker', '', NULL, 'B', 'PO Box 156', 'Hooper', 'Weber', 'UT', '84315', '8014798286', '8017319451', 'PO Box 156', 'Hooper', 'Weber', 'UT', '84315', '8014798286', '8017319451', 'MA', '', '', '0.00', '35.00', '0.00', 3, '2008-08-01', '2013-02-13', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1972551802', 0, 'N', 0, '2013-02-14', NULL, NULL, 0, 0, NULL, NULL),
('528866261', 'W11005835', 'W11005835', 'UTMH1', 'Ogden Center for Counseling', 'Patrick', 'D', 'Gilmore', 'LCSW', 'Mental Health', 'Social Worker', '', NULL, 'O', '4699 Harrison Blvd', 'Ogden', 'Weber', 'UT', '84403', '8014798286', '8017319451', '4699 Harrison Blvd', 'Ogden', 'Weber', 'UT', '84403', '8014798286', '8017319451', 'MA', '', '', '0.00', '35.00', '0.00', 3, '2008-08-01', '2013-02-13', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1972551802', 0, 'N', 0, '2013-02-14', NULL, NULL, 0, 0, NULL, NULL),
('260762942', 'W11005833', 'W11005833', 'UTMH1', 'Ogden Center for Counseling and Assessment', 'John', 'L', 'Kluthe', 'PHD', 'Mental Health', 'Psychology', '', NULL, 'O', '4699 Harrison Blvd Ste 300', 'Ogden', 'Weber', 'UT', '84403', '8014798286', NULL, '4699 Harrison Blvd Ste 300', 'Ogden', 'Weber', 'UT', '84403', '8014798286', '          ', 'PHD', '', '', '0.00', '35.00', '0.00', 3, '2008-08-01', '2013-02-14', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1427192087', 0, 'N', 0, '2013-02-27', NULL, NULL, 0, 0, NULL, NULL),
('260603044', 'W11005877', 'W11005877', 'UTPEHP', 'Care for You Family Health', 'Cresfield', 'W', 'Moody', 'FNP', 'Family Practice', '', '', NULL, 'B', 'PO Box 4807', 'Page', 'Coconino', 'AZ', '86040', '9286601799', NULL, 'PO Box 4807', 'Page', 'Coconino', 'AZ', '86040', '9286601799', '', 'PEHPOOS', 'WUSTDHCPC5', NULL, '0.00', '35.00', '0.00', 3, '2008-08-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1962468678', 0, 'Y', 0, '2011-09-21', NULL, NULL, 0, 0, NULL, NULL),
('260603044', 'W11005876', 'W11005876', 'UTPEHP', 'Care for You Family Health', 'Cresfield', 'W', 'Moody', 'FNP', 'Family Practice', '', '', NULL, 'O', '608 Elm St Ste B', 'Page', 'Coconino', 'AZ', '86040', '9286601799', NULL, '608 Elm St Ste B', 'Page', 'Coconino', 'AZ', '86040', '9286601799', '', 'PEHPOOS', 'WUSTDHCPC5', NULL, '0.00', '35.00', '0.00', 3, '2008-08-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1962468678', 0, 'n', 0, '2011-09-21', 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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('522229954', 'W11005914', 'W11005914', 'UT01', 'Cache Valley Specialty Hospital', 'Ryan', '', 'Godfrey', 'OT CHT', 'Physical Therapy', NULL, NULL, NULL, 'O', '2380 N 400 E', 'North Logan', 'Cache', 'UT', '84341', '4357139680', NULL, '2380 N 400 E', 'North Logan', 'Cache', 'UT', '84341', '4357139680', '          ', 'WestRehab', 'WUSTDHCPC5', '', '0.00', '0.00', '58.00', 3, '2008-07-01', '2008-09-30', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1942348875', 0, 'N', 0, '2011-10-25', NULL, NULL, 0, 0, NULL, NULL),
('870395551', 'W11005963', 'W11005963', 'UT01', NULL, 'Lance', 'M', 'Tilley', 'DC', 'Chiropractic', NULL, NULL, NULL, 'O', '859 Washington Blvd Ste 1', 'Ogden', 'Weber', 'UT', '84404', '8016216155', '8016216158', '867 E 9400 S', 'Sandy', 'Weber', 'UT', '84094', NULL, NULL, 'WLABRAD', 'WUSTDHCPC5', NULL, '0.00', '0.00', '55.46', 3, '2008-07-03', '2010-10-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '0000973631', 0, 'N', 0, '2008-07-11', NULL, NULL, 0, 0, NULL, NULL),
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('522229954', 'W11005904', 'W11005904', 'UT01', 'Summit Hand Therapy', 'Samuel', '', 'DeLong', 'PT', 'Physical Therapy', NULL, NULL, NULL, 'O', '7382 S 1025 E', 'Ogden', 'Weber', 'UT', '84405', '8017732633', NULL, '7382 S 1025 E', 'Ogden', 'Weber', 'UT', '84405', '8017732633', '          ', 'WestRehab', 'WUSTDHCPC5', '', '0.00', '0.00', '58.00', 3, '2008-07-01', '2008-09-30', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1780603910', 0, 'N', 0, '2011-10-26', NULL, NULL, 0, 0, NULL, NULL),
('522229954', 'W11005938', 'W11005938', 'UT01', 'Prorehab', 'David', 'Edmond', 'Nelson', 'PT', 'Physical Therapy', '', '', NULL, 'O', '590 E 100 N Ste 1', 'Price', 'Carbon', 'UT', '84501', '4356131500', NULL, '590 E 100 N Ste 1', 'Price', 'Carbon', 'UT', '84501', '4356131500', '          ', 'WestRehab', 'WUSTDHCPC5', '', '0.00', '0.00', '58.00', 3, '2008-07-01', '2008-09-30', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1568454858', 0, 'N', 0, '2011-04-21', NULL, NULL, 0, 0, NULL, NULL),
('522229954', 'W11005897', 'W11005897', 'UT01', 'MLR - Moab', 'Jeremy', 'F', 'Branch', 'DPT', 'Physical Therapy', '', '', NULL, 'O', '620 W 400 N', 'Moab', 'Grand', 'UT', '84532', '4352593600', NULL, '620 W 400 N', 'Moab', 'Grand', 'UT', '84532', '4352593600', '          ', 'WestRehab', 'WUSTDHCPC5', '', '0.00', '0.00', '58.00', 3, '2008-07-01', '2008-07-03', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1619068376', 0, 'N', 0, '2011-04-21', NULL, NULL, 0, 0, NULL, NULL),
('522229954', 'W11005892', 'W11005892', 'UT01', 'Precision Rehabilitation/Monticello', 'Kathleen', '', 'Aldous', 'DPT', 'Physical Therapy', '', '', NULL, 'O', '364 W 100 N', 'Monticello', 'San Juan', 'UT', '84535', '4355872116', NULL, '364 W 100 N', 'Monticello', 'San Juan', 'UT', '84535', '4355872116', '          ', 'WestRehab', 'WUSTDHCPC5', '', '0.00', '0.00', '58.00', 3, '2008-07-01', '2008-09-30', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1366630774', 0, 'N', 0, '2011-11-29', NULL, NULL, 0, 0, NULL, NULL),
('522229954', 'W11005891', 'W11005891', 'UT01', 'Precision Rehabilitation/Blanding', 'Kathleen', '', 'Aldous', 'DPT', 'Physical Therapy', '', '', NULL, 'O', '818 N 400 W', 'Blanding', 'San Juan', 'UT', '84535', '4356783869', NULL, '818 N 400 W', 'Blanding', 'San Juan', 'UT', '84535', '4356783869', '          ', 'WestRehab', 'WUSTDHCPC5', '', '0.00', '0.00', '58.00', 3, '2008-07-01', '2008-09-30', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1366630774', 0, 'N', 0, '2011-11-29', NULL, NULL, 0, 0, NULL, NULL),
('522229954', 'W11005895', 'W11005895', 'UT01', 'Spine, Orthopedic & Sports Physical Therapy', 'Brandon', '', 'Bliss', 'PT', 'Physical Therapy', NULL, NULL, NULL, 'O', '3303 N University Ave', 'Provo', 'Utah', 'UT', '84604', '8013737438', NULL, '3303 N University Ave', 'Provo', 'Utah', 'UT', '84604', '8013737438', '          ', 'WestRehab', 'WUSTDHCPC5', '', '0.00', '0.00', '58.00', 3, '2008-07-01', '2008-09-30', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1720167752', 0, 'N', 0, '2011-04-20', NULL, NULL, 0, 0, NULL, NULL),
('522229954', 'W11005935', 'W11005935', 'UT01', 'Southern Utah Physical Therapy', 'Adam', 'L', 'Mendenhall', 'PT', 'Physical Therapy', '', '', NULL, 'O', '166 W 1325 N Ste 100', 'Cedar City', 'Iron', 'UT', '84720', '4358651902', NULL, '166 W 1325 N Ste 100', 'Cedar City', 'Iron', 'UT', '84720', '4358651902', '', 'WestRehab', 'WUSTDHCPC5', '', '0.00', '0.00', '58.00', 3, '2008-07-01', '2008-09-30', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1780600049', 0, 'N', 0, '2014-07-11', NULL, NULL, 0, 0, NULL, NULL),
('522229954', 'W11005908', 'W11005908', 'UT01', 'Southern Utah Physical Therapy', 'Brady', '', 'Englestead', 'PT', 'Physical Therapy', '', '', NULL, 'O', '166 W 1325 N Ste 100', 'Cedar City', 'Iron', 'UT', '84720', '4355862665', '', '166 W 1325 N Ste 100', 'Cedar City', 'Iron', 'UT', '84720', '4355862665', '', 'WestRehab', 'WUSTDHCPC5', '', '0.00', '0.00', '58.00', 3, '2008-07-01', '2008-09-30', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1164455887', 0, 'N', 0, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('522229954', 'W11005909', 'W11005909', 'UT01', 'Southern Utah Physical Therapy', 'Randy', '', 'Forsyth', 'PT', 'Physical Therapy', '', '', NULL, 'O', '1335 Northfield Rd Ste 3', 'Cedar City', 'Iron', 'UT', '84720', '4358651902', NULL, '1335 Northfield Rd Ste 3', 'Cedar City', 'Iron', 'UT', '84720', '4358651902', '', 'WestRehab', 'WUSTDHCPC5', '', '0.00', '0.00', '58.00', 3, '2008-07-01', '2008-09-30', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1598704983', 0, 'N', 0, '2014-07-11', NULL, NULL, 0, 0, NULL, NULL),
('522229954', 'W11005930', 'W11005930', 'UT01', 'Southern Utah Physical Therapy', 'Kregg', '', 'Lunt', 'PT', 'Physical Therapy', '', '', NULL, 'O', '1335 Northfield Rd Ste 3', 'Cedar City', 'Iron', 'UT', '84720', '4358651902', NULL, '1335 Northfield Rd Ste 3', 'Cedar City', 'Iron', 'UT', '84720', '4358651902', '          ', 'WestRehab', 'WUSTDHCPC5', '', '0.00', '0.00', '58.00', 3, '2008-07-01', '2008-10-01', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1790711190', 0, 'N', 0, '2012-12-11', NULL, NULL, 0, 0, NULL, NULL),
('522229954', 'W11005898', 'W11005898', 'UT01', 'Southern Utah Physical Therapy', 'G Tyler', '', 'Brinkerhoff', 'PT', 'Physical Therapy', '', '', NULL, 'O', '620 W 400 N', 'Cedar City', 'Iron', 'UT', '84720', '4355862665', '', '620 W 400 N', 'Cedar City', 'Iron', 'UT', '84720', '4355862665', '', 'WestRehab', 'WUSTDHCPC5', '', '0.00', '0.00', '58.00', 3, '2008-07-01', '2008-09-30', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1386660637', 0, 'N', 0, '2014-07-23', NULL, NULL, 0, 0, NULL, NULL),
('522229954', 'W11005915', 'W11005915', 'UT01', 'Gublers Physical Therapy', 'Troy', 'Cal', 'Gubler', 'PT', 'Physical Therapy', NULL, NULL, NULL, 'O', '68 S 700 W', 'Hurricane', 'Washington', 'UT', '84737', '4356359333', NULL, '68 S 700 W', 'Hurricane', 'Washington', 'UT', '84737', '4356359333', '          ', 'WestRehab', 'WUSTDHCPC5', '', '0.00', '0.00', '58.00', 3, '2008-07-01', '2008-09-30', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1033210067', 0, 'N', 0, '2013-11-13', NULL, NULL, 0, 0, NULL, NULL),
('522229954', 'W11005961', 'W11005961', 'UT01', 'Mountain Land Rehabilitation', 'Robert', 'Craig', 'Lloyd', 'PT', 'Physical Therapy', '', '', NULL, 'O', '575 S 200 E Ste 2', 'Ivins', 'Washington', 'UT', '84738', '4356741269', NULL, '575 S 200 E Ste 2', 'Ivins', 'Washington', 'UT', '84738', '4356741269', '          ', 'WestRehab', 'WUSTDHCPC5', '', '0.00', '0.00', '58.00', 3, '2008-07-01', '2008-09-30', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1922102177', 0, 'N', 0, '2011-04-20', NULL, NULL, 0, 0, NULL, NULL),
('522229954', 'W11005954', 'W11005954', 'UT01', 'Mountain Land Rehabilitation Home Health', 'Steve', 'Eugene', 'Swinson', 'PT', 'Physical Therapy', '', '', NULL, 'O', '676 S Bluff St', 'St George', 'Washington', 'UT', '84770', '4356730191', NULL, '676 S Bluff St', 'St George', 'Washington', 'UT', '84770', '4356730191', '          ', 'WestRehab', 'WUSTDHCPC5', '', '0.00', '0.00', '58.00', 3, '2008-07-01', '2008-09-30', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1144281866', 0, 'N', 0, '2011-05-31', NULL, NULL, 0, 0, NULL, NULL),
('522229954', 'W11005919', 'W11005919', 'UT01', 'Mountain Land Rehabilitation Home Health', 'Rowdy', 'J', 'Hatch', 'OT', 'Physical Therapy', NULL, NULL, NULL, 'O', '676 S Bluff St', 'St George', 'Washington', 'UT', '84770', '4356730191', NULL, 'PO Box 74125', 'Salt Lake City', 'Washington', 'UT', '84171', NULL, NULL, 'WestRehab', 'WUSTDHCPC5', NULL, '0.00', '0.00', '58.00', 3, '2008-07-01', '2008-07-23', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1982720579', 0, 'N', 0, '2008-07-10', NULL, NULL, 0, 0, NULL, NULL),
('522229954', 'W11005946', 'W11005946', 'UT01', 'MLR of Vegas', 'Connie', 'S', 'South', 'MPT', 'Physical Therapy', NULL, NULL, NULL, 'O', '8691 W Sahara Ave Ste 100', 'Las Vegas', 'Clark', 'NV', '89117', '7022282120', NULL, 'PO Box 74125', 'Salt Lake City', 'Clark', 'UT', '84171', NULL, NULL, 'WestRehab', 'WUSTDHCPC5', NULL, '0.00', '0.00', '58.00', 3, '2008-02-17', '2008-06-17', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1043435985', 0, 'N', 0, '2008-10-03', NULL, NULL, 0, 0, NULL, NULL),
('522229954', 'W11005953', 'W11005953', 'UT01', 'MLR- Sahara', 'John', NULL, 'Stevens', 'PT', 'Physical Therapy', NULL, NULL, NULL, 'O', '8691 W Sahara Ave Ste 110', 'Las Vegas', 'Clark', 'NV', '89117', '7022282120', NULL, 'PO Box 74125', 'Salt Lake City', 'Clark', 'UT', '84171', NULL, NULL, 'WestRehab', 'WUSTDHCPC5', NULL, '0.00', '0.00', '58.00', 3, '2008-07-01', '2008-09-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1235232836', 0, 'N', 0, '2008-10-03', NULL, NULL, 0, 0, NULL, NULL),
('522229954', 'W11005920', 'W11005920', 'UT01', 'MLR Summerlin', 'Jason', NULL, 'Henne', 'OT', 'Physical Therapy', NULL, NULL, NULL, 'O', '9484 W Lake Mead Blvd Ste 8-10', 'Las Vegas', 'Clark', 'NV', '89134', '7022437744', NULL, 'PO Box 74125', 'Salt Lake City', 'Clark', 'UT', '84171', NULL, NULL, 'WestRehab', 'WUSTDHCPC5', NULL, '0.00', '0.00', '58.00', 3, '2008-07-01', '2008-09-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '0000006669', 0, 'N', 0, '2008-10-03', NULL, NULL, 0, 0, NULL, NULL),
('522229954', 'W11005947', 'W11005947', 'UT01', 'MLR of Vegas', 'Connie', 'S', 'South', 'MPT', 'Physical Therapy', NULL, NULL, NULL, 'O', '9484 W Lake Mead Blvd Ste 8-10', 'Las Vegas', 'Clark', 'NV', '89134', '7022437744', NULL, 'PO Box 74125', 'Salt Lake City', 'Clark', 'UT', '84171', NULL, NULL, 'WestRehab', 'WUSTDHCPC5', NULL, '0.00', '0.00', '58.00', 3, '2008-02-17', '2008-06-17', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1043435985', 0, 'N', 0, '2008-10-03', 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
('810582329', 'W11005964', 'W11005964', 'UT01', 'Good Shepherd Home Care', NULL, NULL, 'Good Shepherd Home Care', 'GROUP', 'Home Health Agency', 'Hospice', NULL, NULL, 'B', '4625 S 2300 E Ste 101', 'Salt Lake City', 'Salt Lake', 'UT', '84117', '8012776474', '8012776475', '4625 S 2300 E', 'Holliday', 'Salt Lake', 'UT', '84117', NULL, NULL, NULL, NULL, '4', '0.00', '35.00', NULL, 3, '2000-01-01', '2000-01-01', 1, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1457439705', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('522229954', 'W11005965', 'W11005965', 'UT01', 'Mountain Land Orthopedic Rheumatology', 'Damon', 'L', 'Aguirre', 'PT', 'Physical Therapy', NULL, NULL, NULL, 'O', '11333 S 1000 E', 'Sandy', 'Salt Lake', 'UT', '84094', '8015713318', NULL, '50 E 9000 S', 'Sandy', 'Salt Lake', 'UT', '84124', NULL, NULL, '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|', '1588730220', 0, 'N', 0, '2008-10-03', NULL, NULL, 0, 0, NULL, NULL),
('522165554', 'W11005977', 'W11005977', 'NA01', 'DJO (Orthopedic Supplies for Provider Use Only)', '', '', 'DJO (Orthopedic Supplies for Provider Use Only)', 'GROUP', 'Durable Medical Equipment', '', '', NULL, 'O', 'Phone Number Only', '', '', '', '', '8003366569', NULL, 'Phone Number Only 8003366569', '', '', '', '', '8003366569', '          ', 'DME80', '', '', '0.00', '35.00', '0.00', 3, '2008-07-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1023296035', 0, 'N', 0, '2012-09-24', NULL, NULL, 0, 0, NULL, NULL),
('522165554', 'W11005982', 'W11005982', 'UT01', 'DJO (Orthopedic Supplies for Provider Use Only)', '', '', 'DJO (Orthopedic Supplies for Provider Use Only)', 'GROUP', 'Durable Medical Equipment', '', '', NULL, 'O', 'Phone Number Only', '', '', '', '', '8003366569', NULL, 'Phone Number Only 8003366569', '', '', '', '', '8003366569', '          ', 'DME80', '', '', '0.00', '35.00', '0.00', 3, '2008-07-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1023296035', 0, 'N', 0, '2012-09-24', NULL, NULL, 0, 0, NULL, NULL),
('522165554', 'W11005981', 'W11005981', 'UT01', 'DJO (Orthopedic Supplies for Provider Use Only)', '', '', 'DJO (Orthopedic Supplies for Provider Use Only)', 'GROUP', 'Durable Medical Equipment', '', '', NULL, 'B', '3434 Solutions Ctr', 'Chicago', 'Cook', 'IL', '60677', '8003282536', NULL, '3434 Solutions Center', 'Chicago', 'Cook', 'IL', '60677', '8003282536', '          ', 'DME80', '', '', '0.00', '35.00', '0.00', 3, '2008-07-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1023296035', 0, 'N', 0, '2012-09-24', NULL, NULL, 0, 0, NULL, NULL),
('522165554', 'W11005980', 'W11005980', 'UT01', 'DJO (Orthopedic Supplies for Provider Use Only)', '', '', 'DJO (Orthopedic Supplies for Provider Use Only)', 'GROUP', 'Durable Medical Equipment', '', '', NULL, 'O', '1430 Decision St', 'Vista', 'Cook', 'IL', '60677', '8003366569', NULL, '1430 Decision St', 'Vista', 'Cook', 'IL', '60677', '8003366569', '          ', 'DME80', '', '', '0.00', '35.00', '0.00', 3, '2008-07-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1023296035', 0, 'Y', 0, '2012-09-24', NULL, NULL, 0, 0, NULL, NULL),
('522165554', 'W11005979', 'W11005979', 'UT01', 'DJO (Orthopedic Supplies)', '', '', 'DJO (Orthopedic Supplies for Provider Use Only)', 'GROUP', 'Durable Medical Equipment', '', '', NULL, 'B', 'PO Box 515471', 'Los Angeles', 'Los Angeles', 'CA', '90051', '8008638010', NULL, 'PO Box 515471', 'Los Angeles', 'Los Angeles', 'CA', '90051', '8008638010', '', 'DME80', NULL, NULL, '0.00', '35.00', '0.00', 3, '2008-07-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1023296035', 0, 'y', 0, '2012-09-24', NULL, NULL, 0, 0, NULL, NULL),
('522165554', 'W11005978', 'W11005978', 'WY01', 'DJO (Orthopedic Supplies)', '', '', 'DJO (Orthopedic Supplies for Provider Use Only)', 'GROUP', 'Durable Medical Equipment', '', '', NULL, 'B', 'PO Box 515471', 'Los Angeles', 'Los Angeles', 'CA', '90051', '8008638010', NULL, 'PO Box 515471', 'Los Angeles', 'Los Angeles', 'CA', '90051', '8008638010', '', 'DME80', NULL, NULL, '0.00', '35.00', '0.00', 3, '2008-07-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1023296035', 0, 'y', 0, '2012-09-24', NULL, NULL, 0, 0, NULL, NULL),
('741849254', 'W11005972', 'W11005972', 'TX01', 'Southeast Surgical Associates', 'John', 'J', 'Gonzalez', 'MD', 'General Surgery', '', '', NULL, 'O', '4242 E Southcross Blvd Ste 1', 'San Antonio', 'Bexar', 'TX', '78222', '2103337510', NULL, '4242 E Southcross Blvd Ste 1', 'San Antonio', 'Bexar', 'TX', '78222', '2103337510', '', 'TXSURGB', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2007-01-01', '2009-07-01', 0, 0, 0, 'South East Baptist Hospital', '', '', '', 'HCFA|UB|', '1700857927', 0, 'N', 0, '2014-06-16', NULL, NULL, 29.374, -98.4109, NULL, NULL),
('741849254', 'W11005971', 'W11005971', 'TX01', 'Southeast Surgical Associates', 'Jeffrey', 'L', 'Glass', 'MD', 'General Surgery', '', '', NULL, 'O', '4242 E Southcross Blvd Ste 1', 'San Antonio', 'Bexar', 'TX', '78222', '2103337510', NULL, '4242 E Southcross Blvd Ste 1', 'San Antonio', 'Bexar', 'TX', '78222', '2103337510', '', 'TXSURGB', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2007-01-01', '2012-08-19', 0, 0, 0, 'Baptist Medical Center', 'North Central Baptist Hospital', '', '', 'HCFA|UB|', '1487615720', 0, 'N', 0, '2014-07-18', NULL, NULL, 29.374, -98.4109, NULL, NULL),
('741849254', 'W11005973', 'W11005973', 'TX01', 'Southeast Surgical Associates', '', '', 'Southeast Surgical Associates', 'GROUP', 'General Surgery', '', '', NULL, 'B', 'PO Box 23409', 'San Antonio', 'Bexar', 'TX', '78223', '2103337510', NULL, 'PO Box 23409', 'San Antonio', 'Bexar', 'TX', '78223', '2103337510', '', 'TXSURGB', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2007-01-01', '2012-08-19', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '0000008843', 0, 'y', 0, '2014-07-18', NULL, NULL, 0, 0, NULL, NULL),
('200606620', 'W11005976', 'W11005976', 'UTPEHP', 'VisualEyes Eyecare', 'Gary', 'N', 'Quarnberg', 'OD', 'Optometry', '', '', NULL, 'O', '140 N Mesa Ste D', 'Fruita', 'Mesa', 'CO', '81521', '9708582020', NULL, '140 N Mesa Ste D', 'Fruita', 'Mesa', 'CO', '81521', '9708582020', '', 'COSTD', 'WUSTDHCPC5', NULL, '0.00', '35.00', '0.00', 3, '2008-07-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1831172196', 0, 'n', 0, '2012-06-27', NULL, NULL, 0, 0, NULL, NULL),
('820277763', 'W11005967', 'W11005967', 'ID01', 'Norco', '', '', 'Norco', 'GROUP', 'Durable Medical Equipment', '', '', NULL, 'O', '315 E Elm St', 'Caldwell', 'Canyon', 'ID', '83605', '2084020100', '2084020103', '315 E Elm St', 'Caldwell', 'Canyon', 'ID', '83605', '2084020100', '2084020103', 'DME80', '', '', '0.00', '35.00', '0.00', 3, '2008-07-11', '2014-03-31', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1932263597', 0, 'N', 0, '2014-05-15', NULL, NULL, 43.6534, -116.695, NULL, NULL),
('820277763', 'W11005968', 'W11005968', 'ID01', 'Norco', '', '', 'Norco', 'GROUP', 'Durable Medical Equipment', '', '', NULL, 'O', '2150 E Fairview Ave', 'Meridian', 'Ada', 'ID', '83642', '2088980202', '2088882266', '2150 E Fairview Ave', 'Meridian', 'Ada', 'ID', '83642', '2088980202', '2088882266', 'DME80', '', '', '0.00', '35.00', '0.00', 3, '2008-07-11', '2014-03-31', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1821158692', 0, 'N', 0, '2014-05-13', NULL, NULL, 0, 0, NULL, NULL),
('820277763', 'W11005966', 'W11005966', 'ID01', 'Norco', '', '', 'Norco', 'GROUP', 'Durable Medical Equipment', '', '', NULL, 'O', '400 Main St', 'Boise', 'Ada', 'ID', '83702', '2083440299', '2083444327', '400 Main St', 'Boise', 'Ada', 'ID', '83702', '2083440299', '2083444327', 'DME80', '', '', '0.00', '35.00', '0.00', 3, '2008-07-11', '2014-03-31', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1902960396', 0, 'N', 0, '2014-05-15', NULL, NULL, 0, 0, NULL, NULL),
('542193185', 'W11005975', 'W11005975', 'ID01', 'Abundant Life Health Care', 'Karole', 'L', 'Beck', 'NP', 'Family Practice', '', '', NULL, 'B', '1770 W State Ste 213 A', 'Boise', 'Ada', 'ID', '83702', '2084339188', NULL, '1770 W State Ste 213 A', 'Boise', 'Ada', 'ID', '83702', '2084339188', '          ', 'IDSTD', 'WUSTDHCPC5', '', '0.00', '30.00', '0.00', 3, '2008-07-11', '2011-09-05', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1467565317', 0, 'N', 0, '2008-07-14', NULL, NULL, 0, 0, NULL, NULL),
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('820496280', 'W11006146', 'W11006146', 'ID01', 'Dermatology Clinic of ID', 'James', 'H', 'Stewart', 'MD PHD', 'Dermatology', '', '', NULL, 'O', '7733 W Emerald', 'Boise', 'Ada', 'ID', '83704', '2083764776', NULL, '7733 W Emerald', 'Boise', 'Ada', 'ID', '83704', '2083764776', '', 'IDSTD', 'WUSTDHCPC5', NULL, '0.00', '30.00', '0.00', 3, '2008-08-01', '2012-08-19', 0, 0, 0, 'Saint Alphonsus Regional Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1104870567', 0, 'n', 0, '2012-10-15', NULL, NULL, 43.6127, -116.278, NULL, NULL);
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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('205026064', 'W11006154', 'W11006154', 'ID01', 'Chiropractic Arts', 'Daniel', 'M', 'Pewe', 'DC', 'Chiropractic', '', '', NULL, 'O', '1305 S 5 Mile Rd', 'Boise', 'Ada', 'ID', '83709', '2083270066', NULL, '1305 S 5 Mile Rd', 'Boise', 'Ada', 'ID', '83709', '2083270066', '          ', 'IDCHIRO1', '', '', '0.00', '35.00', '0.00', 3, '2008-08-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1922012954', 0, 'N', 0, '2012-01-03', NULL, NULL, 43.5931, -116.314, NULL, NULL),
('942854057', 'W11006196', 'W11006196', 'UTPEHP', 'American Fork Pulmonary Clinic', 'Dixie', 'Lee', 'Harris', 'MD', 'Pulmonary', '', '', NULL, 'O', '170 N 1100 E', 'American Fork', 'Utah', 'UT', '84003', '8018554222', NULL, NULL, NULL, 'Utah', NULL, NULL, NULL, NULL, 'IHCPEHP', NULL, NULL, '0.00', '30.00', '0.00', 8, '2008-07-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1740296730', 0, 'N', 0, '2008-07-29', NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W11006175', 'W11006175', 'UTPEHP', 'Legacy OB/Gyn Clinic', 'Ryan', 'N', 'Jones', 'MD', 'Obstetrics and Gynecology', '', '', NULL, 'O', '1159 E 200 N Ste 250', 'American Fork', 'Utah', 'UT', '84003', '8018552980', NULL, '1159 E 200 N Ste 250', 'American Fork', 'Utah', 'UT', '84003', '8018552980', '          ', 'IHCPEHP', '', '', '0.00', '30.00', '0.00', 8, '2008-07-01', '2010-09-15', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1003872433', 0, 'N', 0, '2008-07-29', NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W11006171', 'W11006171', 'UTPEHP', 'Legacy OB/Gyn Clinic', 'Kari', 'F', 'Lawrence', 'MD', 'Obstetrics and Gynecology', '', '', NULL, 'O', '1159 E 200 N Ste 250', 'American Fork', 'Utah', 'UT', '84003', '8018552980', NULL, '1159 E 200 N Ste 250', 'American Fork', 'Utah', 'UT', '84003', '8018552980', '', 'IHCPEHP', NULL, NULL, '0.00', '30.00', '0.00', 8, '2008-07-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1508827072', 0, 'N', 0, '2011-04-28', NULL, NULL, 0, 0, NULL, NULL),
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('942854057', 'W11006188', 'W11006188', 'UTPEHP', 'Legacy OB/Gyn Clinic', 'Bryan', 'M', 'Watabe', 'MD', 'Obstetrics and Gynecology', NULL, NULL, NULL, 'O', '1159 E 200 N Ste 250', 'American Fork', 'Utah', 'UT', '84003', '8018552980', NULL, '1159 E 200 N Ste 250', 'American Fork', 'Utah', 'UT', '84003', '8018552980', '          ', 'IHCPEHP', '', '', '0.00', '30.00', '0.00', 8, '2008-07-01', '2010-09-15', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1245296623', 0, 'N', 0, '2008-07-29', NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W11006205', 'W11006205', 'UTPEHP', 'Legacy OB/Gyn Clinic', 'Sean', 'G', 'Haskett', 'MD', 'Obstetrics and Gynecology', '', '', NULL, 'O', '1159 E 200 N Ste 250', 'American Fork', 'Utah', 'UT', '84003', '8018552980', NULL, '1159 E 200 N Ste 250', 'American Fork', 'Utah', 'UT', '84003', '8018552980', '          ', 'IHCPEHP', '', '', '0.00', '30.00', '0.00', 8, '2008-07-01', '2010-09-15', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1477728343', 0, 'N', 0, '2008-07-29', NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W11006193', 'W11006193', 'UTPEHP', 'Legacy OB/Gyn Clinic', 'Andrea', 'N', 'Smith', 'MD', 'Obstetrics and Gynecology', '', '', NULL, 'O', '1159 E 200 N Ste 250', 'American Fork', 'Utah', 'UT', '84003', '8018552980', NULL, '1159 E 200 N Ste 250', 'American Fork', 'Utah', 'UT', '84003', '8018552980', '          ', 'IHCPEHP', '', '', '0.00', '30.00', '0.00', 8, '2008-07-01', '2010-09-15', 0, 0, 0, 'Salt Lake Regional Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1831155746', 0, 'N', 0, '2012-07-05', NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W11006177', 'W11006177', 'UTPEHP', 'Sports Medicine Specialists - Bountiful', 'Spencer', 'E', 'Richards', 'MD', 'Family Practice', 'Sports Medicine', NULL, NULL, 'O', '425 Medical Dr Ste 220', 'Bountiful', 'Davis', 'UT', '84010', '8019906286', NULL, NULL, NULL, 'Davis', NULL, NULL, NULL, NULL, 'IHCPEHP', NULL, NULL, '0.00', '30.00', '0.00', 8, '2008-07-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1609845775', 0, 'N', 0, '2010-01-12', NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W11006194', 'W11006194', 'UTPEHP', 'Sports Medicine Specialists - Bountiful', 'Benjamin', 'B', 'Betteridge', 'MD', 'Sports Medicine', 'Emergency Medicine', '', NULL, 'O', '425 Medical Dr Ste 220', 'Bountiful', 'Davis', 'UT', '84010', '8019906286', NULL, '425 Medical Dr Ste 220', 'Bountiful', 'Davis', 'UT', '84010', '8019906286', '', 'IHCPEHP', NULL, NULL, '0.00', '30.00', '0.00', 8, '2008-07-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1225007388', 0, 'N', 0, '2013-10-14', NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W11006181', 'W11006181', 'UTPEHP', 'Bountiful Clinic', 'John', 'E', 'Robison', 'MD', 'Dermatology', '', '', NULL, 'O', '390 N Main', 'Bountiful', 'Davis', 'UT', '84010', '8012941000', NULL, '390 N Main', 'Bountiful', 'Davis', 'UT', '84010', '8012941000', '', 'IHCPEHP', NULL, NULL, '0.00', '30.00', '0.00', 8, '2008-07-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1629187638', 0, 'N', 0, '2011-03-07', NULL, NULL, 0, 0, NULL, NULL),
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('942854057', 'W11006187', 'W11006187', 'UTPEHP', 'Bountiful Clinic', 'Quincey', 'G', 'Atkin', 'PhD', 'Mental Health', '', '', NULL, 'O', '390 N Main', 'Bountiful', 'Davis', 'UT', '84010', '8012941000', NULL, '390 N Main', 'Bountiful', 'Davis', 'UT', '84010', '8012941000', '', 'PEHPPHD', NULL, NULL, '0.00', '30.00', '0.00', 8, '2008-07-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1255445672', 0, 'N', 0, '2012-07-02', NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W11006197', 'W11006197', 'UTPEHP', 'Bountiful Cosmetic Dermatology', 'John', 'L', 'Peterson', 'MD', 'Dermatology', '', '', NULL, 'O', '520 Medical Dr Ste 320', 'Bountiful', 'Davis', 'UT', '84010', '8012999050', NULL, '520 Medical Dr Ste 320', 'Bountiful', 'Davis', 'UT', '84010', '8012999050', '', 'IHCPEHP', NULL, '', '0.00', '30.00', '0.00', 8, '2008-07-01', '2008-12-31', 0, 0, 0, 'Lakeview Hospital', '', '', '', 'HCFA|UB|', '1891729109', 0, 'N', 0, '2014-07-14', NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W11006190', 'W11006190', 'UTPEHP', 'Heber Valley Clinic', 'Gary', 'H', 'Sharp', 'MD', 'General Practice', '', '', NULL, 'O', '1473 S Hwy 40 Ste E', 'Heber City', 'Wasatch', 'UT', '84032', '4356574400', NULL, '1473 S Hwy 40 Ste E', 'Heber City', 'Wasatch', 'UT', '84032', '4356574400', '', 'IHCPEHP', NULL, NULL, '0.00', '30.00', '0.00', 8, '2008-07-01', NULL, 0, 0, 0, 'Jordan Valley Medical Center', '', '', '', 'HCFA|UB|', '1811054695', 0, 'N', 0, '2013-10-18', NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W11006191', 'W11006191', 'UTPEHP', 'Heber Valley Clinic', 'Wayne', 'Richard', 'Graham', 'DO', 'Family Practice', '', '', NULL, 'O', '1473 S Hwy 40 Ste E', 'Heber City', 'Wasatch', 'UT', '84032', '4356542500', NULL, '1473 S Hwy 40 Ste E', 'Heber City', 'Wasatch', 'UT', '84032', '4356542500', '          ', 'IHCPEHP', '', '', '0.00', '30.00', '0.00', 8, '2008-07-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1699781054', 0, 'N', 0, '2013-02-06', NULL, NULL, 0, 0, NULL, NULL),
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('942854057', 'W11006200', 'W11006200', 'UTPEHP', 'Central Orem Clinic', 'Kory', 'A', 'Harward', 'DO', 'Obstetrics and Gynecology', NULL, NULL, NULL, 'O', '505 W 400 N', 'Orem', 'Utah', 'UT', '84057', '8017143450', NULL, NULL, NULL, 'Utah', NULL, NULL, NULL, NULL, 'IHCPEHP', NULL, NULL, '0.00', '30.00', '0.00', 8, '2008-07-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1932238250', 0, 'N', 0, '2008-07-29', NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W11006227', 'W11006227', 'UTPEHP', 'Sandy ENT', 'Craig', 'N', 'Stevens', 'MD', 'Ear, Nose and Throat', '', '', NULL, 'O', '9690 S 1300 E Ste 200', 'Sandy', 'Salt Lake', 'UT', '84094', '8015014310', NULL, '9690 S 1300 E Ste 200', 'Sandy', 'Salt Lake', 'UT', '84094', '8015014310', '          ', 'IHCPEHP', '', '', '0.00', '30.00', '0.00', 8, '2008-07-01', '2010-06-13', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1780606194', 0, 'N', 0, '2011-04-28', NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W11006212', 'W11006212', 'UTPEHP', 'Orthopedic Specialty Group - Alta View', 'Russell', 'A', 'Toronto', 'MD', 'General Practice', '', '', NULL, 'O', '9720 S 1300 E Ste E240', 'Sandy', 'Salt Lake', 'UT', '84094', '8015015500', NULL, '9720 S 1300 E Ste E240', 'Sandy', 'Salt Lake', 'UT', '84094', '8015015500', '', 'IHCPEHP', NULL, NULL, '0.00', '30.00', '0.00', 8, '2008-07-01', '2008-09-30', 0, 0, 0, 'Jordan Valley Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1528005618', 0, 'N', 0, '2011-10-12', NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W11006168', 'W11006168', 'UTPEHP', 'Salt Lake Clinic', 'Russell', 'P', 'Maxwell', 'MD', 'Internal Medicine', NULL, NULL, NULL, 'O', '333 S 900 E', 'Salt Lake City', 'Salt Lake', 'UT', '84102', '8019336000', NULL, NULL, NULL, 'Salt Lake', NULL, NULL, NULL, NULL, 'IHCPEHP', NULL, NULL, '0.00', '30.00', '0.00', 8, '2008-07-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1083640767', 0, 'N', 0, '2008-07-29', NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W11006220', 'W11006220', 'UTPEHP', 'Salt Lake Clinic - Radiology', 'Jordan', 'A', 'Kimball', 'MD', 'Radiologist', NULL, NULL, NULL, 'B', '333 S 900 E', 'Salt Lake City', 'Salt Lake', 'UT', '84102', '8015358206', NULL, NULL, NULL, 'Salt Lake', NULL, NULL, NULL, NULL, 'IHCPEHP', NULL, NULL, '0.00', '30.00', '0.00', 8, '2008-07-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1386673135', 0, 'Y', 0, '2008-07-29', NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W11006218', 'W11006218', 'UTPEHP', 'Salt Lake Clinic - Radiology', 'Farrell', 'G', 'Forsberg', 'MD', 'Radiologist', NULL, NULL, NULL, 'B', '333 S 900 E', 'Salt Lake City', 'Salt Lake', 'UT', '84102', '8015358206', NULL, NULL, NULL, 'Salt Lake', NULL, NULL, NULL, NULL, 'IHCPEHP', NULL, NULL, '0.00', '30.00', '0.00', 8, '2008-07-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1184656407', 0, 'Y', 0, '2008-07-29', NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W11006163', 'W11006163', 'UTPEHP', 'Salt Lake Clinic', 'James', 'R', 'Grua', 'MD', 'Endocrinology', '', '', NULL, 'O', '333 S 900 E', 'Salt Lake City', 'Salt Lake', 'UT', '84102', '8019336000', NULL, '333 S 900 E', 'Salt Lake City', 'Salt Lake', 'UT', '84102', '8019336000', '', 'IHCPEHP', NULL, '', '0.00', '30.00', '0.00', 8, '2008-07-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1134159288', 0, 'N', 0, '2014-06-04', NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W11006216', 'W11006216', 'UTPEHP', 'Salt Lake Clinic', 'Alan', 'F', 'Bitner', 'MD', 'Allergy and Immunology', '', '', NULL, 'O', '333 S 900 E', 'Salt Lake City', 'Salt Lake', 'UT', '84102', '8019336000', NULL, '333 S 900 E', 'Salt Lake City', 'Salt Lake', 'UT', '84102', '8019336000', '          ', 'IHCPEHP', '', '', '0.00', '30.00', '0.00', 8, '2008-07-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1972505212', 0, 'N', 0, '2011-09-26', NULL, NULL, 0, 0, NULL, NULL),
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('942854057', 'W11006160', 'W11006160', 'UTPEHP', 'Langeland OB/Gyn', 'Fritjof', 'Fred', 'Langeland', 'MD', 'Obstetrics and Gynecology', NULL, NULL, NULL, 'O', '324 10th Avenue Ste 172', 'Salt Lake City', 'Salt Lake', 'UT', '84103', '8014085155', NULL, NULL, NULL, 'Salt Lake', NULL, NULL, NULL, NULL, 'IHCPEHP', NULL, NULL, '0.00', '30.00', '0.00', 8, '2008-07-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1790730760', 0, 'N', 0, '2008-07-29', NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W11006157', 'W11006157', 'UTPEHP', 'Noyes Surgical Oncology', 'R', 'Dirk', 'Noyes', 'MD', 'General Surgery', NULL, NULL, NULL, 'O', '324 10th Avenue Ste 249', 'Salt Lake City', 'Salt Lake', 'UT', '84103', '8014083555', NULL, NULL, NULL, 'Salt Lake', NULL, NULL, NULL, NULL, 'IHCPEHP', NULL, NULL, '0.00', '30.00', '0.00', 8, '2008-07-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1124107792', 0, 'N', 0, '2008-07-29', NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W11006170', 'W11006170', 'UTPEHP', 'Memorial Clinic', 'Troy', 'B', 'DeMill', 'Aud', 'Audiology', NULL, NULL, NULL, 'O', '2000 S 900 E', 'Salt Lake City', 'Salt Lake', 'UT', '84105', '8014647500', NULL, NULL, NULL, 'Salt Lake', NULL, NULL, NULL, NULL, 'PEHPPREF2', NULL, NULL, '0.00', '30.00', '0.00', 8, '2008-07-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1841322161', 0, 'N', 0, '2008-07-29', NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W11006201', 'W11006201', 'UTPEHP', 'Memorial Clinic', 'Todd', 'A', 'Child', 'MD', 'Ear, Nose and Throat', NULL, NULL, NULL, 'O', '2000 S 900 E', 'Salt Lake City', 'Salt Lake', 'UT', '84105', '8014647500', NULL, NULL, NULL, 'Salt Lake', NULL, NULL, NULL, NULL, 'IHCPEHP', NULL, NULL, '0.00', '30.00', '0.00', 8, '2008-07-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1770520934', 0, 'N', 0, '2008-07-29', NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W11006159', 'W11006159', 'UTPEHP', 'Memorial Clinic', 'Jan', 'Bernhisel', 'Broadbent', 'MD', 'Allergy and Immunology', NULL, NULL, NULL, 'O', '2000 S 900 E', 'Salt Lake City', 'Salt Lake', 'UT', '84105', '8014647500', NULL, NULL, NULL, 'Salt Lake', NULL, NULL, NULL, NULL, 'IHCPEHP', NULL, NULL, '0.00', '30.00', '0.00', 8, '2008-07-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1265487300', 0, 'N', 0, '2008-07-29', NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W11006158', 'W11006158', 'UTPEHP', 'Memorial Clinic', 'David', 'P', 'Hill', 'MD', 'Ear, Nose and Throat', NULL, NULL, NULL, 'O', '2000 S 900 E', 'Salt Lake City', 'Salt Lake', 'UT', '84105', '8014647500', NULL, NULL, NULL, 'Salt Lake', NULL, NULL, NULL, NULL, 'IHCPEHP', NULL, NULL, '0.00', '30.00', '0.00', 8, '2008-07-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1053350132', 0, 'N', 0, '2008-07-29', NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W11006211', 'W11006211', 'UTPEHP', 'Intermountain Surgical Specialists', 'Eric', 'D', 'Anderson', 'MD', 'General Surgery', NULL, NULL, NULL, 'O', '5169 S Cottonwood St Ste 410', 'Murray', 'Salt Lake', 'UT', '84107', '8015071600', NULL, NULL, NULL, 'Salt Lake', NULL, NULL, NULL, NULL, 'IHCPEHP', NULL, NULL, '0.00', '30.00', '0.00', 8, '2008-07-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1649319500', 0, 'N', 0, '2008-07-29', NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W11006225', 'W11006225', 'UTPEHP', 'Orthopedic Specialty Group - Medical Center', 'Steven', 'M', 'Scott', 'MD', 'Orthopedic Surgery', NULL, NULL, NULL, 'O', '5169 S Cottonwood St Ste 430', 'Murray', 'Salt Lake', 'UT', '84107', '8015073475', NULL, NULL, NULL, 'Salt Lake', NULL, NULL, NULL, NULL, 'IHCPEHP', NULL, NULL, '0.00', '30.00', '0.00', 8, '2008-07-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1154313690', 0, 'N', 0, '2008-07-29', NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W11006217', 'W11006217', 'UTPEHP', 'Bowman OB/Gyn', 'Jane', '', 'Bowman', 'MD', 'Obstetrics and Gynecology', NULL, NULL, NULL, 'O', '5770 S 250 E Ste G50', 'Murray', 'Salt Lake', 'UT', '84107', '8013144440', NULL, NULL, NULL, 'Salt Lake', NULL, NULL, NULL, NULL, 'IHCPEHP', NULL, NULL, '0.00', '30.00', '0.00', 8, '2008-07-01', NULL, 0, 0, 0, 'Riverton Childrens Unit Operated by Primary Childrens Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1073621611', 0, 'N', 0, '2008-07-29', NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W11006169', 'W11006169', 'UTPEHP', 'Orthopedic Specialty Group - TOSH', 'Michael', 'C', 'Holmstrom', 'MD', 'Orthopedic Surgery', NULL, NULL, NULL, 'O', '5848 S 300 E Ste 120', 'Murray', 'Salt Lake', 'UT', '84107', '8013144900', NULL, NULL, NULL, 'Salt Lake', NULL, NULL, NULL, NULL, 'IHCPEHP', NULL, NULL, '0.00', '30.00', '0.00', 8, '2008-07-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1356384283', 0, 'N', 0, '2008-07-29', NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W11006174', 'W11006174', 'UTPEHP', 'Holladay Pediatrics', 'Jennifer', '', 'Linford', 'MD', 'Pediatrics', '', '', NULL, 'O', '2180 E 4500 S Ste 210', 'Salt Lake City', 'Salt Lake', 'UT', '84117', '8019474242', NULL, '2180 E 4500 S Ste 210', 'Salt Lake City', 'Salt Lake', 'UT', '84117', '8019474242', '', 'IHCPEHP', NULL, NULL, '0.00', '30.00', '0.00', 8, '2008-07-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1316950967', 0, 'N', 0, '2012-03-21', NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W11006176', 'W11006176', 'UTPEHP', 'Taylorsville Clinic', 'Daniel', 'F', 'Kaelberer', 'MD', 'Obstetrics and Gynecology', NULL, NULL, NULL, 'O', '3845 W 4700 S', 'Taylorsville', 'Salt Lake', 'UT', '84118', '8018402100', NULL, NULL, NULL, 'Salt Lake', NULL, NULL, NULL, NULL, 'IHCPEHP', NULL, NULL, '0.00', '30.00', '0.00', 8, '2008-07-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1376656264', 0, 'N', 0, '2008-07-29', NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W11006164', 'W11006164', 'UTPEHP', 'LDS Hospital Radiation Oncology', 'William', 'T', 'Sause', 'MD', 'Radiation Oncology', '', '', NULL, 'O', '8th Avenue & C St', 'Salt Lake City', 'Salt Lake', 'UT', '84143', '8014081146', NULL, '8th Avenue & C St', 'Salt Lake City', 'Salt Lake', 'UT', '84143', '8014081146', '', 'IHCPEHP', NULL, NULL, '0.00', '30.00', '0.00', 8, '2008-07-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1881612927', 0, 'N', 0, '2010-06-07', NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W11006208', 'W11006208', 'UTPEHP', 'Canyon View Orthopedics & Podiatry Associates ', 'Benjamin', 'Ray', 'Stowers', 'PA-C', 'Orthopedic Surgery', NULL, NULL, NULL, 'O', '1300 N 500 E Ste 130', 'Logan', 'Cache', 'UT', '84341', '4357162800', NULL, NULL, NULL, 'Cache', NULL, NULL, NULL, NULL, 'PEHPMID', NULL, NULL, '0.00', '30.00', '0.00', 8, '2008-07-01', NULL, 0, 0, 0, 'Logan Regional Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1861652539', 0, 'N', 0, '2008-11-05', NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W11006202', 'W11006202', 'UTPEHP', 'Budge Clinic Obstetrics & Gynecology', 'Tandy', 'Garth', 'Olsen', 'MD', 'Obstetrics and Gynecology', NULL, NULL, NULL, 'O', '1400 N 500 E', 'Logan', 'Cache', 'UT', '84341', '4357161920', NULL, NULL, NULL, 'Cache', NULL, NULL, NULL, NULL, 'IHCPEHP', NULL, NULL, '0.00', '30.00', '0.00', 8, '2008-07-01', NULL, 0, 0, 0, 'Logan Regional Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1861476921', 0, 'N', 0, '2008-11-05', NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W11006186', 'W11006186', 'UTPEHP', 'Budge Clinic Internal Medicine', 'David', 'S', 'Faux', 'MD', 'Internal Medicine', '', '', NULL, 'O', '1350 N 500 E', 'Logan', 'Cache', 'UT', '84341', '4357921980', NULL, '1350 N 500 E', 'Logan', 'Cache', 'UT', '84341', '4357921980', '', 'IHCPEHP', NULL, '', '0.00', '30.00', '0.00', 8, '2008-07-01', NULL, 0, 0, 0, 'Logan Regional Hospital', '', '', '', 'HCFA|UB|', '1427268366', 0, 'N', 0, '2014-05-13', NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W11006207', 'W11006207', 'UTPEHP', 'Ogden Cardiovascular Associates', 'Bhavik', 'G', 'Patel', 'MD', 'Cardiovascular Disease', 'General Surgery', NULL, NULL, 'O', '4403 Harrison Blvd Ste 3450', 'Ogden', 'Weber', 'UT', '84403', '8013873475', NULL, NULL, NULL, 'Weber', NULL, NULL, NULL, NULL, 'IHCPEHP', NULL, NULL, '0.00', '30.00', '0.00', 8, '2008-07-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1659588424', 0, 'N', 0, '2008-07-29', NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W11006166', 'W11006166', 'UTPEHP', 'Northern Utah Surgeons', 'Richard', 'L', 'Alder', 'MD', 'General Surgery', '', '', NULL, 'O', '4403 Harrison Blvd Ste 1635', 'Ogden', 'Weber', 'UT', '84403', '8013877450', NULL, '4403 Harrison Blvd Ste 1635', 'Ogden', 'Weber', 'UT', '84403', '8013877450', '          ', 'IHCPEHP', '', '', '0.00', '30.00', '0.00', 8, '2008-07-01', '2011-12-01', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1043309099', 0, 'N', 0, '2012-01-06', NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W11006221', 'W11006221', 'UTPEHP', 'McKay Dee Radiation Oncology', 'Gary', 'L', 'Whipple', 'MD', 'Radiation Oncology', NULL, NULL, NULL, 'O', '4401 Harrison Blvd', 'Ogden', 'Weber', 'UT', '84403', '8013877400', NULL, NULL, NULL, 'Weber', NULL, NULL, NULL, NULL, 'IHCPEHP', NULL, NULL, '0.00', '30.00', '0.00', 8, '2008-07-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1083621361', 0, 'N', 0, '2008-07-29', NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W11006219', 'W11006219', 'UTPEHP', 'Northern Utah Surgeons', 'Steven', 'J', 'Carabine', 'MD', 'General Surgery', NULL, NULL, NULL, 'O', '4403 Harrison Blvd Ste 1635', 'Ogden', 'Weber', 'UT', '84403', '8013877450', NULL, NULL, NULL, 'Weber', NULL, NULL, NULL, NULL, 'IHCPEHP', NULL, NULL, '0.00', '30.00', '0.00', 8, '2008-07-01', NULL, 0, 0, 0, 'Ogden Regional Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1689761165', 0, 'N', 0, '2008-07-29', NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W11006192', 'W11006192', 'UTPEHP', 'McKay Dee ENT Clinic', 'Michael', 'C', 'Scheuller', 'MD', 'Ear, Nose and Throat', NULL, NULL, NULL, 'O', '4403 Harrison Blvd Ste 2645', 'Ogden', 'Weber', 'UT', '84403', '8013872880', NULL, NULL, NULL, 'Weber', NULL, NULL, NULL, NULL, 'IHCPEHP', NULL, NULL, '0.00', '30.00', '0.00', 8, '2008-07-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1336192566', 0, 'N', 0, '2008-07-29', NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W11006183', 'W11006183', 'UTPEHP', 'Northern Utah Surgeons', 'Victor', 'W', 'Varela', 'MD', 'General Surgery', NULL, NULL, NULL, 'O', '4403 Harrison Blvd Ste 1635', 'Ogden', 'Weber', 'UT', '84403', '8013877450', NULL, NULL, NULL, 'Weber', NULL, NULL, NULL, NULL, 'IHCPEHP', NULL, NULL, '0.00', '30.00', '0.00', 8, '2008-07-01', NULL, 0, 0, 0, 'Ogden Regional Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1538277660', 0, 'N', 0, '2008-07-29', NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W11006215', 'W11006215', 'UTPEHP', 'McKay Dee Radiation Oncology', 'Leslye', 'L', 'Ingersoll', 'MD', 'Radiation Oncology', NULL, NULL, NULL, 'O', '4401 Harrison Blvd', 'Ogden', 'Weber', 'UT', '84403', '8013877400', NULL, NULL, NULL, 'Weber', NULL, NULL, NULL, NULL, 'IHCPEHP', NULL, NULL, '0.00', '30.00', '0.00', 8, '2008-07-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1568475846', 0, 'N', 0, '2008-07-29', NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W11006198', 'W11006198', 'UTPEHP', 'Northern Utah Surgeons', 'Robert', 'C', 'Moesinger', 'MD', 'General Surgery', NULL, NULL, NULL, 'O', '4403 Harrison Blvd Ste 1635', 'Ogden', 'Weber', 'UT', '84403', '8013877450', NULL, NULL, NULL, 'Weber', NULL, NULL, NULL, NULL, 'IHCPEHP', NULL, NULL, '0.00', '30.00', '0.00', 8, '2008-07-01', NULL, 0, 0, 0, 'Ogden Regional Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1497717011', 0, 'N', 0, '2008-07-29', NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W11006222', 'W11006222', 'UTPEHP', 'North Canyon Family Practice', 'James', 'Larsen', 'Clark', 'MD', 'Family Practice', NULL, NULL, NULL, 'O', '3200 N Canyon Rd Ste D', 'Provo', 'Utah', 'UT', '84604', '8013733300', NULL, NULL, NULL, 'Utah', NULL, NULL, NULL, NULL, 'IHCPEHP', NULL, NULL, '0.00', '30.00', '0.00', 8, '2008-07-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1194731323', 0, 'N', 0, '2008-07-29', NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W11006213', 'W11006213', 'UTPEHP', 'North Canyon Family Practice', 'Thomas', 'E', 'Myers', 'MD', 'Family Practice', '', '', NULL, 'O', '3200 N Canyon Rd Ste D', 'Provo', 'Utah', 'UT', '84604', '8013733300', NULL, '3200 N Canyon Rd Ste D', 'Provo', 'Utah', 'UT', '84604', '8013733300', '', 'IHCPEHP', NULL, NULL, '0.00', '30.00', '0.00', 8, '2008-07-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1497761621', 0, 'N', 0, '2012-03-20', NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W11006210', 'W11006210', 'UTPEHP', 'Utah Valley Orthopaedics - Provo', 'Jeffrey', 'R', 'Smith', 'MD', 'Orthopedic Surgery', '', '', NULL, 'O', '1134 N 500 W Ste 101', 'Provo', 'Utah', 'UT', '84604', '8013578898', NULL, NULL, NULL, 'Utah', NULL, NULL, NULL, NULL, 'IHCPEHP', NULL, NULL, '0.00', '30.00', '0.00', 8, '2008-07-01', NULL, 0, 0, 0, 'Sanpete Valley Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1972519239', 0, 'N', 0, '2008-07-29', NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W11006214', 'W11006214', 'UTPEHP', 'Utah Valley Hospitalists', 'Kevin', 'J', 'Colver', 'MD', 'Internal Medicine', 'Hospitalist', NULL, NULL, 'O', '1034 N 500 W Ste E388', 'Provo', 'Utah', 'UT', '84604', '8013578310', NULL, NULL, NULL, 'Utah', NULL, NULL, NULL, NULL, 'IHCPEHP', NULL, NULL, '0.00', '30.00', '0.00', 8, '2008-07-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1013922533', 0, 'N', 0, '2008-07-29', NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W11006209', 'W11006209', 'UTPEHP', 'Utah Valley Orthopaedics - Provo', 'Wayne', 'W', 'Mortensen', 'MD', 'Orthopedic Surgery', NULL, NULL, NULL, 'O', '1134 N 500 W Ste 101', 'Provo', 'Utah', 'UT', '84604', '8013578898', NULL, NULL, NULL, 'Utah', NULL, NULL, NULL, NULL, 'IHCPEHP', NULL, NULL, '0.00', '30.00', '0.00', 8, '2008-07-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1346256690', 0, 'N', 0, '2008-07-29', NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W11006180', 'W11006180', 'UTPEHP', 'Utah Valley Pulmonary Clinic', 'Edward', 'Joseph', 'Campbell', 'MD', 'Pulmonary', '', '', NULL, 'O', '1055 N 300 W Ste 500', 'Provo', 'Utah', 'UT', '84604', '8013577291', NULL, '1055 N 300 W Ste 500', 'Provo', 'Utah', 'UT', '84604', '8013577291', '', 'IHCPEHP', NULL, NULL, '0.00', '30.00', '0.00', 8, '2008-07-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1386741833', 0, 'N', 0, '2011-09-26', NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W11006167', 'W11006167', 'UTPEHP', 'Utah Valley Hospitalists', 'Mary', 'Susan', 'Berkebile', 'MD', 'Internal Medicine', 'Hospitalist', NULL, NULL, 'O', '1034 N 500 W Ste E388', 'Provo', 'Utah', 'UT', '84604', '8013578310', NULL, NULL, NULL, 'Utah', NULL, NULL, NULL, NULL, 'IHCPEHP', NULL, NULL, '0.00', '30.00', '0.00', 8, '2008-07-01', NULL, NULL, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1740296037', 0, 'N', 0, '2008-10-23', NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W11006172', 'W11006172', 'UTPEHP', 'North Canyon Family Practice', 'Robert', 'W', 'Taylor', 'MD', 'Family Practice', NULL, NULL, NULL, 'O', '3200 N Canyon Rd Ste D', 'Provo', 'Utah', 'UT', '84604', '8013733300', NULL, NULL, NULL, 'Utah', NULL, NULL, NULL, NULL, 'IHCPEHP', NULL, NULL, '0.00', '30.00', '0.00', 8, '2008-07-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1255347472', 0, 'N', 0, '2008-11-05', NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W11006173', 'W11006173', 'UTPEHP', 'North Canyon Family Practice', 'Gordon', 'W', 'Harkness', 'MD', 'Family Practice', NULL, NULL, NULL, 'O', '3200 N Canyon Rd Ste D', 'Provo', 'Utah', 'UT', '84604', '8013733300', NULL, NULL, NULL, 'Utah', NULL, NULL, NULL, NULL, 'IHCPEHP', NULL, NULL, '0.00', '30.00', '0.00', 8, '2008-07-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1376557611', 0, 'N', 0, '2008-07-29', NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W11006179', 'W11006179', 'UTPEHP', 'Utah Valley Hospitalists', 'Russell', 'W', 'Rhoades', 'DO', 'Internal Medicine', 'Hospitalist', NULL, NULL, 'B', '1034 N 500 W Ste E388', 'Provo', 'Utah', 'UT', '84604', '8013578310', NULL, NULL, NULL, 'Utah', NULL, NULL, NULL, NULL, 'IHCPEHP', NULL, NULL, '0.00', '30.00', '0.00', 8, '2008-07-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1164436507', 0, 'Y', 0, '2008-07-29', NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W11006178', 'W11006178', 'UTPEHP', 'Utah Valley Hospitalists', 'Anne', NULL, 'Perry', 'MD', 'Internal Medicine', 'Hospitalist', NULL, NULL, 'B', '1034 N 500 W Ste E388', 'Provo', 'Utah', 'UT', '84604', '8013578310', NULL, NULL, NULL, 'Utah', NULL, NULL, NULL, NULL, 'IHCPEHP', NULL, NULL, '0.00', '30.00', '0.00', 8, '2008-07-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1457383028', 0, 'Y', 0, '2008-07-29', NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W11006185', 'W11006185', 'UTPEHP', 'Utah Valley Hospitalists', 'Mark', 'D', 'Christenson', 'MD', 'Internal Medicine', 'Hospitalist', '', NULL, 'B', '1034 N 500 W Ste E388', 'Provo', 'Utah', 'UT', '84604', '8013578310', NULL, '1034 N 500 W Ste E388', 'Provo', 'Utah', 'UT', '84604', '8013578310', '', 'IHCPEHP', '', '', '0.00', '30.00', '0.00', 8, '2008-07-01', NULL, 0, 0, 1, 'Saint Alphonsus Regional Medical Center', '', '', '', 'HCFA|UB|', '1699883447', 0, 'Y', 0, '2014-06-13', NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W11006189', 'W11006189', 'UTPEHP', 'Utah Valley Hospitalists', 'Wendell', 'O', 'Eames', 'MD', 'Internal Medicine', 'Hospitalist', NULL, NULL, 'B', '1034 N 500 W Ste E388', 'Provo', 'Utah', 'UT', '84604', '8013578310', NULL, NULL, NULL, 'Utah', NULL, NULL, NULL, NULL, 'IHCPEHP', NULL, NULL, '0.00', '30.00', '0.00', 8, '2008-07-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1902816820', 0, 'Y', 0, '2008-07-29', NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W11006195', 'W11006195', 'UTPEHP', 'Utah Valley Sports Medicine', 'Brent', 'S', 'Rich', 'MD', 'Sports Medicine', 'Family Medicine', NULL, NULL, 'O', '1134 N 500 W Ste 101', 'Provo', 'Utah', 'UT', '84604', '8013578898', NULL, NULL, NULL, 'Utah', NULL, NULL, NULL, NULL, 'IHCPEHP', NULL, NULL, '0.00', '30.00', '0.00', 8, '2008-07-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1982614319', 0, 'N', 0, '2008-07-29', NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W11006203', 'W11006203', 'UTPEHP', 'Provo Cardiovascular & Thoracic Surgery', 'Ulysse', 'G', 'McCann', 'MD', 'Cardiovascular Disease', NULL, NULL, NULL, 'O', '1055 N 300 W Ste 110', 'Provo', 'Utah', 'UT', '84604', '8013577081', NULL, NULL, NULL, 'Utah', NULL, NULL, NULL, NULL, 'IHCPEHP', NULL, NULL, '0.00', '30.00', '0.00', 8, '2008-07-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1700912219', 0, 'N', 0, '2008-07-29', NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W11006184', 'W11006184', 'UTPEHP', 'Physical Medicine & Rehabilitation Clinic ', 'Kirk', 'W', 'Leininger', 'MD', 'Physical Medicine and Rehabilitation', NULL, NULL, NULL, 'O', '1034 N 500 W', 'Provo', 'Utah', 'UT', '84605', '8013578818', NULL, NULL, NULL, 'Utah', NULL, NULL, NULL, NULL, 'IHCPEHP', NULL, NULL, '0.00', '30.00', '0.00', 8, '2008-07-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1386653772', 0, 'N', 0, '2008-07-29', NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W11006199', 'W11006199', 'UTPEHP', 'Snow College Clinic', 'Barbara', 'L', 'Hennagir', 'PA-C', 'Family Practice', '', '', NULL, 'O', '150 E College Avenue', 'Ephraim', 'Sanpete', 'UT', '84627', '4352837216', NULL, '150 E College Avenue', 'Ephraim', 'Sanpete', 'UT', '84627', '4352837216', '', 'PEHPMID', NULL, NULL, '0.00', '30.00', '0.00', 8, '2008-07-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1538215181', 0, 'N', 0, '2011-09-26', NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W11006204', 'W11006204', 'UTPEHP', 'Sevier Valley Family Practice', 'Daniel', 'C', 'Smith', 'MD', 'Family Practice', '', '', NULL, 'O', '70 E 1100 N', 'Richfield', 'Sevier', 'UT', '84701', '4358968254', '', '70 E 1100 N', 'Richfield', 'Sevier', 'UT', '84701', '4358968254', '', 'IHCPEHP', '', '', '0.00', '30.00', '0.00', 8, '2008-07-01', NULL, 0, 0, 0, 'Sevier Valley Hospital', '', '', '', 'HCFA|UB|', '1669672366', 0, 'N', 0, '2014-07-23', NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W11006206', 'W11006206', 'UTPEHP', 'Hurricane Valley Clinic', 'Jed', 'R', 'Gardner', 'MD', 'Family Practice', '', '', NULL, 'O', '75 N 2260 W', 'Hurricane', 'Washington', 'UT', '84737', '4356356500', NULL, '75 N 2260 W', 'Hurricane', 'Washington', 'UT', '84737', '4356356500', '          ', 'IHCPEHP', '', '', '0.00', '30.00', '0.00', 8, '2008-07-01', '2011-12-31', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1861452542', 0, 'N', 0, '2012-02-29', NULL, NULL, 0, 0, NULL, NULL),
('870467930', 'W11006137', 'W11006137', 'UT01', 'Kane County Clinic', 'Jonathan', 'C', 'Bowman', 'MD', 'Family Practice', 'Obstetrics and Gynecology', '', NULL, 'O', '355 N Main St', 'Kanab', 'Kane', 'UT', '84741', '4356444100', NULL, '355 N Main St', 'Kanab', 'Kane', 'UT', '84741', '4356444100', '          ', '', '', '', '0.00', '10.00', '0.00', 6, '2008-08-01', '2013-02-28', 0, 0, 0, 'Kane County Hospital', NULL, NULL, NULL, 'HCFA|', '1619047362', 0, 'N', 0, '2013-03-19', NULL, NULL, 0, 0, NULL, NULL),
('870467930', 'W11006136', 'W11006136', 'UT01', 'Kane County Clinic', 'Darren', 'D', 'Ott', 'DO', 'Family Practice', 'Obstetrics and Gynecology', '', NULL, 'O', '355 N Main St', 'Kanab', 'Kane', 'UT', '84741', '4356444100', NULL, '355 N Main St', 'Kanab', 'Kane', 'UT', '84741', '4356444100', '          ', '', '', '', '0.00', '10.00', '0.00', 6, '2008-08-01', '2013-02-28', 0, 0, 0, 'Kane County Hospital', NULL, NULL, NULL, 'HCFA|', '1295805893', 0, 'N', 0, '2013-03-19', NULL, NULL, 0, 0, NULL, NULL),
('870467930', 'W11006135', 'W11006135', 'UT01', 'Kane County Clinic', 'David', 'M', 'Salter', 'MD', 'Family Practice', '', '', NULL, 'O', '355 N Main St', 'Kanab', 'Kane', 'UT', '84741', '4356444100', NULL, '355 N Main St', 'Kanab', 'Kane', 'UT', '84741', '4356444100', '          ', '', '', '', '0.00', '10.00', '0.00', 6, '2008-08-01', '2013-02-28', 0, 0, 0, 'Kane County Hospital', '', '', '', 'HCFA|', '1639169832', 0, 'N', 0, '2013-03-19', NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W11006161', 'W11006161', 'UTPEHP', 'Dixie Hospitalists', 'William', 'W', 'Barney', 'MD', 'Internal Medicine', 'Cardiovascular Disease', 'Hospitalist', NULL, 'B', '577 S River Rd', 'St George', 'Washington', 'UT', '84790', '4356886200', NULL, '577 S River Rd', 'St George', 'Washington', 'UT', '84790', '4356886200', '', 'IHCPEHP', NULL, '', '0.00', '30.00', '0.00', 8, '2008-07-01', NULL, 0, 0, 0, 'Dixie Regional Medical Center', '', '', '', 'HCFA|UB|', '1194799890', 0, 'Y', 0, '2014-07-16', NULL, NULL, 0, 0, NULL, NULL),
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('942854057', 'W11006447', 'W11006447', 'UTPEHP2', 'Heber Valley Medical Center', 'Gregory', 'Paul', 'Tayler', 'MD', 'Family Practice', NULL, NULL, NULL, 'B', '1485 S Hwy 40', 'Heber City', 'Wasatch', 'UT', '84032', '4356542500', NULL, NULL, NULL, 'Wasatch', NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '5.00', NULL, 8, '2000-01-01', '2000-01-01', 0, NULL, 0, 'Heber Valley Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1043297815', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W11006414', 'W11006414', 'UTPEHP2', 'Summit After Hours Clinic', 'Joseph', 'J', 'Albano', 'MD', 'Family Practice', 'Sports Medicine', NULL, NULL, 'B', '1665 Bonanza Dr', 'Park City', 'Summit', 'UT', '84068', '4356470700', NULL, NULL, NULL, 'Summit', NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '5.00', NULL, 8, '2000-01-01', '2000-01-01', 0, NULL, 0, 'Salt Lake Regional Medical Center', 'St Marks Hospital', NULL, NULL, 'HCFA|UB|', '1003836636', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL);
INSERT INTO `providers_new` (`Provider_Tax_ID`, `Provider_Suffix`, `Provider_Network_ID`, `Provider_Region`, `Provider_Name`, `Provider_Doctor_First_Name`, `Provider_Doctor_Middle_Name`, `Provider_Doctor_Last_Name`, `Provider_Doctor_Degree`, `Provider_Specialty_1`, `Provider_Specialty_2`, `Provider_Specialty_3`, `Provider_Specialty_4`, `Provider_Address_Type`, `Provider_Address`, `Provider_City`, `Provider_County`, `Provider_State`, `Provider_Zip`, `Provider_Phone`, `Provider_Fax`, `Provider_Mailing_Address`, `Provider_Mailing_City`, `Provider_Mailing_County`, `Provider_Mailing_State`, `Provider_Mailing_Zip`, `Provider_Mailing_Phone`, `Provider_Mailing_Fax`, `Provider_Primary_Schedule`, `Provider_Secondary_Schedule`, `Provider_Rate_Sheet`, `Provider_Anes_Rate`, `Provider_Default_Rate`, `Provider_Max_DOS`, `Provider_Min_Match_Value`, `Provider_Effective_Date`, `Provider_Term_Date`, `Provider_Pend`, `Provider_Anes_Minutes`, `Provider_PPO`, `Provider_Hospital_1`, `Provider_Hospital_2`, `Provider_Hospital_3`, `Provider_Hospital_4`, `Provider_Type`, `Provider_NPI`, `Provider_Check_Override`, `Exclude_Dir`, `Audit_Status`, `Last_Change_Date`, `Medicare_ID`, `Provider_Lang`, `Provider_Latitude`, `Provider_Longitude`, `Provider_school`, `Provider_cert`) VALUES
('942854057', 'W11006422', 'W11006422', 'UTPEHP2', 'Summit After Hours Clinic', 'David', 'W', 'Brinton', 'MD', 'Family Practice', 'Sports Medicine', 'Urgent Care', NULL, 'B', '1665 Bonanza Dr', 'Park City', 'Summit', 'UT', '84068', '4356497640', NULL, NULL, NULL, 'Summit', NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '5.00', NULL, 8, '2000-01-01', '2000-01-01', 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1093820706', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W11006421', 'W11006421', 'UTPEHP2', 'Summit After Hours Clinic', 'Cress', 'R', 'Bohnn', 'MD', 'Family Practice', NULL, NULL, NULL, 'B', '1665 Bonanza Dr', 'Park City', 'Summit', 'UT', '84068', '4356470700', NULL, NULL, NULL, 'Summit', NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '5.00', NULL, 8, '2000-01-01', '2000-01-01', 0, NULL, 0, 'Salt Lake Regional Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1861423113', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W11006418', 'W11006418', 'UTPEHP2', 'Summit After Hours Clinic', 'Benjamin', 'B', 'Betteridge', 'MD', 'Sports Medicine', 'Emergency Medicine', NULL, NULL, 'B', '1665 Bonanza Dr', 'Park City', 'Summit', 'UT', '84068', '4356470700', NULL, NULL, NULL, 'Summit', NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '5.00', NULL, 8, '2000-01-01', '2000-01-01', 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1225007388', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W11006449', 'W11006449', 'UTPEHP2', 'Summit After Hours Clinic', 'Sandra', 'L', 'Van Leuven', 'MD', 'Family Practice', NULL, NULL, NULL, 'B', '1665 Bonanza Dr', 'Park City', 'Summit', 'UT', '84068', '4356470700', NULL, NULL, NULL, 'Summit', NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '5.00', NULL, 8, '2000-01-01', '2000-01-01', 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1538109715', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W11006415', 'W11006415', 'UTPEHP2', 'Summit After Hours Clinic', 'D', 'Wain', 'Allen', 'MD', 'Family Practice', NULL, NULL, NULL, 'B', '1665 Bonanza Dr', 'Park City', 'Summit', 'UT', '84068', '4356470700', NULL, NULL, NULL, 'Summit', NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '5.00', NULL, 8, '2000-01-01', '2000-01-01', 0, NULL, 0, 'Salt Lake Regional Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1942224050', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W11006451', 'W11006451', 'UTPEHP2', 'Summit After Hours Clinic', 'Robert', 'T', 'Winn', 'MD', 'Family Practice', 'Pediatrics', NULL, NULL, 'B', '1665 Bonanza Dr', 'Park City', 'Summit', 'UT', '84068', '4356470700', NULL, NULL, NULL, 'Summit', NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '5.00', NULL, 8, '2000-01-01', '2000-01-01', 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1912951393', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
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('942854057', 'W11006445', 'W11006445', 'UTPEHP2', 'Summit After Hours Clinic', 'Lisa', 'M', 'Saturnino', 'MD', 'Family Practice', NULL, NULL, NULL, 'B', '1665 Bonanza Dr', 'Park City', 'Summit', 'UT', '84068', '4356470700', NULL, NULL, NULL, 'Summit', NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '5.00', NULL, 8, '2000-01-01', '2000-01-01', 0, NULL, 0, 'Salt Lake Regional Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1336362490', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W11006444', 'W11006444', 'UTPEHP2', 'Summit After Hours Clinic', 'Spencer', 'E', 'Richards', 'MD', 'Family Practice', 'Sports Medicine', NULL, NULL, 'B', '1665 Bonanza Dr', 'Park City', 'Summit', 'UT', '84068', '4356497640', NULL, NULL, NULL, 'Summit', NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '5.00', NULL, 8, '2000-01-01', '2000-01-01', 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1609845775', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W11006425', 'W11006425', 'UTPEHP2', 'Summit After Hours Clinic', 'Robert', 'J', 'Evers', 'MD', 'Family Practice', NULL, NULL, NULL, 'B', '1665 Bonanza Dr', 'Park City', 'Summit', 'UT', '84068', '4356470700', NULL, NULL, NULL, 'Summit', NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '5.00', NULL, 8, '2000-01-01', '2000-01-01', 0, NULL, 0, 'University Health Care University Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1720033905', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W11006433', 'W11006433', 'UTPEHP2', 'Summit After Hours Clinic', 'R', 'Herbert', 'Lepley', 'APRN', 'Family Practice', 'Advanced Practice Registered Nurse', NULL, NULL, 'B', '1665 Bonanza Dr', 'Park City', 'Summit', 'UT', '84068', '4356470700', NULL, NULL, NULL, 'Summit', NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '5.00', NULL, 8, '2000-01-01', '2000-01-01', 0, NULL, 0, 'Salt Lake Regional Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1588611495', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W11006416', 'W11006416', 'UTPEHP2', 'Summit After Hours Clinic', 'Robert', 'W', 'Barnett', 'MD', 'Family Practice', NULL, NULL, NULL, 'B', '1665 Bonanza Dr', 'Park City', 'Summit', 'UT', '84068', '4356470700', NULL, NULL, NULL, 'Summit', NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '5.00', NULL, 8, '2000-01-01', '2000-01-01', 0, NULL, 0, 'Salt Lake Regional Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1831146752', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W11006448', 'W11006448', 'UTPEHP2', 'Summit After Hours Clinic', 'Kathleen', 'W', 'Thomas', 'APRN', 'Family Practice', 'Advanced Practice Registered Nurse', NULL, NULL, 'B', '1665 Bonanza Dr', 'Park City', 'Summit', 'UT', '84068', '4356497640', NULL, NULL, NULL, 'Summit', NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '5.00', NULL, 8, '2000-01-01', '2000-01-01', 0, NULL, 0, 'Salt Lake Regional Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1740235290', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
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('942854057', 'W11006617', 'W11006617', 'UTPEHP2', 'Safe and Healthy Families', 'Amy', 'H', 'Oxman', 'LCSW', 'Mental Health', 'Social Worker', NULL, NULL, 'O', '5770 S 1500 W Bldg C', 'Taylorsville', 'Salt Lake', 'UT', '84123', '8012653180', NULL, NULL, NULL, 'Salt Lake', NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '8.00', NULL, 8, '2000-01-01', '2000-01-01', 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1073622130', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
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('942854057', 'W11006675', 'W11006675', 'UTPEHP2', 'Center for Counseling', 'Joy', 'L', 'Wawrzyniak', 'LCSW', 'Mental Health', 'Social Worker', NULL, NULL, 'O', '5770 S 1500 E Bldg G', 'Taylorsville', 'Salt Lake', 'UT', '84123', '8012653000', NULL, NULL, NULL, 'Salt Lake', NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '8.00', NULL, 8, '2000-01-01', '2000-01-01', 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1700896891', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W11006621', 'W11006621', 'UTPEHP2', 'Adolescent Residential and Day Treatment', 'Kim', 'D', 'Peterson', 'LCSW', 'Mental Health', 'Social Worker', NULL, NULL, 'O', '5770 S 1500 W', 'Taylorsville', 'Salt Lake', 'UT', '84123', '8012653142', NULL, NULL, NULL, 'Salt Lake', NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '8.00', NULL, 8, '2000-01-01', '2000-01-01', 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '0000008162', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W11006527', 'W11006527', 'UTPEHP2', 'Center for Counseling', 'Ronda', 'D', 'Davis', 'MD', 'Mental Health', 'Pediatric Psychiatry', 'Pediatric Psychiatry', NULL, 'B', '5770 S 1500 W', 'Taylorsville', 'Salt Lake', 'UT', '84123', '8012653000', NULL, NULL, NULL, 'Salt Lake', NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '8.00', NULL, 8, '2000-01-01', '2000-01-01', 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1568564227', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W11006678', 'W11006678', 'UTPEHP2', 'Residential Treatment', 'Scott', 'B', 'Whittle', 'MD', 'Mental Health', 'Psychiatry', NULL, NULL, 'O', '5770 S 1500 W', 'Taylorsville', 'Salt Lake', 'UT', '84123', '8012653142', NULL, NULL, NULL, 'Salt Lake', NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '8.00', NULL, 8, '2000-01-01', '2000-01-01', 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1346395795', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W11006624', 'W11006624', 'UTPEHP2', 'Center for Counseling', 'Jason', 'L', 'Pola', 'LCSW', 'Mental Health', 'Social Worker', NULL, NULL, 'O', '5770 S 1500 W Bldg G', 'Taylorsville', 'Salt Lake', 'UT', '84123', '8012653000', NULL, NULL, NULL, 'Salt Lake', NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '8.00', NULL, 8, '2000-01-01', '2000-01-01', 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1750304515', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W11006625', 'W11006625', 'UTPEHP2', 'Residential Treatment', 'Bruce', 'C', 'Poulsen', 'PHD', 'Mental Health', 'Psychology', NULL, NULL, 'O', '5770 S 1500 W', 'Taylorsville', 'Salt Lake', 'UT', '84123', '8012653142', NULL, NULL, NULL, 'Salt Lake', NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '8.00', NULL, 8, '2000-01-01', '2000-01-01', 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1376669085', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W11006645', 'W11006645', 'UTPEHP2', 'Center for Counseling', 'Kirk', 'A', 'Simon', 'MD', 'Mental Health', 'Psychiatry', NULL, NULL, 'O', '5770 S 1500 W Bldg G', 'Taylorsville', 'Salt Lake', 'UT', '84123', '8012653000', NULL, NULL, NULL, 'Salt Lake', NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '8.00', NULL, 8, '2000-01-01', '2000-01-01', 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1043399611', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W11006681', 'W11006681', 'UTPEHP2', 'Center for Counseling', 'Jennifer', 'Lyn', 'Young', 'APRN', 'Mental Health', 'Advanced Practice Registered Nurse', NULL, NULL, 'O', '5770 S 1500 W Bldg G', 'Taylorsville', 'Salt Lake', 'UT', '84123', '8012653000', NULL, NULL, NULL, 'Salt Lake', NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '8.00', NULL, 8, '2000-01-01', '2000-01-01', 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1871517094', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W11006545', 'W11006545', 'UTPEHP2', 'Adolescent Residential and Day Treatment', 'Cathie', 'R', 'Fox', 'PhD', 'Mental Health', 'Psychology', NULL, NULL, 'O', '5770 S 1500 W', 'Taylorsville', 'Salt Lake', 'UT', '84123', '8012653142', NULL, NULL, NULL, 'Salt Lake', NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '8.00', NULL, 8, '2000-01-01', '2000-01-01', 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1124166582', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W11006554', 'W11006554', 'UTPEHP2', 'Safe and Healthy Families', 'Kevin', 'J', 'Gully', 'PHD', 'Mental Health', 'Psychology', NULL, NULL, 'O', '5770 S 1500 W Bldg C', 'Taylorsville', 'Salt Lake', 'UT', '84123', '8012653180', NULL, NULL, NULL, 'Salt Lake', NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '8.00', NULL, 8, '2000-01-01', '2000-01-01', 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1861586380', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W11006509', 'W11006509', 'UTPEHP2', 'Center for Counseling', 'Ashley', NULL, 'Bittle', 'LCSW', 'Mental Health', 'Social Worker', NULL, NULL, 'O', '5770 S 1500 W', 'Taylorsville', 'Salt Lake', 'UT', '84123', '8012653000', NULL, NULL, NULL, 'Salt Lake', NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '8.00', NULL, 8, '2000-01-01', '2000-01-01', 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1013108695', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W11006548', 'W11006548', 'UTPEHP2', 'Center for Counseling', 'David', 'H', 'Gambles', 'PHD', 'Mental Health', 'Psychology', NULL, NULL, 'O', '5770 S 1500 W', 'Taylorsville', 'Salt Lake', 'UT', '84123', '8012653000', NULL, NULL, NULL, 'Salt Lake', NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '8.00', NULL, 8, '2000-01-01', '2000-01-01', 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1619902079', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W11006507', 'W11006507', 'UTPEHP2', 'Center for Counseling', 'C', 'Michelle', 'Benson', 'APRN', 'Mental Health', 'Advanced Practice Registered Nurse', NULL, NULL, 'O', '5770 S 1500 W Bldg G', 'Taylorsville', 'Salt Lake', 'UT', '84123', '8012653000', NULL, NULL, NULL, 'Salt Lake', NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '8.00', NULL, 8, '2000-01-01', '2000-01-01', 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1457453102', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W11006618', 'W11006618', 'UTPEHP2', 'Center for Counseling', 'Larissa', NULL, 'Peay', 'LCSW', 'Mental Health', 'Social Worker', NULL, NULL, 'O', '5770 S 1500 W Bldg G', 'Taylorsville', 'Salt Lake', 'UT', '84123', '8012653000', NULL, NULL, NULL, 'Salt Lake', NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '8.00', NULL, 8, '2000-01-01', '2000-01-01', 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '0000008103', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W11006552', 'W11006552', 'UTPEHP2', 'Center for Counseling', 'Mannix', 'G', 'Glines', 'LCSW', 'Mental Health', 'Social Worker', NULL, NULL, 'O', '5770 S 1500 W Bldg G', 'Taylorsville', 'Salt Lake', 'UT', '84123', '8012653000', NULL, NULL, NULL, 'Salt Lake', NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '8.00', NULL, 8, '2000-01-01', '2000-01-01', 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1386606358', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W11006591', 'W11006591', 'UTPEHP2', 'Center for Counseling', 'Dorann', 'C', 'Mitchell', 'LCSW', 'Mental Health', 'Social Worker', NULL, NULL, 'O', '5770 S 1500 W Bldg G', 'Taylorsville', 'Salt Lake', 'UT', '84123', '8012653000', NULL, NULL, NULL, 'Salt Lake', NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '8.00', NULL, 8, '2000-01-01', '2000-01-01', 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1801819677', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W11006640', 'W11006640', 'UTPEHP2', 'Primary Childrens Medical Center', 'Katherin', 'F', 'Sherry', 'MD', 'Pediatric Psychiatry', NULL, NULL, NULL, 'O', '5770 S 1500 W', 'Taylorsville', 'Salt Lake', 'UT', '84123', '8012553000', NULL, NULL, NULL, 'Salt Lake', NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '8.00', NULL, 8, '2000-01-01', '2000-01-01', 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1669446472', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W11006501', 'W11006501', 'UTPEHP2', 'Primary Childrens Center for Counseling', 'James', 'C', 'Ashworth', 'MD', 'Mental Health', 'Pediatric Psychiatry', NULL, NULL, 'B', '5770 S 1500 W', 'Taylorsville', 'Salt Lake', 'UT', '84123', '8012653000', NULL, NULL, NULL, 'Salt Lake', NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '8.00', NULL, 8, '2000-01-01', '2000-01-01', 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1679514988', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W11006541', 'W11006541', 'UTPEHP2', 'Center for Counseling', 'Richard', 'C', 'Ferre', 'MD', 'Mental Health', 'Psychiatry', NULL, NULL, 'O', '5770 S 1500 W Bldg G', 'Taylorsville', 'Salt Lake', 'UT', '84123', '8012653000', NULL, NULL, NULL, 'Salt Lake', NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '8.00', NULL, 8, '2000-01-01', '2000-01-01', 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1548283302', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W11006637', 'W11006637', 'UTPEHP2', 'Center for Counseling', 'L', 'Kristin H', 'Shadow', 'MD', 'Mental Health', 'Pediatric Psychiatry', NULL, NULL, 'O', '5770 S 1500 W Bldg G', 'Taylorsville', 'Salt Lake', 'UT', '84123', '8012653000', NULL, NULL, NULL, 'Salt Lake', NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '8.00', NULL, 8, '2000-01-01', '2000-01-01', 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1922028497', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W11006653', 'W11006653', 'UTPEHP2', 'Center for Counseling', 'Claire', 'R', 'Stoecker', 'LCSW', 'Mental Health', 'Social Worker', NULL, NULL, 'O', '5770 S 1500 W Bldg G', 'Taylorsville', 'Salt Lake', 'UT', '84123', '8012653000', NULL, NULL, NULL, 'Salt Lake', NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '8.00', NULL, 8, '2000-01-01', '2000-01-01', 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1093735565', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W11006515', 'W11006515', 'UTPEHP2', 'Center for Counseling', 'Nancy', 'L', 'Cantor', 'PHD', 'Mental Health', 'Psychology', NULL, NULL, 'O', '5770 S 1500 W Bldg G', 'Taylorsville', 'Salt Lake', 'UT', '84123', '8012653000', NULL, NULL, NULL, 'Salt Lake', NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '8.00', NULL, 8, '2000-01-01', '2000-01-01', 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1144243312', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W11006575', 'W11006575', 'UTPEHP2', 'Center for Counseling', 'Merrill', 'D', 'Kingston', 'PHD', 'Mental Health', 'Psychology', NULL, NULL, 'O', '5770 S 1500 W Bldg G', 'Taylorsville', 'Salt Lake', 'UT', '84123', '8012653000', NULL, NULL, NULL, 'Salt Lake', NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '8.00', NULL, 8, '2000-01-01', '2000-01-01', 0, NULL, 0, 'Primary Childrens Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1821019399', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W11006588', 'W11006588', 'UTPEHP2', 'Center for Counseling', 'Monty', 'D', 'Millerberg', 'LCSW', 'Mental Health', 'Social Worker', NULL, NULL, 'O', '5770 S 1500 W Bldg G', 'Taylorsville', 'Salt Lake', 'UT', '84123', '8012653000', NULL, NULL, NULL, 'Salt Lake', NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '8.00', NULL, 8, '2000-01-01', '2000-01-01', 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1235152091', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W11006583', 'W11006583', 'UTPEHP2', 'Acute Inpatient', 'Isabel', 'P', 'Martinez', 'LCSW', 'Mental Health', 'Social Worker', NULL, NULL, 'O', '5770 S 1500 W', 'Taylorsville', 'Salt Lake', 'UT', '84123', '8012653000', NULL, NULL, NULL, 'Salt Lake', NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '8.00', NULL, 8, '2000-01-01', '2000-01-01', 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '0000007451', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W11006652', 'W11006652', 'UTPEHP2', 'Adolescent Residential and Day Treatment', 'Carla', 'J', 'Stoddard', 'LCSW', 'Mental Health', 'Social Worker', NULL, NULL, 'O', '5770 S 1500 W', 'Taylorsville', 'Salt Lake', 'UT', '84123', '8012653142', NULL, NULL, NULL, 'Salt Lake', NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '8.00', NULL, 8, '2000-01-01', '2000-01-01', 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '0000008921', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W11006650', 'W11006650', 'UTPEHP2', 'Safe and Healthy Families', 'Amy', NULL, 'Spratling', 'LPC', 'Mental Health', 'Counseling', NULL, NULL, 'O', '5770 S 1500 W Bldg C', 'Taylorsville', 'Salt Lake', 'UT', '84123', '8012653180', NULL, NULL, NULL, 'Salt Lake', NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '8.00', NULL, 8, '2000-01-01', '2000-01-01', 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1598973414', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W11006539', 'W11006539', 'UTPEHP2', 'Residential Treatment', 'Florence', NULL, 'Fairbanks', 'APRN', 'Mental Health', 'Advanced Practice Registered Nurse', NULL, NULL, 'O', '5770 S 1500 W', 'Taylorsville', 'Salt Lake', 'UT', '84123', '8012653142', NULL, NULL, NULL, 'Salt Lake', NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '8.00', NULL, 8, '2000-01-01', '2000-01-01', 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1154348993', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL);
INSERT INTO `providers_new` (`Provider_Tax_ID`, `Provider_Suffix`, `Provider_Network_ID`, `Provider_Region`, `Provider_Name`, `Provider_Doctor_First_Name`, `Provider_Doctor_Middle_Name`, `Provider_Doctor_Last_Name`, `Provider_Doctor_Degree`, `Provider_Specialty_1`, `Provider_Specialty_2`, `Provider_Specialty_3`, `Provider_Specialty_4`, `Provider_Address_Type`, `Provider_Address`, `Provider_City`, `Provider_County`, `Provider_State`, `Provider_Zip`, `Provider_Phone`, `Provider_Fax`, `Provider_Mailing_Address`, `Provider_Mailing_City`, `Provider_Mailing_County`, `Provider_Mailing_State`, `Provider_Mailing_Zip`, `Provider_Mailing_Phone`, `Provider_Mailing_Fax`, `Provider_Primary_Schedule`, `Provider_Secondary_Schedule`, `Provider_Rate_Sheet`, `Provider_Anes_Rate`, `Provider_Default_Rate`, `Provider_Max_DOS`, `Provider_Min_Match_Value`, `Provider_Effective_Date`, `Provider_Term_Date`, `Provider_Pend`, `Provider_Anes_Minutes`, `Provider_PPO`, `Provider_Hospital_1`, `Provider_Hospital_2`, `Provider_Hospital_3`, `Provider_Hospital_4`, `Provider_Type`, `Provider_NPI`, `Provider_Check_Override`, `Exclude_Dir`, `Audit_Status`, `Last_Change_Date`, `Medicare_ID`, `Provider_Lang`, `Provider_Latitude`, `Provider_Longitude`, `Provider_school`, `Provider_cert`) VALUES
('942854057', 'W11006587', 'W11006587', 'UTPEHP2', 'Center for Counseling', 'Deborah', 'L', 'Mennenga', 'MD', 'Mental Health', 'Psychiatry', NULL, NULL, 'O', '5770 S 1500 W Bldg G', 'Taylorsville', 'Salt Lake', 'UT', '84123', '8012653000', NULL, NULL, NULL, 'Salt Lake', NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '8.00', NULL, 8, '2000-01-01', '2000-01-01', 0, NULL, 0, 'Primary Childrens Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1669493920', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W11006578', 'W11006578', 'UTPEHP2', 'Center for Counseling', 'Barbara', 'R', 'Lester', 'LCSW', 'Mental Health', 'Social Worker', NULL, NULL, 'O', '5770 S 1500 W Bldg G', 'Taylorsville', 'Salt Lake', 'UT', '84123', '8012653000', NULL, NULL, NULL, 'Salt Lake', NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '8.00', NULL, 8, '2000-01-01', '2000-01-01', 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1689697443', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
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('942854057', 'W11006382', 'W11006382', 'UTPEHP2', 'Fillmore Community Medical Center', 'Nicole', 'A', 'Clark', 'MD', 'Family Practice', NULL, NULL, NULL, 'B', '674 S Highway 99', 'Fillmore', 'Millard', 'UT', '84631', '4357435857', NULL, NULL, NULL, 'Millard', NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '5.00', NULL, 8, '2000-01-01', '2000-01-01', 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1760598411', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W11006406', 'W11006406', 'UTPEHP2', 'Fillmore Community Medical Center', 'Lisa', 'M', 'Saturnino', 'MD', 'Family Practice', NULL, NULL, NULL, 'B', '674 S Highway 99', 'Fillmore', 'Millard', 'UT', '84631', '4357435857', NULL, NULL, NULL, 'Millard', NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '5.00', NULL, 8, '2000-01-01', '2000-01-01', 0, NULL, 0, 'Salt Lake Regional Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1336362490', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W11006375', 'W11006375', 'UTPEHP2', 'Fillmore Community Medical Center', 'Scott', 'H', 'Beckstead', 'DO', 'Family Practice', NULL, NULL, NULL, 'B', '674 S Highway 99', 'Fillmore', 'Millard', 'UT', '84631', '4357435857', NULL, NULL, NULL, 'Millard', NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '5.00', NULL, 8, '2000-01-01', '2000-01-01', 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1508810854', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W11006399', 'W11006399', 'UTPEHP2', 'Fillmore Community Medical Center', 'Jeffrey', 'S', 'McClellan', 'MD', 'Radiologist', NULL, NULL, NULL, 'B', '674 S Highway 99', 'Fillmore', 'Millard', 'UT', '84631', '4357435857', NULL, NULL, NULL, 'Millard', NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '5.00', NULL, 8, '2000-01-01', '2000-01-01', 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1518910108', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W11006409', 'W11006409', 'UTPEHP2', 'Fillmore Community Medical Center', 'Gary', 'M', 'Watts', 'MD', 'Radiologist', NULL, NULL, NULL, 'O', '674 S Highway 99', 'Fillmore', 'Millard', 'UT', '84631', '4357435857', NULL, NULL, NULL, 'Millard', NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '5.00', NULL, 8, '2000-01-01', '2000-01-01', 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1528014792', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W11006405', 'W11006405', 'UTPEHP2', 'Fillmore Community Medical Center', 'Joseph', 'D', 'Rasband', 'MD', 'Radiology', NULL, NULL, NULL, 'B', '674 S Highway 99', 'Fillmore', 'Millard', 'UT', '84631', '4357435857', NULL, NULL, NULL, 'Millard', NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '5.00', NULL, 8, '2000-01-01', '2000-01-01', 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1922059542', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W11006411', 'W11006411', 'UTPEHP2', 'Fillmore Community Medical Center', 'Karl', 'N', 'Weenig', 'MD', 'Family Practice', 'Sports Medicine', NULL, NULL, 'B', '674 S Highway 99', 'Fillmore', 'Millard', 'UT', '84631', '4357435857', NULL, NULL, NULL, 'Millard', NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '5.00', NULL, 8, '2000-01-01', '2000-01-01', 0, NULL, 0, 'Mountain View Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1740242973', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W11006412', 'W11006412', 'UTPEHP2', 'Fillmore Community Medical Center', 'Steve', 'Fred', 'Wilstead', 'CRNA', 'Certified Nurse Anesthetist', NULL, NULL, NULL, 'O', '674 S Highway 99', 'Fillmore', 'Millard', 'UT', '84631', '4357435857', NULL, NULL, NULL, 'Millard', NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '5.00', NULL, 8, '2000-01-01', '2000-01-01', 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1679521744', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W11006383', 'W11006383', 'UTPEHP2', 'Fillmore Community Medical Center', 'John', 'S', 'Collins', 'MD', 'Vascular Surgery', 'Radiologist', NULL, NULL, 'B', '674 S Highway 99', 'Fillmore', 'Millard', 'UT', '84631', '4357435857', NULL, NULL, NULL, 'Millard', NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '5.00', NULL, 8, '2000-01-01', '2000-01-01', 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1215974266', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W11006381', 'W11006381', 'UTPEHP2', 'Fillmore Community Medical Center', 'Brent', 'C', 'Chandler', 'MD', 'Radiologist', NULL, NULL, NULL, 'B', '674 S Highway 99', 'Fillmore', 'Millard', 'UT', '84631', '4357435857', NULL, NULL, NULL, 'Millard', NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '5.00', NULL, 8, '2000-01-01', '2000-01-01', 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1346292026', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W11006387', 'W11006387', 'UTPEHP2', 'Fillmore Community Medical Center', 'Jared', 'C', 'Dunn', 'MD', 'Family Practice', NULL, NULL, NULL, 'B', '674 S Highway 99', 'Fillmore', 'Millard', 'UT', '84631', '4357435857', NULL, NULL, NULL, 'Millard', NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '5.00', NULL, 8, '2000-01-01', '2000-01-01', 0, NULL, 0, 'Riverton Childrens Unit Operated by Primary Childrens Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1003823808', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL);
