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
('200800269', 'TX0001000', 'TX0001000', 'TX01', 'San Antonio Molecular Imaging', '', '', 'San Antonio Molecular Imaging', '', 'Imaging Center', 'Radiology', '', NULL, 'O', '9102 Floyd Curl Dr Ste 193', 'San Antonio', 'Bexar', 'TX', '78240', '2102470880', NULL, '9102 Floyd Curl Dr Ste 193', 'San Antonio', 'Bexar', 'TX', '78240', '2102470880', '          ', 'TXONCOL', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2007-01-01', '2012-08-01', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '0000008569', 0, 'N', 0, '2012-08-29', NULL, NULL, 29.5287, -98.5918, NULL, NULL),
('200800269', 'TX0001001', 'TX0001001', 'TX01', 'San Antonio Molecular Imaging', '', '', 'San Antonio Molecular Imaging', '', 'Imaging Center', 'Radiology', '', NULL, 'B', 'PO Box 686', 'San Antonio', 'Bexar', 'TX', '78293', '2102470880', NULL, 'PO Box 686', 'San Antonio', 'Bexar', 'TX', '78293', '2102470880', '          ', 'TXONCOL', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2007-01-01', '2012-08-01', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '0000008569', 0, 'Y', 0, '2012-08-29', NULL, NULL, 0, 0, NULL, NULL),
('742072186', 'TX0001002', 'TX0001002', 'TX01', 'San Antonio Infectious Diseases Consultants', '', '', 'San Antonio Infectious Diseases Conultants', '', 'Infectious Disease', '', '', NULL, 'O', '8042 Wurzbach Rd Ste 280', 'San Antonio', 'Bexar', 'TX', '78229', '2106148100', NULL, '8042 Wurzbach Rd', 'San Antonio', 'Bexar', 'TX', '78229', '2106148100', '', 'TXSURGE', 'TXHCPCS', NULL, '0.00', '50.00', '0.00', 3, '2007-01-01', NULL, NULL, 0, 0, '', '', '', '', 'HCFA|UB|', '0000008567', 0, 'N', 0, '2011-07-22', NULL, NULL, 29.514, -98.5778, NULL, NULL),
('742072186', 'TX0001003', 'TX0001003', 'TX01', 'San Antonio Infectious Diseases Consultants', '', '', 'San Antonio Infectious Diseases Conultants', '', 'Infectious Disease', '', '', NULL, 'O', '343 W Houston St Ste 808', 'San Antonio', 'Bexar', 'TX', '78205', '2102249616', NULL, '8042 Wurzbach Rd', 'San Antonio', 'Bexar', 'TX', '78229', '2102249616', '', 'TXSURGE', 'TXHCPCS', NULL, '0.00', '50.00', '0.00', 3, '2007-01-01', NULL, NULL, 0, 0, '', '', '', '', 'HCFA|UB|', '0000008567', 0, 'N', 0, '2011-07-22', NULL, NULL, 29.4264, -98.4967, NULL, NULL),
('742072186', 'TX0001004', 'TX0001004', 'TX01', 'San Antonio Infectious Diseases Conultants', '', '', 'San Antonio Infectious Diseases Conultants', '', 'Infectious Disease', '', '', NULL, 'O', '11901 Toepperwein Ste 1202', 'San Antonio', 'Bexar', 'TX', '78233', '2104908941', NULL, '8042 Wurzbach Rd', 'San Antonio', 'Bexar', 'TX', '78229', '2104908941', '          ', 'TXSURGE', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2007-01-01', NULL, NULL, 0, NULL, '', '', '', '', 'HCFA|UB|', '0000008567', 0, 'Y', 0, '2011-07-22', NULL, NULL, 29.5467, -98.3425, NULL, NULL),
('742072186', 'TX0001005', 'TX0001005', 'TX01', 'San Antonio Infectious Diseases Conultants', 'Charles', 'J', 'Lerner', 'MD', 'Infectious Disease', '', '', NULL, 'O', '8042 Wurzbach Rd Ste 280', 'San Antonio', 'Bexar', 'TX', '78229', '2106148100', NULL, '8042 Wurzbach Rd', 'San Antonio', 'Bexar', 'TX', '78229', '2106148100', '          ', 'TXSURGE', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2007-01-01', '2010-04-30', NULL, 0, NULL, '', '', '', '', 'HCFA|UB|', '1770573701', 0, 'N', 0, '2011-04-01', NULL, NULL, 29.5151, -98.5765, NULL, NULL),
('742072186', 'TX0001006', 'TX0001006', 'TX01', 'San Antonio Infectious Diseases Conultants', 'Richard', 'E', 'Thorner', 'MD', 'Infectious Disease', '', '', NULL, 'O', '8042 Wurzbach Rd Ste 280', 'San Antonio', 'Bexar', 'TX', '78229', '2106148100', NULL, '8042 Wurzbach Rd Ste 280', 'San Antonio', 'Bexar', 'TX', '78229', '2106148100', '', 'TXSURGE', 'TXHCPCS', NULL, '0.00', '50.00', '0.00', 3, '2007-01-01', NULL, 0, 0, 0, 'Baptist Medical Center', '', '', '', 'HCFA|UB|', '1952391948', 0, 'N', 0, '2014-03-13', NULL, NULL, 29.514, -98.5778, NULL, NULL),
('742072186', 'TX0001007', 'TX0001007', 'TX01', 'San Antonio Infectious Diseases Consultants', 'Richard', 'J', 'Fetchick', 'MD', 'Infectious Disease', '', '', NULL, 'O', '8042 Wurzbach Rd Ste 280', 'San Antonio', 'Bexar', 'TX', '78229', '2106148100', NULL, '8042 Wurzbach Rd Ste 280', 'San Antonio', 'Bexar', 'TX', '78229', '2106148100', '', 'TXSURGE', 'TXHCPCS', NULL, '0.00', '50.00', '0.00', 3, '2007-01-01', NULL, 0, 0, 0, 'Baptist Medical Center', '', '', '', 'HCFA|UB|', '1134119183', 0, 'N', 0, '2013-03-28', NULL, NULL, 29.514, -98.5778, NULL, NULL),
('742072186', 'TX0001008', 'TX0001008', 'TX01', 'San Antonio Infectious Diseases Consultants', 'Carl', 'M', 'Berkowitz', 'MD', 'Infectious Disease', '', '', NULL, 'O', '8042 Wurzbach Rd Ste 280', 'San Antonio', 'Bexar', 'TX', '78229', '2106148100', NULL, '8042 Wurzbach Rd Ste 280', 'San Antonio', 'Bexar', 'TX', '78229', '2106148100', '', 'TXSURGE', 'TXHCPCS', NULL, '0.00', '50.00', '0.00', 3, '2007-01-01', NULL, 0, 0, 0, 'Baptist Medical Center', '', '', '', 'HCFA|UB|', '1124018163', 0, 'N', 0, '2012-06-25', NULL, NULL, 29.514, -98.5778, NULL, NULL),
('742072186', 'TX0001009', 'TX0001009', 'TX01', 'San Antonio Infectious Diseases Consultants', 'Caroline', 'C', 'Dewitt', 'MD', 'Infectious Disease', '', '', NULL, 'O', '8042 Wurzbach Rd Ste 280', 'San Antonio', 'Bexar', 'TX', '78229', '2106148100', NULL, '8042 Wurzbach Rd Ste 280', 'San Antonio', 'Bexar', 'TX', '78229', '2106148100', '', 'TXSURGE', 'TXHCPCS', NULL, '0.00', '50.00', '0.00', 3, '2007-01-01', NULL, 0, 0, 0, 'Baptist Medical Center', '', '', '', 'HCFA|UB|', '1518957547', 0, 'N', 0, '2013-06-26', NULL, NULL, 29.514, -98.5778, NULL, NULL),
('742072186', 'TX0001010', 'TX0001010', 'TX01', 'San Antonio Infectious Diseases Consultants', 'Alison', 'J', 'Berry', 'MD', 'Infectious Disease', '', '', NULL, 'O', '8042 Wurzbach Rd Ste 280', 'San Antonio', 'Bexar', 'TX', '78229', '2106148100', NULL, '8042 Wurzbach Rd Ste 280', 'San Antonio', 'Bexar', 'TX', '78229', '2106148100', '', 'TXSURGE', 'TXHCPCS', NULL, '0.00', '50.00', '0.00', 3, '2007-01-01', NULL, 0, 0, 0, 'Baptist Beaumont Hospital', '', '', '', 'HCFA|UB|', '1487644423', 0, 'N', 0, '2013-12-10', NULL, NULL, 29.514, -98.5778, NULL, NULL),
('742072186', 'TX0001011', 'TX0001011', 'TX01', 'San Antonio Infectious Diseases Conultants', 'Luis', 'A', 'Cisneros', 'MD', 'Infectious Disease', '', '', NULL, 'O', '343 W Houston St Ste 808', 'San Antonio', 'Bexar', 'TX', '78205', '2102249616', NULL, '343 W Houston St Ste 808', 'San Antonio', 'Bexar', 'TX', '78205', '2102249616', '', 'TXSURGE', 'TXHCPCS', NULL, '0.00', '50.00', '0.00', 3, '2007-01-01', NULL, 0, 0, 0, 'Baptist Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1235129263', 0, 'N', 0, '2013-06-21', NULL, NULL, 29.4264, -98.4967, NULL, NULL),
('742072186', 'TX0001012', 'TX0001012', 'TX01', 'San Antonio Infectious Diseases Conultants', 'Alison', 'J', 'Berry', 'MD', 'Infectious Disease', '', '', NULL, 'O', '11901 Toepperwein Ste 1202', 'San Antonio', 'Bexar', 'TX', '78233', '2104908941', NULL, '11901 Toepperwein Ste 1202', 'San Antonio', 'Bexar', 'TX', '78233', '2104908941', '          ', 'TXSURGE', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2007-01-01', '2011-03-24', 0, 0, 0, 'Baptist Beaumont Hospital', '', '', '', 'HCFA|UB|', '1487644423', 0, 'N', 0, '2014-02-26', NULL, NULL, 29.5463, -98.343, NULL, NULL),
('742072186', 'TX0001013', 'TX0001013', 'TX01', 'San Antonio Infectious Diseases Conultants Infusion Suites', '', '', 'San Antonio Infectious Diseases Conultants Infusion Suites', '', 'Infectious Disease', '', '', NULL, 'O', '8042 Wurzbach Rd Ste 280', 'San Antonio', 'Bexar', 'TX', '78229', '2106143090', NULL, '8042 Wurzbach Rd Ste 280', 'San Antonio', 'Bexar', 'TX', '78229', '2106143090', '', 'TXSURGE', 'TXHCPCS', NULL, '0.00', '50.00', '0.00', 3, '2007-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '0000008568', 0, 'N', 0, '2013-10-15', NULL, NULL, 29.514, -98.5778, NULL, NULL),
('742072186', 'TX0001014', 'TX0001014', 'TX01', 'San Antonio Infectious Diseases Conultants Infusion Suites', '', '', 'San Antonio Infectious Diseases Conultants Infusion Suites', '', 'Infectious Disease', '', '', NULL, 'O', '343 W Houston St Ste 808', 'San Antonio', 'Bexar', 'TX', '78205', '2102240732', NULL, '343 W Houston St Ste 808', 'San Antonio', 'Bexar', 'TX', '78205', '2102240732', '', 'TXSURGE', 'TXHCPCS', NULL, '0.00', '50.00', '0.00', 3, '2007-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '0000008568', 0, 'N', 0, '2013-10-15', NULL, NULL, 29.4264, -98.4967, NULL, NULL),
('742072186', 'TX0001015', 'TX0001015', 'TX01', 'San Antonio Infectious Diseases Conultants Infusion Suites', '', '', 'San Antonio Infectious Diseases Conultants Infusion Suites', '', 'Infectious Disease', '', '', NULL, 'O', '11901 Toepperwein Ste 1202', 'San Antonio', 'Bexar', 'TX', '78233', '2105994094', NULL, '11901 Toepperwein Ste 1202', 'San Antonio', 'Bexar', 'TX', '78233', '2105994094', '', 'TXSURGE', 'TXHCPCS', NULL, '0.00', '50.00', '0.00', 3, '2007-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '0000008568', 0, 'N', 0, '2013-10-15', NULL, NULL, 29.5467, -98.3425, NULL, NULL),
('742789421', 'TX0001016', 'TX0001016', 'TX01', NULL, 'Theodore', 'W', 'Bedard', 'MD', 'Rheumatology', NULL, NULL, NULL, 'O', '8601 Village Dr Ste 212', 'San Antonio', 'Bexar', 'TX', '78217', '2106546281', NULL, '8601 Village Dr', 'San Antonio', '', 'TX', '78217', '', '', 'TXSTD', 'TXHCPCS', NULL, '0.00', '50.00', '0.00', 3, '2007-01-01', '2012-08-19', 0, 0, 0, 'North East Baptist Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1083615827', 0, 'N', 0, '2007-01-11', NULL, NULL, 29.5178, -98.4283, NULL, NULL),
('742579931', 'TX0001017', 'TX0001017', 'TX01', '', 'Sheldon', 'G', 'Gross', 'MD', 'Pediatric Neurology', '', '', NULL, 'O', '4499 Medical Dr Ste 396', 'San Antonio', 'Bexar', 'TX', '78229', '2106143737', '          ', '4499 Medical Dr Ste 396', 'San Antonio', 'Bexar', 'TX', '78229', '2106143737', '          ', 'TXORTHO', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2007-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1922001395', 0, 'Y', 0, '2014-04-01', NULL, NULL, 29.5094, -98.5732, NULL, NULL),
('200773806', 'TX0001018', 'TX0001018', 'TX01', 'New Dimensions', '', '', 'New Dimensions', '', 'General Surgery', '', '', NULL, 'B', '9150 Huebner Rd Ste 250', 'San Antonio', 'Bexar', 'TX', '78240', '2106143370', NULL, '9150 Huebner Rd Ste 250', 'San Antonio', 'Bexar', 'TX', '78240', '2106143370', '          ', 'TXSURGA', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2007-01-01', '2010-10-10', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '0000007828', 0, 'Y', 0, '2010-09-07', NULL, NULL, 29.5273, -98.5948, NULL, NULL),
('200773806', 'TX0001019', 'TX0001019', 'TX01', '', 'John', 'A', 'Pilcher', 'MD', 'General Surgery', '', '', NULL, 'O', '9150 Huebner Rd Ste 250', 'San Antonio', 'Bexar', 'TX', '78240', '2106143370', NULL, '9150 Huebner Rd Ste 250', 'San Antonio', 'Bexar', 'TX', '78240', '2106143370', '          ', 'TXSURGA', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2007-01-01', '2010-10-10', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1356339550', 0, 'Y', 0, '2010-09-07', NULL, NULL, 29.5273, -98.5948, NULL, NULL),
('200773806', 'TX0001020', 'TX0001020', 'TX01', '', 'Dana', 'L', 'Reiss', 'MD', 'General Surgery', '', '', NULL, 'O', '9150 Huebner Rd Ste 250', 'San Antonio', 'Bexar', 'TX', '78240', '2106143370', NULL, '9150 Huebner Rd Ste 250', 'San Antonio', 'Bexar', 'TX', '78240', '2106143370', '          ', 'TXSURGA', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2007-01-01', '2010-10-10', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1760470066', 0, 'Y', 0, '2010-09-07', NULL, NULL, 29.5273, -98.5948, NULL, NULL),
('200773806', 'TX0001021', 'TX0001021', 'TX01', 'Surgical Consultants of San Antonio', 'Michael', 'V', 'Seger', 'MD', 'General Surgery', NULL, NULL, NULL, 'O', '9150 Huebner Rd Ste 250', 'San Antonio', 'Bexar', 'TX', '78240', '2106143370', NULL, '9150 Huebner Rd', 'San Antonio', '', 'TX', '78240', '', '', 'TXSURGA', 'TXHCPCS', NULL, '0.00', '50.00', '0.00', 3, '2007-01-01', '2009-07-24', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '0000008648', 0, 'N', 0, '2007-01-11', NULL, NULL, 29.5273, -98.5948, NULL, NULL),
('200773806', 'TX0001022', 'TX0001022', 'TX01', '', 'Lloyd', 'H', 'Stegemann', 'MD', 'General Surgery', '', '', NULL, 'O', '9150 Huebner Rd Ste 250', 'San Antonio', 'Bexar', 'TX', '78240', '2106143370', NULL, '9150 Huebner Rd Ste 250', 'San Antonio', 'Bexar', 'TX', '78240', '2106143370', '          ', 'TXSURGA', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2007-01-01', '2010-10-10', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1134117450', 0, 'Y', 0, '2010-09-07', NULL, NULL, 29.5273, -98.5948, NULL, NULL),
('200773806', 'TX0001023', 'TX0001023', 'TX01', 'Surgical Consultants of San Antonio', 'Frank', 'D', 'Duperier', 'MD', 'General Surgery', NULL, NULL, NULL, 'O', '9150 Huebner Rd Ste 250', 'San Antonio', 'Bexar', 'TX', '78240', '2106143370', NULL, '9150 Huebner Rd', 'San Antonio', '', 'TX', '78240', '', '', 'TXSURGA', 'TXHCPCS', NULL, '0.00', '50.00', '0.00', 3, '2007-01-01', '2009-07-24', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '0000006059', 0, 'N', 0, '2007-01-11', NULL, NULL, 29.5273, -98.5948, NULL, NULL),
('200773806', 'TX0001024', 'TX0001024', 'TX01', '', 'Paul', 'M', 'Selinkoff', 'MD', 'General Surgery', '', '', NULL, 'O', '9150 Huebner Rd Ste 250', 'San Antonio', 'Bexar', 'TX', '78240', '2106143370', NULL, '9150 Huebner Rd Ste 250', 'San Antonio', 'Bexar', 'TX', '78240', '2106143370', '          ', 'TXSURGA', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2007-01-01', '2010-10-10', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1023006335', 0, 'Y', 0, '2010-09-07', NULL, NULL, 29.5273, -98.5948, NULL, NULL),
('742939553', 'TX0001025', 'TX0001025', 'TX01', 'Neurology & Neurophysiology', 'Peter', 'A', 'Tarbox', 'MD', 'Neurology', NULL, NULL, NULL, 'O', '2829 Babcock Rd Ste 425', 'San Antonio', 'Bexar', 'TX', '78229', '2106145242', NULL, '2829 Babcock', 'San Antonio', '', 'TX', '78229', '', '', 'TXORTHO', 'TXHCPCS', NULL, '0.00', '50.00', '0.00', 3, '2007-01-01', '2009-07-01', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '0000009003', 0, 'N', 0, '2007-01-11', NULL, NULL, 29.5138, -98.5907, NULL, NULL),
('742939553', 'TX0001026', 'TX0001026', 'TX01', 'Neurology & Neurophysiology', 'Bruce', 'I', 'Lobar', 'MA', 'Neurology', NULL, NULL, NULL, 'O', '2829 Babcock Rd Ste 425', 'San Antonio', 'Bexar', 'TX', '78229', '2106145242', NULL, '2829 Babcock', 'San Antonio', '', 'TX', '78229', '', '', 'TXORTHO', 'TXHCPCS', NULL, '0.00', '50.00', '0.00', 3, '2007-01-01', '2009-04-28', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '0000007311', 0, 'N', 0, '2007-01-11', NULL, NULL, 29.5138, -98.5907, NULL, NULL),
('742939553', 'TX0001027', 'TX0001027', 'TX01', 'Neurology & Neurophysiology', 'Bruce', 'I', 'Lobar', 'MA', 'Neurology', NULL, NULL, NULL, 'O', '540 Madison Oak Dr Ste 620', 'San Antonio', 'Bexar', 'TX', '78258', '2107986387', NULL, '2829 Babcock', 'San Antonio', '', 'TX', '78229', '', '', 'TXORTHO', 'TXHCPCS', NULL, '0.00', '50.00', '0.00', 3, '2007-01-01', '2009-04-28', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '0000007311', 0, 'N', 0, '2007-01-11', NULL, NULL, 29.6203, -98.4928, NULL, NULL),
('742939553', 'TX0001028', 'TX0001028', 'TX01', 'Neurology & Neurophysiology', 'Yanko', 'A', 'Yankov', 'PHD', 'Neurology', NULL, NULL, NULL, 'O', '540 Madison Oak Dr Ste 620', 'San Antonio', 'Bexar', 'TX', '78258', '2107986387', NULL, '2829 Babcock', 'San Antonio', '', 'TX', '78229', '', '', 'TXORTHO', 'TXHCPCS', NULL, '0.00', '50.00', '0.00', 3, '2007-01-01', '2009-07-01', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '0000009698', 0, 'N', 0, '2007-01-11', NULL, NULL, 29.6203, -98.4928, NULL, NULL),
('742915297', 'TX0001029', 'TX0001029', 'TX01', 'South Texas Oncology & Hematology PA', 'Nena', NULL, 'Mirkovic', 'MD', 'Radiation Oncology', NULL, NULL, NULL, 'O', '155 E Sonterra Blvd Ste 200', 'San Antonio', 'Bexar', 'TX', '78258', '2104040606', NULL, '7979 Wurzbach Rd', 'San Antonio', '', 'TX', '78229', '', '', 'TXONCOL', 'TXHCPCS', NULL, '0.00', '50.00', NULL, 3, '2007-01-01', '2007-01-01', 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '7641', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('742915297', 'TX0001030', 'TX0001030', 'TX01', 'South Texas Oncology and Hematology', 'Lon', 'S', 'Smith', 'MD', 'Hematology and Oncology', 'Oncology', '', NULL, 'O', '8215 Ewing Halsell', 'San Antonio', 'Bexar', 'TX', '78229', '2106165700', NULL, '8215 Ewing Halsel', 'San Antonio', 'Bexar', 'TX', '78229', '2106165700', '', 'TXONCOL', 'TXHCPCS', NULL, '0.00', '50.00', '0.00', 3, '2007-01-01', NULL, 0, 0, 0, 'North East Baptist Hospital', NULL, NULL, NULL, 'HCFA|UB|', '0000008767', 0, 'N', 0, '2013-01-23', NULL, NULL, 29.5161, -98.5768, NULL, NULL),
('742915297', 'TX0001031', 'TX0001031', 'TX01', 'South Texas Oncology & Hematology PA', 'Maria', 'A', 'Sosa', 'MD', 'Hematology and Oncology', NULL, NULL, NULL, 'O', '155 E Sonterra Blvd Ste 200', 'San Antonio', 'Bexar', 'TX', '78258', '2104040606', NULL, '7979 Wurzbach Rd', 'San Antonio', '', 'TX', '78229', '', '', 'TXONCOL', 'TXHCPCS', NULL, '0.00', '50.00', NULL, 3, '2007-01-01', '2007-08-01', 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', NULL, 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('742083988', 'TX0001032', 'TX0001032', 'TX01', 'Renal Associates', 'Irfan', NULL, 'Aqha-Sakdc', 'MD', 'Nephrology', NULL, NULL, NULL, 'O', '8042 Wurzbach Rd Ste 500', 'San Antonio', 'Bexar', 'TX', '78229', '2106927228', NULL, '7434 Louis Pasteur Dr', 'San Antonio', '', 'TX', '78229', '', '', 'TXSTD', 'TXHCPCS', NULL, '0.00', '50.00', '0.00', 3, '2007-01-01', '2008-06-01', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '0000005067', 0, 'N', 0, '2007-01-18', NULL, NULL, 29.5151, -98.5765, NULL, NULL),
('742083988', 'TX0001033', 'TX0001033', 'TX01', 'Renal Associates', 'Lisa', 'O', 'Cabrera', 'MD', 'Nephrology', '', '', NULL, 'O', '497 10th St Ste 102', 'Floresville', 'Wilson', 'TX', '78114', '8303931750', NULL, '497 10th St Ste 102', 'Floresville', 'Wilson', 'TX', '78114', '8303931750', '', 'TXSTD', 'TXHCPCS', NULL, '0.00', '50.00', '0.00', 3, '2007-01-01', '2012-08-19', 0, 0, 0, 'Mission Trail Baptist Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1811962723', 0, 'N', 0, '2013-05-24', NULL, NULL, 29.1502, -98.1628, NULL, NULL),
('742083988', 'TX0001034', 'TX0001034', 'TX01', 'Renal Associates', 'Lisa', 'O', 'Cabrera', 'MD', 'Nephrology', '', '', NULL, 'O', '4242 E Southcross Blvd Ste 16', 'San Antonio', 'Bexar', 'TX', '78222', '2103597888', NULL, '4242 E Southcross Blvd Ste 16', 'San Antonio', 'Bexar', 'TX', '78222', '2103597888', '', 'TXSTD', 'TXHCPCS', NULL, '0.00', '50.00', '0.00', 3, '2007-01-01', '2012-08-19', 0, 0, 0, 'Mission Trail Baptist Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1811962723', 0, 'N', 0, '2013-05-24', NULL, NULL, 29.374, -98.4109, NULL, NULL),
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('742503534', 'TX0001071', 'TX0001071', 'TX01', 'South Texas Spinal Clinic', 'Jerjis', 'J', 'Denno', 'MD', 'Orthopedic Surgery', '', '', NULL, 'O', '1406 E Houston St', 'Beeville', 'Bee', 'TX', '78102', '2106146432', NULL, '1406 E Houston St', 'Beeville', 'Bee', 'TX', '78102', '2106146432', '', 'TXNEURO', 'TXHCPCS', NULL, '0.00', '50.00', '0.00', 3, '2007-03-01', '2012-08-19', 0, 0, 0, 'Baptist Medical Center', '', '', '', 'HCFA|UB|', '1033186515', 0, 'N', 0, '2013-07-10', NULL, NULL, 0, 0, NULL, NULL),
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('743015679', 'TX0001091', 'TX0001091', 'TX01', 'Admit PA', 'Dominic', '', 'Meza', 'MD', 'Internal Medicine', '', '', NULL, 'O', '18850 Redland Rd', 'San Antonio', 'Bexar', 'TX', '78259', '2105765299', NULL, '18850 Redland Rd', 'San Antonio', 'Bexar', 'TX', '78259', '2105765299', '', 'TXSTD', 'TXHCPCS', NULL, '0.00', '50.00', '0.00', 3, '2007-03-01', '2012-08-19', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '0000007588', 0, 'N', 0, '2012-09-04', NULL, NULL, 0, 0, NULL, NULL),
('743015679', 'TX0001092', 'TX0001092', 'TX01', 'Admit PA', 'Dominic', '', 'Meza', 'MD', 'Internal Medicine', '', '', NULL, 'B', 'PO Box 701154', 'San Antonio', 'Bexar', 'TX', '78270', '2105765299', NULL, 'PO Box 701154', 'San Antonio', 'Bexar', 'TX', '78270', '2105765299', '', 'TXSTD', 'TXHCPCS', NULL, '0.00', '50.00', '0.00', 3, '2007-03-01', '2012-08-19', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '0000007588', 0, 'Y', 0, '2012-09-04', NULL, NULL, 0, 0, NULL, NULL);
INSERT INTO `providers_new` (`Provider_Tax_ID`, `Provider_Suffix`, `Provider_Network_ID`, `Provider_Region`, `Provider_Name`, `Provider_Doctor_First_Name`, `Provider_Doctor_Middle_Name`, `Provider_Doctor_Last_Name`, `Provider_Doctor_Degree`, `Provider_Specialty_1`, `Provider_Specialty_2`, `Provider_Specialty_3`, `Provider_Specialty_4`, `Provider_Address_Type`, `Provider_Address`, `Provider_City`, `Provider_County`, `Provider_State`, `Provider_Zip`, `Provider_Phone`, `Provider_Fax`, `Provider_Mailing_Address`, `Provider_Mailing_City`, `Provider_Mailing_County`, `Provider_Mailing_State`, `Provider_Mailing_Zip`, `Provider_Mailing_Phone`, `Provider_Mailing_Fax`, `Provider_Primary_Schedule`, `Provider_Secondary_Schedule`, `Provider_Rate_Sheet`, `Provider_Anes_Rate`, `Provider_Default_Rate`, `Provider_Max_DOS`, `Provider_Min_Match_Value`, `Provider_Effective_Date`, `Provider_Term_Date`, `Provider_Pend`, `Provider_Anes_Minutes`, `Provider_PPO`, `Provider_Hospital_1`, `Provider_Hospital_2`, `Provider_Hospital_3`, `Provider_Hospital_4`, `Provider_Type`, `Provider_NPI`, `Provider_Check_Override`, `Exclude_Dir`, `Audit_Status`, `Last_Change_Date`, `Medicare_ID`, `Provider_Lang`, `Provider_Latitude`, `Provider_Longitude`, `Provider_school`, `Provider_cert`) VALUES
('743015679', 'TX0001093', 'TX0001093', 'TX01', 'Admit PA', 'William', '', 'Mallott', 'MD', 'Internal Medicine', '', '', NULL, 'O', '18850 Redland Rd', 'San Antonio', 'Bexar', 'TX', '78259', '2105765299', NULL, '18850 Redland Rd', 'San Antonio', 'Bexar', 'TX', '78259', '2105765299', '', 'TXSTD', 'TXHCPCS', NULL, '0.00', '50.00', '0.00', 3, '2007-03-01', '2012-08-19', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '0000007408', 0, 'N', 0, '2012-09-04', NULL, NULL, 0, 0, NULL, NULL),
('743015679', 'TX0001094', 'TX0001094', 'TX01', 'Admit PA', 'William', '', 'Mallott', 'MD', 'Internal Medicine', '', '', NULL, 'B', 'PO Box 701154', 'San Antonio', 'Bexar', 'TX', '78270', '2105765299', NULL, 'PO Box 701154', 'San Antonio', 'Bexar', 'TX', '78270', '2105765299', '', 'TXSTD', 'TXHCPCS', NULL, '0.00', '50.00', '0.00', 3, '2007-03-01', '2012-08-19', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '0000007408', 0, 'Y', 0, '2012-09-04', NULL, NULL, 0, 0, NULL, NULL),
('743015679', 'TX0001095', 'TX0001095', 'TX01', 'Admit PA', 'Minh', '', 'Do', 'MD', 'Internal Medicine', '', '', NULL, 'O', '18850 Redland Rd', 'San Antonio', 'Bexar', 'TX', '78259', '2105765299', NULL, '18850 Redland Rd', 'San Antonio', 'Bexar', 'TX', '78259', '2105765299', '', 'TXSTD', 'TXHCPCS', NULL, '0.00', '50.00', '0.00', 3, '2007-03-01', '2012-08-19', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '0000005996', 0, 'N', 0, '2012-09-04', NULL, NULL, 0, 0, NULL, NULL),
('743015679', 'TX0001096', 'TX0001096', 'TX01', 'Admit PA', 'Minh', '', 'Do', 'MD', 'Internal Medicine', '', '', NULL, 'B', 'PO Box 701154', 'San Antonio', 'Bexar', 'TX', '78270', '2105765299', NULL, 'PO Box 701154', 'San Antonio', 'Bexar', 'TX', '78270', '2105765299', '', 'TXSTD', 'TXHCPCS', NULL, '0.00', '50.00', '0.00', 3, '2007-03-01', '2012-08-19', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '0000005996', 0, 'Y', 0, '2012-09-04', NULL, NULL, 0, 0, NULL, NULL),
('743015679', 'TX0001097', 'TX0001097', 'TX01', 'Admit PA', 'Brian', '', 'Gould', 'MD', 'Internal Medicine', '', '', NULL, 'O', '18850 Redland Rd', 'San Antonio', 'Bexar', 'TX', '78259', '2105765299', NULL, '18850 Redland Rd', 'San Antonio', 'Bexar', 'TX', '78259', '2105765299', '', 'TXSTD', 'TXHCPCS', NULL, '0.00', '50.00', '0.00', 3, '2007-03-01', '2012-08-19', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '0000006462', 0, 'N', 0, '2012-09-04', NULL, NULL, 0, 0, NULL, NULL),
('743015679', 'TX0001098', 'TX0001098', 'TX01', 'Admit PA', 'Brian', '', 'Gould', 'MD', 'Internal Medicine', '', '', NULL, 'B', 'PO Box 701154', 'San Antonio', 'Bexar', 'TX', '78270', '2105765299', NULL, 'PO Box 701154', 'San Antonio', 'Bexar', 'TX', '78270', '2105765299', '', 'TXSTD', 'TXHCPCS', NULL, '0.00', '50.00', '0.00', 3, '2007-03-01', '2012-08-19', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '0000006462', 0, 'Y', 0, '2012-09-04', NULL, NULL, 0, 0, NULL, NULL),
('743015679', 'TX0001099', 'TX0001099', 'TX01', 'Admit PA', 'Vanessa', 'Bernal', 'Smeberg', 'MD', 'Internal Medicine', '', '', NULL, 'O', '18850 Redland Rd', 'San Antonio', 'Bexar', 'TX', '78259', '2105765299', NULL, '18850 Redland Rd', 'San Antonio', 'Bexar', 'TX', '78259', '2105765299', '', 'TXSTD', 'TXHCPCS', NULL, '0.00', '50.00', '0.00', 3, '2007-03-01', '2012-08-19', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '0000008749', 0, 'N', 0, '2013-05-09', NULL, NULL, 0, 0, NULL, NULL),
('743015679', 'TX0001100', 'TX0001100', 'TX01', 'Admit PA', 'Vanessa', 'Bernal', 'Smeberg', 'MD', 'Internal Medicine', '', '', NULL, 'B', 'PO Box 701154', 'San Antonio', 'Bexar', 'TX', '78270', '2105765299', NULL, 'PO Box 701154', 'San Antonio', 'Bexar', 'TX', '78270', '2105765299', '', 'TXSTD', 'TXHCPCS', NULL, '0.00', '50.00', '0.00', 3, '2007-03-01', '2012-08-19', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '0000008749', 0, 'Y', 0, '2013-05-09', NULL, NULL, 0, 0, NULL, NULL),
('743015679', 'TX0001101', 'TX0001101', 'TX01', 'Admit PA', 'Judy', '', 'Shumway', 'MD', 'Internal Medicine', '', '', NULL, 'O', '18850 Redland Rd', 'San Antonio', 'Bexar', 'TX', '78259', '2105765299', NULL, '18850 Redland Rd', 'San Antonio', 'Bexar', 'TX', '78259', '2105765299', '', 'TXSTD', 'TXHCPCS', NULL, '0.00', '50.00', '0.00', 3, '2007-03-01', '2012-08-19', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '0000008711', 0, 'N', 0, '2013-05-09', NULL, NULL, 0, 0, NULL, NULL),
('743015679', 'TX0001102', 'TX0001102', 'TX01', 'Admit PA', 'Judy', '', 'Shumway', 'MD', 'Internal Medicine', '', '', NULL, 'B', 'PO Box 701154', 'San Antonio', 'Bexar', 'TX', '78270', '2105765299', NULL, 'PO Box 701154', 'San Antonio', 'Bexar', 'TX', '78270', '2105765299', '', 'TXSTD', 'TXHCPCS', NULL, '0.00', '50.00', '0.00', 3, '2007-03-01', '2012-08-19', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '0000008711', 0, 'Y', 0, '2013-05-09', NULL, NULL, 0, 0, NULL, NULL),
('320056334', 'TX0001103', 'TX0001103', 'TX01', 'Texas Inpatient Physicians Association', '', '', 'Texas Inpatient Physicians Association', '', 'Internal Medicine', '', '', NULL, 'B', '18850 Redland Rd', 'San Antonio', 'Bexar', 'TX', '78259', '2103840011', NULL, '18850 Redland Rd', 'San Antonio', 'Bexar', 'TX', '78259', '2103840011', '', 'TXSTD', 'TXHCPCS', NULL, '0.00', '50.00', '0.00', 3, '2007-03-01', '2012-08-19', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '0000009038', 0, 'Y', 0, '2012-08-29', NULL, NULL, 0, 0, NULL, NULL),
('320056334', 'TX0001104', 'TX0001104', 'TX01', 'Texas Inpatient Physicians Association', '', '', 'Texas Inpatient Physicians Association', '', 'Internal Medicine', '', '', NULL, 'B', 'PO Box 701194', 'San Antonio', 'Bexar', 'TX', '78270', '2103840011', NULL, 'PO Box 701194', 'San Antonio', 'Bexar', 'TX', '78270', '2103840011', '', 'TXSTD', 'TXHCPCS', NULL, '0.00', '50.00', '0.00', 3, '2007-03-01', '2012-08-19', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '0000009038', 0, 'Y', 0, '2012-08-29', NULL, NULL, 0, 0, NULL, NULL),
('320056334', 'TX0001105', 'TX0001105', 'TX01', 'Texas Inpatient Physicians Association', 'Marium', '', 'Steele', 'MD', 'Internal Medicine', '', '', NULL, 'O', '18850 Redland Rd', 'San Antonio', 'Bexar', 'TX', '78259', '2103840011', NULL, '18850 Redland Rd', 'San Antonio', 'Bexar', 'TX', '78259', '2103840011', '', 'TXSTD', 'TXHCPCS', NULL, '0.00', '50.00', '0.00', 3, '2007-03-01', '2012-08-19', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '0000008892', 0, 'N', 0, '2012-08-29', NULL, NULL, 0, 0, NULL, NULL),
('320056334', 'TX0001106', 'TX0001106', 'TX01', 'Texas Inpatient Physicians Association', 'Marium', '', 'Steele', 'MD', 'Internal Medicine', '', '', NULL, 'B', 'PO Box 701194', 'San Antonio', 'Bexar', 'TX', '78270', '2103840011', NULL, 'PO Box 701194', 'San Antonio', 'Bexar', 'TX', '78270', '2103840011', '', 'TXSTD', 'TXHCPCS', NULL, '0.00', '50.00', '0.00', 3, '2007-03-01', '2012-08-19', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '0000008892', 0, 'Y', 0, '2012-08-29', NULL, NULL, 0, 0, NULL, NULL),
('320056334', 'TX0001107', 'TX0001107', 'TX01', 'Texas Inpatient Physicians Association', 'Eduard', 'J', 'Uribe', 'MD', 'Internal Medicine', '', '', NULL, 'O', '18850 Redland Rd', 'San Antonio', 'Bexar', 'TX', '78259', '2103840011', NULL, '18850 Redland Rd', 'San Antonio', 'Bexar', 'TX', '78259', '2103840011', '', 'TXSTD', 'TXHCPCS', NULL, '0.00', '50.00', '0.00', 3, '2007-03-01', '2012-08-19', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '0000009337', 0, 'N', 0, '2012-08-29', NULL, NULL, 0, 0, NULL, NULL),
('320056334', 'TX0001108', 'TX0001108', 'TX01', 'Texas Inpatient Physicians Association', 'Eduard', 'J', 'Uribe', 'MD', 'Internal Medicine', '', '', NULL, 'B', 'PO Box 701194', 'San Antonio', 'Bexar', 'TX', '78270', '2103840011', NULL, 'PO Box 701194', 'San Antonio', 'Bexar', 'TX', '78270', '2103840011', '', 'TXSTD', 'TXHCPCS', NULL, '0.00', '50.00', '0.00', 3, '2007-03-01', '2012-08-19', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '0000009337', 0, 'Y', 0, '2012-08-29', NULL, NULL, 0, 0, NULL, NULL),
('320056334', 'TX0001109', 'TX0001109', 'TX01', 'Texas Inpatient Physicians Association', 'Edward', '', 'Sternaman', 'MD', 'Internal Medicine', '', '', NULL, 'O', '18850 Redland Rd', 'San Antonio', 'Bexar', 'TX', '78259', '2103840011', NULL, '18850 Redland Rd', 'San Antonio', 'Bexar', 'TX', '78259', '2103840011', '', 'TXSTD', 'TXHCPCS', NULL, '0.00', '50.00', '0.00', 3, '2007-03-01', '2012-08-19', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '0000008907', 0, 'N', 0, '2012-08-29', NULL, NULL, 0, 0, NULL, NULL),
('320056334', 'TX0001110', 'TX0001110', 'TX01', 'Texas Inpatient Physicians Association', 'Edward', '', 'Sternaman', 'MD', 'Internal Medicine', '', '', NULL, 'B', 'PO Box 701194', 'San Antonio', 'Bexar', 'TX', '78270', '2103840011', NULL, 'PO Box 701194', 'San Antonio', 'Bexar', 'TX', '78270', '2103840011', '', 'TXSTD', 'TXHCPCS', NULL, '0.00', '50.00', '0.00', 3, '2007-03-01', '2012-08-19', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '0000008907', 0, 'Y', 0, '2012-08-29', NULL, NULL, 0, 0, NULL, NULL),
('320056334', 'TX0001111', 'TX0001111', 'TX01', 'Texas Inpatient Physicians Association', 'Cybele', '', 'Mathai', 'MD', 'Internal Medicine', '', '', NULL, 'O', '18850 Redland Rd', 'San Antonio', 'Bexar', 'TX', '78259', '2103840011', NULL, '18850 Redland Rd', 'San Antonio', 'Bexar', 'TX', '78259', '2103840011', '', 'TXSTD', 'TXHCPCS', NULL, '0.00', '50.00', '0.00', 3, '2007-03-01', '2012-08-19', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '0000007470', 0, 'N', 0, '2012-08-29', NULL, NULL, 0, 0, NULL, NULL),
('320056334', 'TX0001112', 'TX0001112', 'TX01', 'Texas Inpatient Physicians Association', 'Cybele', '', 'Mathai', 'MD', 'Internal Medicine', '', '', NULL, 'B', 'PO Box 701194', 'San Antonio', 'Bexar', 'TX', '78270', '2103840011', NULL, 'PO Box 701194', 'San Antonio', 'Bexar', 'TX', '78270', '2103840011', '', 'TXSTD', 'TXHCPCS', NULL, '0.00', '50.00', '0.00', 3, '2007-03-01', '2012-08-19', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '0000007470', 0, 'Y', 0, '2012-08-29', NULL, NULL, 0, 0, NULL, NULL),
('320056334', 'TX0001113', 'TX0001113', 'TX01', 'Texas Inpatient Physicians Association', 'Felipe', '', 'Navas', 'MD', 'Internal Medicine', '', '', NULL, 'O', '18850 Redland Rd', 'San Antonio', 'Bexar', 'TX', '78259', '2103840011', NULL, '18850 Redland Rd', 'San Antonio', 'Bexar', 'TX', '78259', '2103840011', '', 'TXSTD', 'TXHCPCS', NULL, '0.00', '50.00', '0.00', 3, '2007-03-01', '2012-08-19', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '0000007796', 0, 'N', 0, '2012-08-29', NULL, NULL, 0, 0, NULL, NULL),
('320056334', 'TX0001114', 'TX0001114', 'TX01', 'Texas Inpatient Physicians Association', 'Felipe', '', 'Navas', 'MD', 'Internal Medicine', '', '', NULL, 'B', 'PO Box 701194', 'San Antonio', 'Bexar', 'TX', '78270', '2103840011', NULL, 'PO Box 701194', 'San Antonio', 'Bexar', 'TX', '78270', '2103840011', '', 'TXSTD', 'TXHCPCS', NULL, '0.00', '50.00', '0.00', 3, '2007-03-01', '2012-08-19', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '0000007796', 0, 'Y', 0, '2012-08-29', NULL, NULL, 0, 0, NULL, NULL),
('320056334', 'TX0001115', 'TX0001115', 'TX01', 'Texas Inpatient Physicians Association', 'Connor', '', 'Chase', 'MD', 'Internal Medicine', '', '', NULL, 'O', '18850 Redland Rd', 'San Antonio', 'Bexar', 'TX', '78259', '2103840011', NULL, '18850 Redland Rd', 'San Antonio', 'Bexar', 'TX', '78259', '2103840011', '', 'TXSTD', 'TXHCPCS', NULL, '0.00', '50.00', '0.00', 3, '2007-03-01', '2012-08-19', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '0000005653', 0, 'N', 0, '2012-08-29', NULL, NULL, 0, 0, NULL, NULL),
('320056334', 'TX0001116', 'TX0001116', 'TX01', 'Texas Inpatient Physicians Association', 'Connor', '', 'Chase', 'MD', 'Internal Medicine', '', '', NULL, 'B', 'PO Box 701194', 'San Antonio', 'Bexar', 'TX', '78270', '2103840011', NULL, 'PO Box 701194', 'San Antonio', 'Bexar', 'TX', '78270', '2103840011', '', 'TXSTD', 'TXHCPCS', NULL, '0.00', '50.00', '0.00', 3, '2007-03-01', '2012-08-19', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '0000005653', 0, 'Y', 0, '2012-08-29', NULL, NULL, 0, 0, NULL, NULL),
('451987143', 'TX0001117', 'TX0001117', 'TX01', 'Toyota Family Health Center', 'James', 'D', 'Ramos', 'PA-C', 'Family Practice', NULL, NULL, NULL, 'O', '1 Lone Star Pass Bldg 46', 'San Antonio', 'Bexar', 'TX', '78264', '2102635700', NULL, '1 Lone Star Pass Bldg 46', 'San Antonio', '', 'TX', '78264', '', '', 'TXSTD', 'TXHCPCS', NULL, '0.00', '50.00', '0.00', 3, '2007-03-01', '2009-11-02', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '0000008315', 0, 'N', 0, '2007-03-08', NULL, NULL, 0, 0, NULL, NULL),
('742997354', 'TX0001119', 'TX0001119', 'TX01', 'Texas Plastic Surgery', 'Jaime', 'R', 'Garza', 'MD DDS PA', 'Plastic Surgery', NULL, NULL, NULL, 'O', '21 Spurs Ln Ste 120', 'San Antonio', 'Bexar', 'TX', '78240', '2106160301', NULL, '2829 Babcock', 'San Antonio', '', 'TX', '78229', '', '', 'TXSURGA', 'TXHCPCS', NULL, '0.00', '50.00', '0.00', 3, '2007-04-01', '2012-08-19', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1689678575', 0, 'N', 0, '2007-10-03', NULL, NULL, 29.5271, -98.5917, NULL, NULL),
('200163261', 'TX0001120', 'TX0001120', 'TX01', NULL, 'Daniel', '', 'Hyun', 'MD', 'Neurology', '', '', NULL, 'O', '315 N San Saba Ste 1110', 'San Antonio', 'Bexar', 'TX', '78207', '2102263326', NULL, '315 N San Saba Ste 1110', 'San Antonio', 'Bexar', 'TX', '78207', '2102263326', '', 'TXSURGD', 'TXHCPCS', NULL, '0.00', '50.00', '0.00', 3, '2007-03-01', '2012-08-19', 0, 0, 0, 'Baptist Medical Center', '', '', '', 'HCFA|UB|', '1902087240', 0, 'N', 0, '2014-03-25', NULL, NULL, 29.4279, -98.5002, NULL, NULL),
('200163261', 'TX0001121', 'TX0001121', 'TX01', NULL, 'Daniel', '', 'Hyun', 'MD', 'Neurology', '', '', NULL, 'O', '31 Stone Wall Bend', 'San Antonio', 'Bexar', 'TX', '78256', '2102263326', NULL, '31 Stone Wall Bend', 'San Antonio', 'Bexar', 'TX', '78256', '2102263326', '', 'TXSURGD', 'TXHCPCS', NULL, '0.00', '50.00', '0.00', 3, '2007-03-01', '2012-08-19', 0, 0, 0, 'Baptist Medical Center', '', '', '', 'HCFA|UB|', '1902087240', 0, 'N', 0, '2014-03-25', NULL, NULL, 0, 0, NULL, NULL),
('203940074', 'TX0001122', 'TX0001122', 'TX01', 'Childrens Critical Care of San Antonio PA', 'John', 'M', 'Marcum', 'MD', 'Internal Medicine', '', '', NULL, 'O', '520 Madison Oak', 'San Antonio', 'Bexar', 'TX', '78258', '2107858282', NULL, '1150 N Loop 1604 W', 'San Antonio', 'Bexar', 'TX', '78248', '2107858282', '', 'TXINTB', 'TXHCPCS', NULL, '0.00', '50.00', '0.00', 3, '2007-03-01', '2009-07-22', NULL, 0, 0, '', '', '', '', 'HCFA|UB|', '0000007424', 0, 'Y', 0, '2011-07-08', NULL, NULL, 0, 0, NULL, NULL),
('203940074', 'TX0001123', 'TX0001123', 'TX01', 'Childrens Critical Care of San Antonio PA', 'John', 'M', 'Marcum', 'MD', 'Internal Medicine', '', '', NULL, 'O', '1150 N Loop 1604 W Ste 108-474', 'San Antonio', 'Bexar', 'TX', '78248', '2107858282', NULL, '1150 N Loop 1604 W', 'San Antonio', 'Bexar', 'TX', '78248', '2107858282', '', 'TXINTB', 'TXHCPCS', NULL, '0.00', '50.00', '0.00', 3, '2007-03-01', '2009-07-22', NULL, 0, 0, '', '', '', '', 'HCFA|UB|', '0000007424', 0, 'Y', 0, '2011-07-08', NULL, NULL, 0, 0, NULL, NULL),
('742975191', 'TX0001124', 'TX0001124', 'TX01', NULL, 'Yolanda', '', 'Marcos', 'MD', 'Internal Medicine', '', '', NULL, 'O', '510 Med Ct Ste 210', 'San Antonio', 'Bexar', 'TX', '78258', '2104944290', NULL, '510 Med Ct Ste 210', 'San Antonio', 'Bexar', 'TX', '78258', '2104944290', '', 'TXINT', 'TXHCPCS', NULL, '0.00', '50.00', '0.00', 3, '2007-04-01', '2012-08-19', 0, 0, 0, 'Baptist Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1104845445', 0, 'N', 0, '2013-01-30', NULL, NULL, 29.6248, -98.4928, NULL, NULL),
('742975191', 'TX0001125', 'TX0001125', 'TX01', NULL, 'Yolanda', '', 'Marcos', 'MD', 'Internal Medicine', '', '', NULL, 'B', 'PO Box 659506', 'San Antonio', 'Bexar', 'TX', '78265', '2104944290', NULL, 'PO Box 659506', 'San Antonio', 'Bexar', 'TX', '78265', '2104944290', '', 'TXINT', 'TXHCPCS', NULL, '0.00', '50.00', '0.00', 3, '2007-04-01', '2012-08-19', 0, 0, 0, 'Baptist Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1104845445', 0, 'Y', 0, '2013-01-30', NULL, NULL, 0, 0, NULL, NULL),
('742145952', 'TX0001126', 'TX0001126', 'TX01', 'Endocrinology-Nuclear Medicine Associates PA', '', '', 'Endocrinology-Nuclear Medicine Associates PA', 'MD', 'Endocrinology', '', '', NULL, 'O', '1303 McCullough Ave Ste 374', 'San Antonio', 'Bexar', 'TX', '78212', '2102235483', NULL, '1303 McCullough Ave Ste 374', 'San Antonio', 'Bexar', 'TX', '78212', '2102235483', '', 'TXSTD', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2007-04-01', '2012-08-19', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '0000006128', 0, 'N', 0, '2014-07-08', NULL, NULL, 29.4412, -98.4924, NULL, NULL),
('742145952', 'TX0001127', 'TX0001127', 'TX01', 'Endocrinology-Nuclear Medicine Associates PA', 'Richard', 'A', 'Becker', 'MD', 'Endocrinology', '', '', NULL, 'O', '1303 McCullough Ave Ste 374', 'San Antonio', 'Bexar', 'TX', '78212', '2102235483', NULL, '1303 McCullough Ave Ste 374', 'San Antonio', 'Bexar', 'TX', '78212', '2102235483', '', 'TXSTD', 'TXHCPCS', NULL, '0.00', '50.00', '0.00', 3, '2007-04-01', '2012-08-19', 0, 0, 0, 'Baptist Medical Center', '', '', '', 'HCFA|UB|', '1306985676', 0, 'N', 0, '2012-08-20', NULL, NULL, 29.4412, -98.4924, NULL, NULL),
('742145952', 'TX0001128', 'TX0001128', 'TX01', 'Endocrinology-Nuclear Medicine Associates PA', 'Harry', 'L', 'Uy', 'MD', 'Endocrinology', '', '', NULL, 'O', '1303 McCullough Ave Ste 374', 'San Antonio', 'Bexar', 'TX', '78212', '2102235483', NULL, '1303 McCullough Ave Ste 374', 'San Antonio', 'Bexar', 'TX', '78212', '2102235483', '', 'TXSTD', 'TXHCPCS', NULL, '0.00', '50.00', '0.00', 3, '2007-04-01', '2012-08-19', 0, 0, 0, 'Baptist Medical Center', '', '', '', 'HCFA|UB|', '1962541466', 0, 'N', 0, '2012-06-01', NULL, NULL, 29.4412, -98.4924, NULL, NULL),
('742145952', 'TX0001129', 'TX0001129', 'TX01', 'Endocrinology-Nuclear Medicine Associates PA', 'Robert ', 'F', 'Dons', 'MD', 'Endocrinology', '', '', NULL, 'O', '1303 McCullough Ave Ste 374', 'San Antonio', 'Bexar', 'TX', '78212', '2102235483', NULL, '1303 McCullough Ave Ste 374', 'San Antonio', 'Bexar', 'TX', '78212', '2102235483', '', 'TXSTD', 'TXHCPCS', NULL, '0.00', '50.00', '0.00', 3, '2007-04-01', '2012-08-19', 0, 0, 0, 'Baptist Medical Center', '', '', '', 'HCFA|UB|', '1508905928', 0, 'N', 0, '2012-08-20', NULL, NULL, 29.4412, -98.4924, NULL, NULL),
('742145952', 'TX0001130', 'TX0001130', 'TX01', 'Endocrinology-Nuclear Medicine Associates PA', 'Bryan', 'M', 'Kahl', 'MD', 'Endocrinology', NULL, NULL, NULL, 'O', '1303 McCullough Ave Ste 374', 'San Antonio', 'Bexar', 'TX', '78212', '2102235483', NULL, '1303 McCullough Ave', 'San Antonio', '', 'TX', '78212', '', '', 'TXSTD', 'TXHCPCS', NULL, '0.00', '50.00', '0.00', 3, '2007-04-01', '2008-08-15', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '0000007022', 0, 'N', 0, '2007-03-08', NULL, NULL, 29.4412, -98.4924, NULL, NULL),
('742145952', 'TX0001131', 'TX0001131', 'TX01', 'Endocrinology-Nuclear Medicine Associates PA', 'Nancy', 'A', 'Lee', 'MD', 'Endocrinology', '', '', NULL, 'O', '1303 McCullough Ave Ste 374', 'San Antonio', 'Bexar', 'TX', '78212', '2102235483', NULL, '1303 McCullough Ave Ste 374', 'San Antonio', 'Bexar', 'TX', '78212', '2102235483', '', 'TXSTD', 'TXHCPCS', NULL, '0.00', '50.00', '0.00', 3, '2007-04-01', '2012-08-19', 0, 0, 0, 'Baptist Medical Center', '', '', '', 'HCFA|UB|', '1922147271', 0, 'N', 0, '2012-05-31', NULL, NULL, 29.4412, -98.4924, NULL, NULL),
('760714523', 'TX0001132', 'TX0001132', 'TX01', 'Baptist Medical Center', '', '', 'Baptist Medical Center', '', 'Hospital', '', '', NULL, 'B', 'PO Box 848333', 'Dallas', 'Dallas', 'TX', '75284', '2102977000', NULL, 'PO Box 848333', 'Dallas', 'Dallas', 'TX', '75284', '2102977000', '          ', '', '', 'Baptist', '0.00', '100.00', '0.00', 3, '2007-01-01', '2012-08-29', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '0000005181', 0, 'Y', 0, '2013-07-26', NULL, NULL, 0, 0, NULL, NULL),
('760714523', 'TX0001133', 'TX0001133', 'TX01', 'Baptist Medical Center Laboratory', '', '', 'Baptist Medical Center Laboratory', '', 'Laboratory', '', '', NULL, 'B', 'PO Box 848333', 'Dallas', 'Dallas', 'TX', '75284', '2102977000', NULL, 'PO Box 848333', 'Dallas', 'Dallas', 'TX', '75284', '2102977000', '', '', NULL, 'Baptist', '0.00', '100.00', '0.00', 3, '2007-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '0000005182', 0, 'Y', 0, '2013-01-18', NULL, NULL, 0, 0, NULL, NULL),
('760714523', 'TX0001134', 'TX0001134', 'TX01', 'Health Link', NULL, NULL, 'Health Link', 'PT', 'Physical Therapy', NULL, NULL, NULL, 'B', 'PO Box 848333', 'Dallas', 'Dallas', 'TX', '75284', '2102977000', NULL, NULL, NULL, '', NULL, NULL, '', '', '', NULL, 'Baptist', '0.00', '100.00', '0.00', 3, '2007-01-01', NULL, 1, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '0000006633', 0, 'Y', 0, '2007-03-13', NULL, NULL, 0, 0, NULL, NULL),
('760714523', 'TX0001135', 'TX0001135', 'TX01', 'Healthy Womens Center', '', '', 'Healthy Women''s Center', '', 'Laboratory', NULL, NULL, NULL, 'B', 'PO Box 848333', 'Dallas', 'Dallas', 'TX', '75284', '2102977000', NULL, '615 Soledad', 'San Antonio', '', 'TX', '78205', '', '', '', NULL, 'Baptist', '0.00', '100.00', '0.00', 3, '2007-01-01', NULL, 1, 0, 0, '', '', '', '', 'HCFA|UB|', '0000006641', 0, 'Y', 0, '2007-03-13', NULL, NULL, 0, 0, NULL, NULL),
('760714523', 'TX0001136', 'TX0001136', 'TX01', 'North Central Baptist Hospital', '', '', 'North Central Baptist Hospital', '', 'Hospital', '', '', NULL, 'B', 'PO Box 848333', 'Dallas', 'Dallas', 'TX', '75284', '2102977000', NULL, 'PO Box 848333', 'Dallas', 'Dallas', 'TX', '75284', '2102977000', '          ', '', '', 'Baptist', '0.00', '100.00', '0.00', 3, '2007-01-01', '2012-08-29', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '0000007900', 0, 'Y', 0, '2012-08-30', NULL, NULL, 0, 0, NULL, NULL),
('760714523', 'TX0001137', 'TX0001137', 'TX01', 'North Central Baptist Hospital Laboratory', '', '', 'North Central Baptist Hospital Laboratory', '', 'Laboratory', '', '', NULL, 'B', 'PO Box 848333', 'Dallas', 'Dallas', 'TX', '75284', '2102977000', NULL, 'PO Box 848333', 'Dallas', 'Dallas', 'TX', '75284', '2102977000', '', '', NULL, 'Baptist', '0.00', '100.00', '0.00', 3, '2007-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '0000007901', 0, 'Y', 0, '2013-01-18', NULL, NULL, 0, 0, NULL, NULL),
('760714523', 'TX0001138', 'TX0001138', 'TX01', 'North East Baptist Hospital', '', '', 'North East Baptist Hospital', '', 'Hospital', '', '', NULL, 'B', 'PO Box 848333', 'Dallas', 'Dallas', 'TX', '75284', '2102977000', NULL, 'PO Box 848333', 'Dallas', 'Dallas', 'TX', '75284', '2102977000', '          ', '', '', 'Baptist', '0.00', '100.00', '0.00', 3, '2007-01-01', '2012-08-29', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '0000007903', 0, 'Y', 0, '2012-08-30', NULL, NULL, 0, 0, NULL, NULL),
('760714523', 'TX0001139', 'TX0001139', 'TX01', 'South East Baptist Hospital', '', '', 'South East Baptist Hospital', '', 'Hospital', '', '', NULL, 'B', 'PO Box 848333', 'Dallas', 'Dallas', 'TX', '75284', '2102977000', NULL, 'PO Box 848333', 'Dallas', 'Dallas', 'TX', '75284', '2102977000', '          ', '', '', 'Baptist', '0.00', '100.00', '0.00', 3, '2007-01-01', '2012-08-29', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '0000008828', 0, 'Y', 0, '2012-11-05', NULL, NULL, 0, 0, NULL, NULL),
('760714523', 'TX0001140', 'TX0001140', 'TX01', 'South East Baptist Hospital Laboratory', '', '', 'South East Baptist Hospital Laboratory', '', 'Laboratory', '', '', NULL, 'B', 'PO Box 848333', 'Dallas', 'Dallas', 'TX', '75284', '2102977000', NULL, 'PO Box 848333', 'Dallas', 'Dallas', 'TX', '75284', '2102977000', '', '', NULL, 'Baptist', '0.00', '100.00', '0.00', 3, '2007-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '0000008829', 0, 'Y', 0, '2013-01-18', NULL, NULL, 0, 0, NULL, NULL),
('760714523', 'TX0001141', 'TX0001141', 'TX01', 'St Lukes Baptist Hospital', '', '', 'St Lukes Baptist Hospital', '', 'Hospital', '', '', NULL, 'B', 'PO Box 848333', 'Dallas', 'Dallas', 'TX', '75284', '2102977000', NULL, 'PO Box 848333', 'Dallas', 'Dallas', 'TX', '75284', '2102977000', '          ', '', '', 'Baptist', '0.00', '100.00', '0.00', 3, '2007-01-01', '2012-08-29', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '0000008874', 0, 'Y', 0, '2012-08-30', NULL, NULL, 0, 0, NULL, NULL),
('760714523', 'TX0001142', 'TX0001142', 'TX01', 'Womens Health Center', '', '', 'Women''s Health Center', '', 'Laboratory', NULL, NULL, NULL, 'B', 'PO Box 848333', 'Dallas', 'Dallas', 'TX', '75284', '2102977000', NULL, '615 Soledad', 'San Antonio', '', 'TX', '78205', '', '', '', NULL, 'Baptist', '0.00', '100.00', '0.00', 3, '2007-01-01', NULL, 1, 0, 0, '', '', '', '', 'HCFA|UB|', '0000009662', 0, 'Y', 0, '2007-03-13', NULL, NULL, 0, 0, NULL, NULL),
('331082073', 'TX0001143', 'TX0001143', 'TX01', 'VHS San Antonio Imaging', '', '', 'VHS San Antonio Imaging', 'Group', 'Imaging Center', 'Radiology', '', NULL, 'B', 'PO Box 849553', 'Dallas', 'Dallas', 'TX', '75284', '2103510784', NULL, 'PO Box 849553', 'Dallas', 'Dallas', 'TX', '75284', '2103510784', '          ', 'TXIMAG', '', '', '0.00', '40.00', '0.00', 3, '2007-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1457350993', 0, 'Y', 0, '2013-10-07', NULL, NULL, 0, 0, NULL, NULL),
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('331082073', 'TX0001145', 'TX0001145', 'TX01', 'North Central Baptist Imaging Center', NULL, NULL, 'North Central Baptist Imaging Center', 'Group', 'Imaging Center', 'Radiology', NULL, NULL, 'B', 'PO Box 849553', 'Dallas', 'Dallas', 'TX', '75284', '2104031600', NULL, '615 Soledad', 'San Antonio', '', 'TX', '78205', '', '', 'TXIMAG', NULL, NULL, '0.00', '50.00', NULL, 3, '2007-01-01', '2007-01-01', 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', NULL, 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('331082073', 'TX0001146', 'TX0001146', 'TX01', 'Northeast Baptist Imaging Center', NULL, NULL, 'Northeast Baptist Imaging Center', 'Group', 'Imaging Center', 'Radiology', NULL, NULL, 'B', 'PO Box 849553', 'Dallas', 'Dallas', 'TX', '75284', '2105905822', NULL, '615 Soledad', 'San Antonio', '', 'TX', '78205', '', '', 'TXIMAG', NULL, NULL, '0.00', '50.00', NULL, 3, '2007-01-01', '2007-01-01', 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', NULL, 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('331082073', 'TX0001147', 'TX0001147', 'TX01', 'Southeast Baptist Imaging Center', NULL, NULL, 'Southeast Baptist Imaging Center', 'Group', 'Imaging Center', 'Radiology', NULL, NULL, 'B', 'PO Box 849553', 'Dallas', 'Dallas', 'TX', '75284', '2103043430', NULL, '615 Soledad', 'San Antonio', '', 'TX', '78205', '', '', 'TXIMAG', NULL, NULL, '0.00', '50.00', NULL, 3, '2007-01-01', '2007-01-01', 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', NULL, 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('200075829', 'TX0001148', 'TX0001148', 'TX01', 'San Antonio Gastroenterology Endoscopy Center', '', '', 'San Antonio Gastroenterology Endoscopy Center', 'Group', 'Endoscopy Center', '', '', NULL, 'O', '520 E Euclid Ave', 'San Antonio', 'Bexar', 'TX', '78212', '2102710606', NULL, '520 E Euclid Ave', 'San Antonio', 'Bexar', 'TX', '78212', '2102710606', '          ', '', '', 'OP-1', '0.00', '100.00', '0.00', 3, '2007-01-01', '2012-09-19', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '0000008566', 0, 'N', 0, '2013-04-30', NULL, NULL, 29.4394, -98.4894, NULL, NULL),
('200075829', 'TX0001149', 'TX0001149', 'TX01', 'San Antonio Gastroenterology Endoscopy Center', '', '', 'San Antonio Gastroenterology Endoscopy Center', 'Group', 'Endoscopy Center', '', '', NULL, 'B', 'PO Box 849932', 'Dallas', 'Dallas', 'TX', '75284', '2102710606', NULL, 'PO Box 849932', 'Dallas', 'Dallas', 'TX', '75284', '2102710606', '          ', '', '', 'OP-1', '0.00', '100.00', '0.00', 3, '2007-01-01', '2012-09-19', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '0000008566', 0, 'Y', 0, '2013-04-30', NULL, NULL, 0, 0, NULL, NULL),
('742898805', 'TX0001150', 'TX0001150', 'TX01', 'Surgical Consultants of San Antonio', 'John', '', 'Pilcher', 'MD', 'General Surgery', '', '', NULL, 'O', '2829 Babcock Rd Ste 415', 'San Antonio', 'Bexar', 'TX', '78229', '2106143370', NULL, '2833 Babcock Ste 415', 'San Antonio', 'Bexar', 'TX', '78229', '2106143370', '', 'TXSURGA', 'TXHCPCS', NULL, '0.00', '50.00', '0.00', 3, '2007-01-01', '2008-03-19', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '0000008202', 0, 'N', 0, '2010-09-07', NULL, NULL, 29.5138, -98.5907, NULL, NULL),
('742625722', 'TX0001151', 'TX0001151', 'TX01', 'Alamo ENT Associates', 'William', 'W', 'Gordon', 'MD', 'Ear, Nose and Throat', 'Pediatric Ear, Nose and Throat', '', NULL, 'B', 'PO Box 2679', 'San Antonio', 'Bexar', 'TX', '78229', '2106160096', NULL, 'PO Box 2679', 'San Antonio', 'Bexar', 'TX', '78229', '2106160096', '', 'TXSURGB', 'TXHCPCS', NULL, '0.00', '50.00', '0.00', 3, '2007-01-01', '2012-08-19', 0, 0, 0, 'Baptist Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1205844297', 0, 'Y', 0, '2013-04-04', NULL, NULL, 0, 0, NULL, NULL),
('742625722', 'TX0001152', 'TX0001152', 'TX01', 'Alamo ENT Associates', 'Cary', 'E', 'Stratton', 'MD', 'Ear, Nose and Throat', '', '', NULL, 'B', 'PO Box 2679', 'San Antonio', 'Bexar', 'TX', '78229', '2106160096', NULL, 'PO Box 2679', 'San Antonio', 'Bexar', 'TX', '78229', '2106160096', '', 'TXSURGB', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2007-01-01', '2012-08-19', 0, 0, 0, 'Baptist Medical Center', '', '', '', 'HCFA|UB|', '1578571568', 0, 'Y', 0, '2014-07-17', NULL, NULL, 0, 0, NULL, NULL),
('742625722', 'TX0001153', 'TX0001153', 'TX01', 'Alamo ENT Associates', 'Thomas', 'W', 'Nau', 'MD', 'Ear, Nose and Throat', 'Pediatric Ear, Nose and Throat', '', NULL, 'B', 'PO Box 2679', 'San Antonio', 'Bexar', 'TX', '78229', '2106160096', NULL, 'PO Box 2679', 'San Antonio', 'Bexar', 'TX', '78229', '2106160096', '', 'TXSURGB', 'TXHCPCS', NULL, '0.00', '50.00', '0.00', 3, '2007-01-01', '2012-08-19', 0, 0, 0, 'Baptist Medical Center', 'North East Baptist Hospital', NULL, NULL, 'HCFA|UB|', '1942218938', 0, 'Y', 0, '2013-04-04', NULL, NULL, 0, 0, NULL, NULL),
('742625722', 'TX0001154', 'TX0001154', 'TX01', 'Alamo ENT Associates', 'William', 'C', 'Smith', 'MD', 'Ear, Nose and Throat', '', '', NULL, 'B', 'PO Box 2679', 'San Antonio', 'Bexar', 'TX', '78229', '2106160096', NULL, 'PO Box 2679', 'San Antonio', 'Bexar', 'TX', '78229', '2106160096', '', 'TXSURGB', 'TXHCPCS', NULL, '0.00', '50.00', '0.00', 3, '2007-01-01', '2012-08-19', 0, 0, 0, 'North East Baptist Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1336140680', 0, 'Y', 0, '2013-05-28', NULL, NULL, 0, 0, NULL, NULL),
('742625722', 'TX0001155', 'TX0001155', 'TX01', 'Alamo ENT Associates', 'Jeffrey', 'S', 'Rosenbloom', 'MD', 'Ear, Nose and Throat', 'Pediatric Ear, Nose and Throat', '', NULL, 'B', 'PO Box 2679', 'San Antonio', 'Bexar', 'TX', '78229', '2106160096', NULL, 'PO Box 2679', 'San Antonio', 'Bexar', 'TX', '78229', '2106160096', '', 'TXSURGB', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2007-01-01', '2012-08-19', 0, 0, 0, 'North East Baptist Hospital', '', '', '', 'HCFA|UB|', '1386652378', 0, 'Y', 0, '2014-06-17', NULL, NULL, 0, 0, NULL, NULL),
('742625722', 'TX0001156', 'TX0001156', 'TX01', 'Alamo ENT Associates', 'Charles', 'P', 'Biediger', 'MD', 'Ear, Nose and Throat', '', '', NULL, 'B', 'PO Box 2679', 'San Antonio', 'Bexar', 'TX', '78229', '2106160096', NULL, 'PO Box 2679', 'San Antonio', 'Bexar', 'TX', '78229', '2106160096', '', 'TXSURGB', 'TXHCPCS', NULL, '0.00', '50.00', '0.00', 3, '2007-01-01', '2012-08-19', 0, 0, 0, 'North East Baptist Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1033127022', 0, 'Y', 0, '2013-04-04', NULL, NULL, 0, 0, NULL, NULL),
('742625722', 'TX0001157', 'TX0001157', 'TX01', 'Alamo ENT Associates', 'John', 'D', 'Edwards', 'MD', 'Ear, Nose and Throat', 'Pediatric Ear, Nose and Throat', '', NULL, 'B', 'PO Box 2679', 'San Antonio', 'Bexar', 'TX', '78229', '2106160096', NULL, 'PO Box 2679', 'San Antonio', 'Bexar', 'TX', '78229', '2106160096', '', 'TXSURGB', 'TXHCPCS', NULL, '0.00', '50.00', '0.00', 3, '2007-01-01', '2012-08-19', 0, 0, 0, 'North East Baptist Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1336158294', 0, 'Y', 0, '2013-06-27', NULL, NULL, 0, 0, NULL, NULL),
('743003947', 'TX0001159', 'TX0001159', 'TX01', 'The San Antonio Orthopaedic Group', 'Heather', 'A', 'McKenzie', 'MD', 'Physical Medicine and Rehabilitation', NULL, NULL, NULL, 'O', '150 E Sonterra Blvd Ste 300', 'San Antonio', 'Bexar', 'TX', '78258', '2103965265', NULL, '400 Concord Plaza Dr', 'San Antonio', '', 'TX', '78216', '', '', 'TXORTHO', 'TXHCPCS', NULL, '0.00', '50.00', '0.00', 3, '2007-01-01', '2009-10-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '0000007525', 0, 'N', 0, '2007-03-13', NULL, NULL, 29.6152, -98.4924, NULL, NULL),
('870687050', 'U33000139', 'U33000139', 'UT01', 'Iron Mission Dialysis Center', '', '', 'Iron Mission Dialysis Center', 'GROUP', 'Dialysis Center', '', '', NULL, 'O', '1277 Northfield Rd', 'Cedar City', 'Iron', 'UT', '84720', '4358678175', NULL, 'PO Box 27071', 'Salt Lake City', 'Iron', 'UT', '84127', '4358678175', '', '', NULL, NULL, '0.00', '60.00', '0.00', 3, '2006-01-01', '2008-12-31', NULL, 0, 0, '', '', '', '', 'HCFA|UB|', '1336248855', 0, 'N', 0, '2011-01-10', NULL, NULL, 0, 0, NULL, NULL),
('870542585', 'U33000289', 'U33000289', 'UT01', 'Kolff Dialysis Center', '', '', 'Kolff Dialysis Center', 'GROUP', 'Dialysis Center', '', '', NULL, 'O', '85 Medical Dr', 'Salt Lake City', 'Salt Lake', 'UT', '84112', '8015817659', NULL, 'PO Box 27071', 'Salt Lake City', 'Salt Lake', 'UT', '84127', '8015817659', '', '', NULL, NULL, '0.00', '60.00', '0.00', 3, '2006-01-01', '2008-12-31', NULL, 0, 0, '', '', '', '', 'HCFA|UB|', '1326147422', 0, 'N', 0, '2011-12-15', NULL, NULL, 0, 0, NULL, NULL),
('870542579', 'U33000291', 'U33000291', 'UT01', 'South Valley Dialysis Center', '', '', 'South Valley Dialysis Center', 'GROUP', 'Dialysis Center', '', '', NULL, 'O', '8750 Sandy Pkwy', 'Sandy', 'Salt Lake', 'UT', '84070', '8012338745', NULL, 'PO Box 27071', 'Salt Lake City', 'Salt Lake', 'UT', '84127', '8012338745', '', '', NULL, NULL, '0.00', '60.00', '0.00', 3, '2006-01-01', '2008-12-31', NULL, 0, 0, '', '', '', '', 'HCFA|UB|', '1508965625', 0, 'N', 0, '2011-01-07', NULL, NULL, 0, 0, NULL, NULL),
('870542584', 'U33000293', 'U33000293', 'UT01', 'Bonneville Dialysis Center', '', '', 'Bonneville Dialysis Center', 'GROUP', 'Dialysis Center', '', '', NULL, 'O', '5575 S 500 E', 'Ogden', 'Weber', 'UT', '84405', '8014790351', NULL, 'PO Box 27071', 'Salt Lake City', 'Weber', 'UT', '84127', '8014790351', '', '', NULL, NULL, '0.00', '60.00', '0.00', 3, '2006-01-01', '2008-12-31', NULL, 0, 0, '', '', '', '', 'HCFA|UB|', '1003915513', 0, 'N', 0, '2011-01-10', NULL, NULL, 0, 0, NULL, NULL),
('870542583', 'U33000295', 'U33000295', 'UT01', 'Dixie Dialysis Center', '', '', 'Dixie Dialysis Center', 'GROUP', 'Dialysis Center', '', '', NULL, 'O', '720 S River Rd Ste D-1100', 'St George', 'Washington', 'UT', '84791', '4356560857', NULL, 'PO Box 27071', 'Salt Lake City', 'Washington', 'UT', '84127', '4356560857', '', '', NULL, NULL, '0.00', '60.00', '0.00', 3, '2006-01-01', '2008-12-31', NULL, 0, 0, '', '', '', '', 'HCFA|UB|', '1326147844', 0, 'N', 0, '2011-01-10', NULL, NULL, 0, 0, NULL, NULL),
('870576193', 'U33000298', 'U33000298', 'UT01', 'Lakeside Dialysis Center', '', '', 'Lakeside Dialysis Center', 'GROUP', 'Dialysis Center', '', '', NULL, 'O', '532 S 500 W', 'Bountiful', 'Davis', 'UT', '84010', '8012993470', NULL, 'PO Box 27071', 'Salt Lake City', 'Davis', 'UT', '84127', '8012993470', '', '', NULL, NULL, '0.00', '60.00', '0.00', 3, '2006-01-01', '2008-12-31', NULL, 0, 0, '', '', '', '', 'HCFA|UB|', '1508965617', 0, 'N', 0, '2011-01-10', NULL, NULL, 0, 0, NULL, NULL),
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('870542582', 'U33000414', 'U33000414', 'UT01', 'Gem State Reg Dialysis Ctr', NULL, NULL, 'Gem State Reg Dialysis Ctr', 'GROUP', 'Dialysis Center', NULL, NULL, NULL, 'O', '2225 Teton Plz Ste A', 'Idaho Falls', 'Bonneville', 'ID', '83404', '2085224831', NULL, 'PO Box 27071', 'Salt Lake City', '', 'UT', '84127', '', '', '', NULL, NULL, '0.00', '60.00', '0.00', 3, '2006-01-01', '2008-12-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '0000006393', 0, 'N', 0, '2006-12-27', NULL, NULL, 0, 0, NULL, NULL),
('870542581', 'U33000416', 'U33000416', 'UT01', 'Castleview Dialysis Center', '', '', 'Castleview Dialysis Center', 'GROUP', 'Dialysis Center', '', '', NULL, 'O', '230 N Hospital Dr', 'Price', 'Carbon', 'UT', '84501', '4356378696', NULL, 'PO Box 27071', 'Salt Lake City', 'Carbon', 'UT', '84127', '4356378696', '', '', NULL, NULL, '0.00', '60.00', '0.00', 3, '2006-01-01', '2008-12-31', NULL, 0, 0, '', '', '', '', 'HCFA|UB|', '1083713598', 0, 'N', 0, '2011-01-10', NULL, NULL, 0, 0, NULL, NULL),
('141919178', 'U33000566', 'U33000566', 'UT01', 'Intermountain Pediatrics Dialysis', NULL, NULL, 'Intermountain Pediatrics Dialysis', 'GROUP', 'Dialysis Center', NULL, NULL, NULL, 'O', '50 N Medical Dr', 'Salt Lake City', 'Salt Lake', 'UT', '84132', '8015813212', NULL, 'PO Box 27071', 'Salt Lake City', '', 'UT', '84127', '', '', '', NULL, NULL, '0.00', '15.00', '0.00', 3, '2006-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1235238379', 0, 'N', 0, '2006-12-27', NULL, NULL, 40.7685, -111.837, NULL, NULL),
('870442129', 'U73000001', 'U73000001', 'UT01', 'U of U Department of Anesthesiology', 'Brandon', 'C', 'Dial', 'MD', 'Anesthesiology', NULL, NULL, NULL, 'b', 'Po Box 581053', 'Salt Lake City', 'Salt Lake', 'UT', '84158', '8012133800', NULL, NULL, NULL, '', NULL, NULL, '', '', NULL, NULL, '1000', '44.00', NULL, NULL, 3, '2007-01-01', '2007-07-31', 1, 12, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1275567802', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
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('870490866', 'U73000003', 'U73000003', 'UT01', 'University Health Care', 'Wendy', 'M', 'Rusin', 'APRN', 'General Surgery', 'Neurology', '', NULL, 'o', '50 N Medical Dr', 'Salt Lake City', 'Salt Lake', 'UT', '84132', '8015813595', NULL, '50 N Medical Dr', 'Salt Lake City', 'Salt Lake', 'UT', '84132', '8015813595', '          ', 'WUUUMG5', 'WUSTDHCPC5', '', '0.00', '25.00', '0.00', 3, '2007-01-01', '2012-09-16', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1235282872', 0, 'N', 0, '2012-09-17', NULL, NULL, 0, 0, NULL, NULL),
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('870490866', 'U73000005', 'U73000005', 'UT01', 'University of Utah Surgical Associates', 'Judith', 'A', 'Sampson', 'FNP', 'General Surgery', NULL, NULL, 'General Surgery', 'O', '50 NMedical Dr', 'Salt Lake City', 'Salt Lake', 'UT', '84132', '8015817738', NULL, NULL, NULL, '', NULL, NULL, '', '', 'WUUUMG5', 'WUSTDHCPC5', NULL, '0.00', '25.00', NULL, 3, '2007-01-01', '2006-12-31', 0, NULL, 0, 'Dixie Regional Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1538112214', 0, 'n', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870490866', 'U73000006', 'U73000006', 'UT01', 'University of Utah Surgical Associates', 'Judith', 'A', 'Sampson', 'APRN', 'Family Practice', '', '', NULL, 'B', 'PO Box 413035', 'Salt Lake City', 'Salt Lake', 'UT', '84141', '8012133800', NULL, 'PO Box 413035', 'Salt Lake City', 'Salt Lake', 'UT', '84141', '8012133800', '          ', 'WUUUMG5', 'WUSTDHCPC5', '', '0.00', '25.00', '0.00', 3, '2007-01-01', '2012-06-01', 0, 0, 0, 'Dixie Regional Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1538112214', 0, 'N', 0, '2012-06-28', NULL, NULL, 0, 0, NULL, NULL),
('870551055', 'U73000007', 'U73000007', 'UT01', 'Pediatric Cardiothoracic Surgeons', 'Linda', 'M', 'Lambert', 'APRN', 'Cardiovascular Disease', '', '', NULL, 'B', 'PO Box 58049', 'Salt Lake City', 'Salt Lake', 'UT', '84158', '8012133800', NULL, 'PO Box 58049', 'Salt Lake City', 'Salt Lake', 'UT', '84158', '8012133800', '          ', 'WUUPEDS', 'WUSTDHCPC5', '', '0.00', '15.00', '0.00', 3, '2007-01-01', '2012-09-17', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1013060524', 0, 'N', 0, '2012-09-18', NULL, NULL, 0, 0, NULL, NULL),
('870551055', 'U73000008', 'U73000008', 'UT01', 'Pediatric Cardiothoracic Surgeons', 'Linda', 'M', 'Lambert', 'APRN', 'Cardiovascular Disease', '', '', NULL, 'o', '100 N Mario Capecchi Dr', 'Salt Lake City', 'Salt Lake', 'UT', '84113', '8015883345', NULL, '100 N Mario Capecchi Dr', 'Salt Lake City', 'Salt Lake', 'UT', '84113', '8015883345', '          ', 'WUUPEDS', 'WUSTDHCPC5', '', '0.00', '15.00', '0.00', 3, '2007-01-01', '2012-09-17', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1013060524', 0, 'N', 0, '2012-09-18', NULL, NULL, 0, 0, NULL, NULL),
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('237268471', 'U73000022', 'U73000022', 'UT01', 'University Radiology Associates', 'Betty', 'J', 'Manaster', 'MD', 'Radiologist', '', '', NULL, 'B', 'PO Box 413025', 'Salt Lake City', 'Salt Lake', 'UT', '84141', '8012133800', NULL, 'PO Box 413025', 'Salt Lake City', 'Salt Lake', 'UT', '84141', '8012133800', '          ', 'WUUUMG5', 'WUSTDHCPC5', '', '0.00', '25.00', '0.00', 3, '2007-01-01', '2012-08-01', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1578644282', 0, 'N', 0, '2012-08-02', 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
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('320186101', 'U73000026', 'U73000026', 'UT01', 'U of U Pediatric Diagnostic Cardiology', NULL, NULL, 'U of U Pediatric Diagnostic Cardiology', 'GROUP', 'Pediatrics', '', '', NULL, 'B', 'PO Box 413021', 'Salt Lake City', 'Salt Lake', 'UT', '84141', '8012133800', NULL, 'PO Box 413021', 'Salt Lake City', 'Salt Lake', 'UT', '84141', '8012133800', '          ', 'WUUPEDS', 'WUSTDHCPC5', '', '0.00', '15.00', '0.00', 3, '2006-12-01', '2012-07-26', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1710016340', 0, 'Y', 0, '2012-07-27', NULL, NULL, 0, 0, NULL, NULL),
('320186101', 'U73000027', 'U73000027', 'UT01', 'U of U Pediatric Diagnostic Cardiology', 'Christopher', 'R', 'Mart', 'MD', 'Pediatric Cardiology', 'Pediatrics', '', NULL, 'B', 'PO Box 413021', 'Salt Lake City', 'Salt Lake', 'UT', '84141', '8012133800', NULL, 'PO Box 413021', 'Salt Lake City', 'Salt Lake', 'UT', '84141', '8012133800', '          ', 'WUUPEDS', 'WUSTDHCPC5', '', '0.00', '15.00', '0.00', 3, '2006-12-01', '2012-05-01', 0, 0, 0, 'Primary Childrens Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1346329810', 0, 'Y', 0, '2012-07-27', NULL, NULL, 0, 0, NULL, NULL),
('320186101', 'U73000028', 'U73000028', 'UT01', 'U of U Pediatric Diagnostic Cardiology', 'Lois', 'LuAnn', 'Minich', 'MD', 'Pediatric Cardiology', '', '', NULL, 'B', 'PO Box 413021', 'Salt Lake City', 'Salt Lake', 'UT', '84141', '8012133800', NULL, 'PO Box 413021', 'Salt Lake City', 'Salt Lake', 'UT', '84141', '8012133800', '          ', 'WUUPEDS', 'WUSTDHCPC5', '', '0.00', '15.00', '0.00', 3, '2006-12-01', '2012-05-01', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1578642146', 0, 'Y', 0, '2012-07-27', NULL, NULL, 0, 0, NULL, NULL),
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('237268471', 'U77000033', 'U77000033', 'UT01', 'University Radiology Associates', 'Franklin', 'J', 'Miller, Jr', 'MD', 'Diagnostic Radiology', 'Diagnostic Radiology', NULL, 'Radiology', 'O', '50 N Medical Dr', 'Salt Lake City', 'Salt Lake', 'UT', '84132', '8015812121', NULL, NULL, NULL, '', NULL, NULL, '', '', 'WUUUMG5', 'WUSTDHCPC5', NULL, '0.00', '25.00', NULL, 3, '2006-08-01', '2006-12-31', 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', NULL, 0, 'y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('237268471', 'U77000034', 'U77000034', 'UT01', 'University Radiology Associates', 'Kevin', 'R', 'Moore', 'MD', 'Diagnostic Radiology', 'Diagnostic Radiology', NULL, 'Radiology', 'O', '50 N Medical Dr', 'Salt Lake City', 'Salt Lake', 'UT', '84132', '8015812121', NULL, NULL, NULL, '', NULL, NULL, '', '', 'WUUUMG5', 'WUSTDHCPC5', NULL, '0.00', '25.00', NULL, 3, '2006-08-01', '2006-12-31', 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1306940739', 0, 'y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('237268471', 'U77000035', 'U77000035', 'UT01', 'University Radiology Associates', 'Glen', NULL, 'Morrell', 'MD, PhD', 'Radiologist', '', '', NULL, 'o', '50 N Medical Dr', 'Salt Lake City', 'Salt Lake', 'UT', '84132', '8015812121', NULL, '50 N Medical Dr', 'Salt Lake City', 'Salt Lake', 'UT', '84132', '8015812121', '          ', 'WUUUMG5', 'WUSTDHCPC5', '', '0.00', '25.00', '0.00', 3, '2006-08-01', '2012-08-01', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1174613780', 0, 'Y', 0, '2012-08-02', NULL, NULL, 0, 0, NULL, NULL),
('237268471', 'U77000036', 'U77000036', 'UT01', 'University Radiology Associates', 'Kathryn', 'Ann', 'Morton', 'MD', 'Radiologist', '', '', NULL, 'o', '50 N Medical Dr', 'Salt Lake City', 'Salt Lake', 'UT', '84132', '8015812121', NULL, '50 N Medical Dr', 'Salt Lake City', 'Salt Lake', 'UT', '84132', '8015812121', '          ', 'WUUUMG5', 'WUSTDHCPC5', '', '0.00', '25.00', '0.00', 3, '2006-08-01', '2012-08-01', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1891885406', 0, 'Y', 0, '2012-08-02', NULL, NULL, 0, 0, NULL, NULL),
('237268471', 'U77000037', 'U77000037', 'UT01', 'University Radiology Associates', 'Kathleen', 'A', 'Murray', 'MD', 'Radiologist', NULL, NULL, NULL, 'o', '50 N Medical Dr', 'Salt Lake City', 'Salt Lake', 'UT', '84132', '8015812121', NULL, NULL, NULL, '', NULL, NULL, '', '', 'WUUUMG5', 'WUSTDHCPC5', NULL, '0.00', '25.00', '0.00', 3, '2006-08-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1790875300', 0, 'Y', 0, '2007-02-07', NULL, NULL, 40.7685, -111.837, NULL, NULL),
('237268471', 'U77000038', 'U77000038', 'UT01', 'University Radiology Associates', 'Perry', 'P', 'Ng', 'MD', 'Radiologist', NULL, NULL, NULL, 'o', '50 N Medical Dr', 'Salt Lake City', 'Salt Lake', 'UT', '84132', '8015812121', NULL, '50 N Medical Dr', 'Salt Lake City', 'Salt Lake', 'UT', '84132', '8015812121', '          ', 'WUUUMG5', 'WUSTDHCPC5', '', '0.00', '25.00', '0.00', 3, '2006-08-01', '2012-08-01', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1336239946', 0, 'Y', 0, '2012-08-02', NULL, NULL, 0, 0, NULL, NULL),
('237268471', 'U77000039', 'U77000039', 'UT01', 'University Radiology Associates', 'Kenneth', 'J', 'Nowers', 'MD', 'Radiologist', NULL, NULL, NULL, 'o', '50 N Medical Dr', 'Salt Lake City', 'Salt Lake', 'UT', '84132', '8015812121', NULL, NULL, NULL, '', NULL, NULL, '', '', 'WUUUMG5', 'WUSTDHCPC5', NULL, '0.00', '25.00', '0.00', 3, '2006-08-01', '2009-06-05', 0, 0, 0, 'Cassia Regional Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1720037641', 0, 'Y', 0, '2007-02-07', NULL, NULL, 0, 0, NULL, NULL),
('237268471', 'U77000040', 'U77000040', 'UT01', 'University Radiology Associates', 'Karen', 'Y', 'Oh', 'MD', 'Radiologist', NULL, NULL, NULL, 'o', '50 N Medical Dr', 'Salt Lake City', 'Salt Lake', 'UT', '84132', '8015812121', NULL, NULL, NULL, '', NULL, NULL, '', '', 'WUUUMG5', 'WUSTDHCPC5', NULL, '0.00', '25.00', NULL, 3, '2006-08-01', '2007-01-08', 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', NULL, 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('237268471', 'U77000041', 'U77000041', 'UT01', 'University Radiology Associates', 'Jeffrey', 'D', 'Olpin', 'MD', 'Radiologist', '', '', NULL, 'o', '50 N Medical Dr', 'Salt Lake City', 'Salt Lake', 'UT', '84132', '8015812121', NULL, '50 N Medical Dr', 'Salt Lake City', 'Salt Lake', 'UT', '84132', '8015812121', '          ', 'WUUUMG5', 'WUSTDHCPC5', '', '0.00', '25.00', '0.00', 3, '2006-08-01', '2012-08-01', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1609966225', 0, 'Y', 0, '2012-08-02', NULL, NULL, 0, 0, NULL, NULL),
('237268471', 'U77000042', 'U77000042', 'UT01', 'University Radiology Associates', 'Kathleen', 'A', 'ONeil', 'MD', 'Radiologist', NULL, NULL, NULL, 'o', '50 N Medical Dr', 'Salt Lake City', 'Salt Lake', 'UT', '84132', '8015812121', NULL, '50 N Medical Dr', 'Salt Lake City', 'Salt Lake', 'UT', '84132', '8015812121', '', 'WUUUMG5', 'WUSTDHCPC5', NULL, '0.00', '25.00', '0.00', 3, '2006-08-01', '2008-01-24', 0, 0, 0, 'Lakeview Hospital', 'St Marks Hospital', NULL, NULL, 'HCFA|UB|', '1881693950', 0, 'Y', 0, '2012-10-12', NULL, NULL, 0, 0, NULL, NULL),
('237268471', 'U77000043', 'U77000043', 'UT01', 'University Radiology Associates', 'Anne', 'G', 'Osborn', 'MD', 'Radiologist', '', '', NULL, 'o', '50 N Medical Dr', 'Salt Lake City', 'Salt Lake', 'UT', '84132', '8015812121', NULL, '50 N Medical Dr', 'Salt Lake City', 'Salt Lake', 'UT', '84132', '8015812121', '          ', 'WUUUMG5', 'WUSTDHCPC5', '', '0.00', '25.00', '0.00', 3, '2006-08-01', '2012-08-01', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1598846388', 0, 'Y', 0, '2012-08-02', NULL, NULL, 0, 0, NULL, NULL),
('237268471', 'U77000044', 'U77000044', 'UT01', 'University Radiology Associates', 'Brett', 'T', 'Parkinson', 'MD', 'Radiologist', 'Diagnostic Radiology', NULL, 'Radiology', 'o', '50 N Medical Dr', 'Salt Lake City', 'Salt Lake', 'UT', '84132', '8015812121', NULL, NULL, NULL, '', NULL, NULL, '', '', 'WUUUMG5', 'WUSTDHCPC5', NULL, '0.00', '25.00', NULL, 3, '2006-08-01', '2007-01-24', 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', NULL, 0, 'y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('237268471', 'U77000045', 'U77000045', 'UT01', 'University Radiology Associates', 'Christopher', 'J', 'Parr', 'MD', 'Diagnostic Radiology', 'Diagnostic Radiology', NULL, 'Radiology', 'O', '50 N Medical Dr', 'Salt Lake City', 'Salt Lake', 'UT', '84132', '8015812121', NULL, NULL, NULL, '', NULL, NULL, '', '', 'WUUUMG5', 'WUSTDHCPC5', NULL, '0.00', '25.00', NULL, 3, '2006-08-01', '2006-12-31', 0, NULL, 0, 'Ogden Regional Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1063410157', 0, 'y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('237268471', 'U77000046', 'U77000046', 'UT01', 'University Radiology Associates', 'Kathleen', 'H', 'Puglia', 'MD', 'Obstetrics and Gynecology', 'OB Diagnotic', 'Radiologist', NULL, 'o', '50 N Medical Dr', 'Salt Lake City', 'Salt Lake', 'UT', '84132', '8015812121', NULL, NULL, NULL, '', NULL, NULL, '', '', 'WUUUMG5', 'WUSTDHCPC5', NULL, '0.00', '25.00', '0.00', 3, '2006-08-01', '2008-06-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1770673394', 0, 'Y', 0, '2007-02-07', NULL, NULL, 0, 0, NULL, NULL),
('237268471', 'U77000047', 'U77000047', 'UT01', 'University Radiology Associates', 'Ulrich', 'A', 'Rassner', 'MD', 'Radiologist', '', '', NULL, 'o', '50 N Medical Dr', 'Salt Lake City', 'Salt Lake', 'UT', '84132', '8015812121', NULL, '50 N Medical Dr', 'Salt Lake City', 'Salt Lake', 'UT', '84132', '8015812121', '          ', 'WUUUMG5', 'WUSTDHCPC5', '', '0.00', '25.00', '0.00', 3, '2006-08-01', '2012-08-01', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1619921897', 0, 'Y', 0, '2012-08-02', NULL, NULL, 0, 0, NULL, NULL),
('237268471', 'U77000048', 'U77000048', 'UT01', 'University Radiology Associates', 'Karen', 'L', 'Salzman', 'MD', 'Radiologist', '', '', NULL, 'o', '50 N Medical Dr', 'Salt Lake City', 'Salt Lake', 'UT', '84132', '8015812121', NULL, '50 N Medical Dr', 'Salt Lake City', 'Salt Lake', 'UT', '84132', '8015812121', '          ', 'WUUUMG5', 'WUSTDHCPC5', '', '0.00', '25.00', '0.00', 3, '2006-08-01', '2012-08-01', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1003906629', 0, 'Y', 0, '2012-08-02', NULL, NULL, 0, 0, NULL, NULL),
('237268471', 'U77000049', 'U77000049', 'UT01', 'University Radiology Associates', 'R', 'Kent', 'Sanders', 'MD', 'Radiologist', '', '', NULL, 'o', '50 N Medical Dr', 'Salt Lake City', 'Salt Lake', 'UT', '84132', '8015812121', NULL, '50 N Medical Dr', 'Salt Lake City', 'Salt Lake', 'UT', '84132', '8015812121', '          ', 'WUUUMG5', 'WUSTDHCPC5', '', '0.00', '25.00', '0.00', 3, '2006-08-01', '2012-08-01', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '0000008579', 0, 'Y', 0, '2012-08-02', NULL, NULL, 0, 0, NULL, NULL),
('237268471', 'U77000050', 'U77000050', 'UT01', 'University Radiology Associates', 'Peter', NULL, 'Schloesser', 'MD', 'Radiologist', NULL, NULL, NULL, 'o', '50 N Medical Dr', 'Salt Lake City', 'Salt Lake', 'UT', '84132', '8015812121', NULL, NULL, NULL, '', NULL, NULL, '', '', 'WUUUMG5', 'WUSTDHCPC5', NULL, '0.00', '25.00', NULL, 3, '2006-08-01', '2007-07-01', 0, NULL, 0, 'Cassia Regional Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1508806233', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('237268471', 'U77000051', 'U77000051', 'UT01', 'University Radiology Associates', 'Akram', 'M', 'Shaaban', 'MD', 'Radiologist', '', '', NULL, 'o', '50 N Medical Dr', 'Salt Lake City', 'Salt Lake', 'UT', '84132', '8015812121', NULL, '50 N Medical Dr', 'Salt Lake City', 'Salt Lake', 'UT', '84132', '8015812121', '          ', 'WUUUMG5', 'WUSTDHCPC5', '', '0.00', '25.00', '0.00', 3, '2006-08-01', '2012-08-01', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1184714701', 0, 'Y', 0, '2012-08-02', NULL, NULL, 0, 0, NULL, NULL),
('237268471', 'U77000052', 'U77000052', 'UT01', 'University Radiology Associates', 'Timothy', 'J', 'Sherry', 'MD', 'Radiologist', NULL, NULL, NULL, 'o', '50 N Medical Dr', 'Salt Lake City', 'Salt Lake', 'UT', '84132', '8015812121', NULL, NULL, NULL, '', NULL, NULL, '', '', 'WUUUMG5', 'WUSTDHCPC5', NULL, '0.00', '25.00', '0.00', 3, '2006-08-01', '2009-07-01', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1184678369', 0, 'Y', 0, '2007-02-07', NULL, NULL, 0, 0, NULL, NULL),
('237268471', 'U77000053', 'U77000053', 'UT01', 'University Radiology Associates', 'Daniel', 'M', 'Sommers', 'MD', 'Radiologist', '', '', NULL, 'o', '50 N Medical Dr', 'Salt Lake City', 'Salt Lake', 'UT', '84132', '8015812121', NULL, '50 N Medical Dr', 'Salt Lake City', 'Salt Lake', 'UT', '84132', '8015812121', '          ', 'WUUUMG5', 'WUSTDHCPC5', '', '0.00', '25.00', '0.00', 3, '2006-08-01', '2012-08-01', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1720191216', 0, 'Y', 0, '2012-08-02', NULL, NULL, 0, 0, NULL, NULL),
('237268471', 'U77000054', 'U77000054', 'UT01', 'University Radiology Associates', 'Jerry', 'M', 'Speckman', 'MD', 'Diagnostic Radiology', 'Diagnostic Radiology', NULL, 'Radiology', 'O', '50 N Medical Dr', 'Salt Lake City', 'Salt Lake', 'UT', '84132', '8015812121', NULL, NULL, NULL, '', NULL, NULL, '', '', 'WUUUMG5', 'WUSTDHCPC5', NULL, '0.00', '25.00', NULL, 3, '2006-08-01', '2006-12-31', 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1629049101', 0, 'y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('237268471', 'U77000055', 'U77000055', 'UT01', 'University Radiology Associates', 'Brian', 'M', 'Steele', 'MD', 'Radiologist', 'Diagnostic Radiology', NULL, 'Radiology', 'o', '50 N Medical Dr', 'Salt Lake City', 'Salt Lake', 'UT', '84132', '8015812121', NULL, NULL, NULL, '', NULL, NULL, '', '', 'WUUUMG5', 'WUSTDHCPC5', NULL, '0.00', '25.00', NULL, 3, '2006-08-01', '2006-12-31', 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', NULL, 0, 'y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('237268471', 'U77000056', 'U77000056', 'UT01', 'University Radiology Associates', 'Edwin', 'A', 'Stevens', 'MD', 'Radiologist', '', '', NULL, 'o', '50 N Medical Dr', 'Salt Lake City', 'Salt Lake', 'UT', '84132', '8015812121', NULL, '50 N Medical Dr', 'Salt Lake City', 'Salt Lake', 'UT', '84132', '8015812121', '          ', 'WUUUMG5', 'WUSTDHCPC5', '', '0.00', '25.00', '0.00', 3, '2006-08-01', '2012-08-01', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1922198555', 0, 'Y', 0, '2012-08-02', NULL, NULL, 0, 0, NULL, NULL),
('237268471', 'U77000057', 'U77000057', 'UT01', 'University Radiology Associates', 'Stephen', 'G', 'Thiede', 'MD', 'Diagnostic Radiology', 'Diagnostic Radiology', NULL, 'Radiology', 'O', '50 N Medical Dr', 'Salt Lake City', 'Salt Lake', 'UT', '84132', '8015812121', NULL, NULL, NULL, '', NULL, NULL, '', '', 'WUUUMG5', 'WUSTDHCPC5', NULL, '0.00', '25.00', NULL, 3, '2006-08-01', '2006-12-31', 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', NULL, 0, 'y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('237268471', 'U77000058', 'U77000058', 'UT01', 'University Radiology Associates', 'Sheldon', 'L', 'Thieszen', 'MD, PhD', 'Radiologist', NULL, NULL, NULL, 'o', '50 N Medical Dr', 'Salt Lake City', 'Salt Lake', 'UT', '84132', '8015812121', NULL, NULL, NULL, '', NULL, NULL, '', '', 'WUUUMG5', 'WUSTDHCPC5', NULL, '0.00', '25.00', NULL, 3, '2006-08-01', '2006-08-01', 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', NULL, 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('237268471', 'U77000059', 'U77000059', 'UT01', 'University Radiology Associates', 'Cheryl', 'A', 'Walczak', 'MD', 'Radiologist', '', '', NULL, 'o', '50 N Medical Dr', 'Salt Lake City', 'Salt Lake', 'UT', '84124', '8015812121', NULL, '50 N Medical Dr', 'Salt Lake City', 'Salt Lake', 'UT', '84124', '8015812121', '          ', 'WUUUMG5', 'WUSTDHCPC5', '', '0.00', '25.00', '0.00', 3, '2006-08-01', '2012-08-01', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1891875704', 0, 'Y', 0, '2012-08-02', NULL, NULL, 0, 0, NULL, NULL),
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('237268471', 'U77000063', 'U77000063', 'UT01', 'University Radiology Associates', 'Blake', 'W', 'Arnold', 'MD', 'Diagnostic Radiology', 'Diagnostic Radiology', NULL, 'Radiology', 'B', 'PO Box 581200', 'Salt Lake City', 'Salt Lake', 'UT', '84158', '8012133800', NULL, NULL, NULL, '', NULL, NULL, '', '', 'WUUUMG5', 'WUSTDHCPC5', NULL, '0.00', '25.00', NULL, 3, '2006-08-01', '2006-12-31', 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', NULL, 0, 'y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
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('237268471', 'U77000066', 'U77000066', 'UT01', 'University Radiology Associates', 'Allene', 'S', 'Burdette', 'MD', 'Radiologist', '', '', NULL, 'B', 'PO Box 413025', 'Salt Lake City', 'Salt Lake', 'UT', '84141', '8012133800', NULL, NULL, NULL, 'Salt Lake', NULL, NULL, '8012133800', '          ', 'WUUUMG5', 'WUSTDHCPC5', '', '0.00', '25.00', '0.00', 3, '2006-08-01', '2010-10-05', NULL, 0, NULL, '', '', '', '', 'HCFA|UB|', '1841387891', 0, 'N', 0, '2011-05-25', NULL, NULL, 0, 0, NULL, NULL),
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('237268471', 'U77000105', 'U77000105', 'UT01', 'University Radiology Associates', 'Kathleen', 'H', 'Puglia', 'MD', 'Obstetrics and Gynecology', 'OB Diagnotic', 'Radiologist', NULL, 'B', 'PO Box 581200', 'Salt Lake City', 'Salt Lake', 'UT', '84158', '8012133800', NULL, NULL, NULL, '', NULL, NULL, '', '', 'WUUUMG5', 'WUSTDHCPC5', NULL, '0.00', '25.00', '0.00', 3, '2006-08-01', '2008-06-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1770673394', 0, 'y', 0, '2007-02-07', NULL, NULL, 0, 0, NULL, NULL),
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('237268471', 'U77000114', 'U77000114', 'UT01', 'University Radiology Associates', 'Brian', 'M', 'Steele', 'MD', 'Radiologist', 'Diagnostic Radiology', NULL, 'Radiology', 'b', 'PO Box 581200', 'Salt Lake City', 'Salt Lake', 'UT', '84158', '8012133800', NULL, NULL, NULL, '', NULL, NULL, '', '', 'WUUUMG5', 'WUSTDHCPC5', NULL, '0.00', '25.00', NULL, 3, '2006-08-01', '2006-12-31', 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', NULL, 0, 'y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
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('237268471', 'U77000121', 'U77000121', 'UT01', 'University Radiology Associates', 'Hyo-Chun', NULL, 'Yoon', 'MD, PhD', 'Radiologist', 'Diagnostic Radiology', NULL, 'Radiology', 'b', 'PO Box 581200', 'Salt Lake City', 'Salt Lake', 'UT', '84158', '8012133800', NULL, NULL, NULL, '', NULL, NULL, '', '', 'WUUUMG5', 'WUSTDHCPC5', NULL, '0.00', '25.00', NULL, 3, '2006-08-01', '2007-03-09', 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', NULL, 0, 'y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
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('270101195', 'U77000123', 'U77000123', 'UT01', 'University Health Care', 'Carla', 'O', 'Amis', 'SP', 'Speech Therapy', '', '', NULL, 'o', '417 Wakara Way Ste 1112', 'Salt Lake City', 'Salt Lake', 'UT', '84108', '8015813506', NULL, '417 Wakara Way Ste 1112', 'Salt Lake City', 'Salt Lake', 'UT', '84108', '8015813506', '          ', 'WUUUMG5', 'WUSTDHCPC5', '', '0.00', '25.00', '0.00', 3, '2006-08-01', '2012-09-18', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '0000005013', 0, 'N', 0, '2012-09-19', NULL, NULL, 0, 0, NULL, NULL),
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('270101195', 'U77000125', 'U77000125', 'UT01', 'University Health Care', 'Mary', 'D', 'Foye', 'SP', 'Speech Therapy', '', '', NULL, 'o', '417 Wakara Way Ste 1112', 'Salt Lake City', 'Salt Lake', 'UT', '84108', '8015813506', NULL, '417 Wakara Way Ste 1112', 'Salt Lake City', 'Salt Lake', 'UT', '84108', '8015813506', '          ', 'WUUUMG5', 'WUSTDHCPC5', '', '0.00', '25.00', '0.00', 3, '2006-08-01', '2012-09-18', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1063591535', 0, 'N', 0, '2012-09-19', NULL, NULL, 0, 0, NULL, NULL),
('270101195', 'U77000126', 'U77000126', 'UT01', 'University Health Care', 'Janet', 'H', 'Goldstein', 'SP', 'Speech Therapy', '', '', NULL, 'o', '417 Wakara Way Ste 1112', 'Salt Lake City', 'Salt Lake', 'UT', '84108', '8015813506', NULL, '417 Wakara Way Ste 1112', 'Salt Lake City', 'Salt Lake', 'UT', '84108', '8015813506', '          ', 'WUUUMG5', 'WUSTDHCPC5', '', '0.00', '25.00', '0.00', 3, '2006-08-01', '2012-09-18', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1154400620', 0, 'N', 0, '2012-09-19', 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
('270101195', 'U77000127', 'U77000127', 'UT01', 'University Health Care', 'Michelle', 'G', 'Hard', 'SP', 'Speech Therapy', '', '', NULL, 'o', '417 Wakara Way Ste 1112', 'Salt Lake City', 'Salt Lake', 'UT', '84108', '8015813506', NULL, '417 Wakara Way Ste 1112', 'Salt Lake City', 'Salt Lake', 'UT', '84108', '8015813506', '          ', 'WUUUMG5', 'WUSTDHCPC5', '', '0.00', '25.00', '0.00', 3, '2006-08-01', '2012-09-18', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1245319714', 0, 'N', 0, '2012-09-19', NULL, NULL, 0, 0, NULL, NULL),
('270101195', 'U77000128', 'U77000128', 'UT01', 'University Health Care', 'Lori', 'E', 'Krasny', 'SP', 'Speech Therapy', '', '', NULL, 'o', '417 Wakara Way Ste 1112', 'Salt Lake City', 'Salt Lake', 'UT', '84108', '8015813506', NULL, '417 Wakara Way Ste 1112', 'Salt Lake City', 'Salt Lake', 'UT', '84108', '8015813506', '          ', 'WUUUMG5', 'WUSTDHCPC5', '', '0.00', '25.00', '0.00', 3, '2006-08-01', '2012-09-18', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '0000007153', 0, 'N', 0, '2012-09-19', NULL, NULL, 0, 0, NULL, NULL),
('270101195', 'U77000129', 'U77000129', 'UT01', 'University Health Care', 'Susan', 'H', 'Kruger', 'SP', 'Speech Therapy', '', '', NULL, 'o', '417 Wakara Way Ste 1112', 'Salt Lake City', 'Salt Lake', 'UT', '84108', '8015813506', NULL, '417 Wakara Way Ste 1112', 'Salt Lake City', 'Salt Lake', 'UT', '84108', '8015813506', '          ', 'WUUUMG5', 'WUSTDHCPC5', '', '0.00', '25.00', '0.00', 3, '2006-08-01', '2012-09-18', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1043399512', 0, 'N', 0, '2012-09-19', NULL, NULL, 0, 0, NULL, NULL),
('270101195', 'U77000130', 'U77000130', 'UT01', 'University Health Care', 'Julia', 'V', 'Lidgard', 'SP', 'Speech Therapy', '', '', NULL, 'o', '417 Wakara Way Ste 1112', 'Salt Lake City', 'Salt Lake', 'UT', '84108', '8015813506', NULL, '417 Wakara Way Ste 1112', 'Salt Lake City', 'Salt Lake', 'UT', '84108', '8015813506', '          ', 'WUUUMG5', 'WUSTDHCPC5', '', '0.00', '25.00', '0.00', 3, '2006-08-01', '2012-09-18', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1053490524', 0, 'N', 0, '2012-09-19', NULL, NULL, 0, 0, NULL, NULL),
('270101195', 'U77000131', 'U77000131', 'UT01', 'University Health Care', 'Stephanie', 'B', 'McVicar', 'AAA-C', 'Speech Therapy', '', '', NULL, 'o', '417 Wakara Way Ste 1112', 'Salt Lake City', 'Salt Lake', 'UT', '84108', '8015813506', NULL, '417 Wakara Way Ste 1112', 'Salt Lake City', 'Salt Lake', 'UT', '84108', '8015813506', '          ', 'WUUUMG5', 'WUSTDHCPC5', '', '0.00', '25.00', '0.00', 3, '2006-08-01', '2012-09-18', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1144309618', 0, 'N', 0, '2012-09-19', NULL, NULL, 0, 0, NULL, NULL),
('270101195', 'U77000132', 'U77000132', 'UT01', 'U of U Communications & Disorders Speech & Hearing Clinic', 'Cynthia', 'G', 'Montana', 'SP', 'Speech Therapy', 'Physical Therapy', NULL, 'Speech Therapy', 'O', '417 Wakara Way Ste 1112', 'Salt Lake City', 'Salt Lake', 'UT', '84108', '8015813506', NULL, NULL, NULL, '', NULL, NULL, '', '', 'WUUUMG5', 'WUSTDHCPC5', NULL, '0.00', '25.00', NULL, 3, '2006-08-01', '2006-12-31', 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', NULL, 0, 'n', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('270101195', 'U77000133', 'U77000133', 'UT01', 'University Health Care', 'Susan', 'R', 'Naidu', 'Audio', 'Speech Therapy', '', '', NULL, 'o', '417 Wakara Way Ste 1112', 'Salt Lake City', 'Salt Lake', 'UT', '84108', '8015813506', NULL, '417 Wakara Way Ste 1112', 'Salt Lake City', 'Salt Lake', 'UT', '84108', '8015813506', '          ', 'WUUUMG5', 'WUSTDHCPC5', '', '0.00', '25.00', '0.00', 3, '2006-08-01', '2012-09-18', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1508945072', 0, 'N', 0, '2012-09-19', NULL, NULL, 0, 0, NULL, NULL),
('270101195', 'U77000134', 'U77000134', 'UT01', 'U of U Communications & Disorders Speech & Hearing Clinic', 'Carla', 'O', 'Amis', 'SP', 'Speech Therapy', '', '', NULL, 'B', 'Po Box 58896', 'Salt Lake City', 'Salt Lake', 'UT', '84158', '8012133800', NULL, 'Po Box 58896', 'Salt Lake City', 'Salt Lake', 'UT', '84158', '8012133800', '          ', 'WUUUMG5', 'WUSTDHCPC5', '', '0.00', '25.00', '0.00', 3, '2006-08-01', '2012-09-18', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '0000005013', 0, 'N', 0, '2012-09-19', NULL, NULL, 0, 0, NULL, NULL),
('270101195', 'U77000135', 'U77000135', 'UT01', 'U of U Communications & Disorders Speech & Hearing Clinic', 'Mark', 'M', 'Cantor', 'MS, CCC,SLP', 'Physical Therapy', 'Speech Therapy', NULL, NULL, 'B', 'Po Box 58896', 'Salt Lake City', 'Salt Lake', 'UT', '84158', '8012133800', NULL, 'Po Box 58896', 'Salt Lake City', 'Salt Lake', 'UT', '84158', '8012133800', '          ', 'WUUUMG5', 'WUSTDHCPC5', '', '0.00', '25.00', '0.00', 3, '2006-08-01', '2012-09-18', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1144333139', 0, 'N', 0, '2012-09-19', NULL, NULL, 0, 0, NULL, NULL),
('270101195', 'U77000136', 'U77000136', 'UT01', 'U of U Communications & Disorders Speech & Hearing Clinic', 'Mary', 'D', 'Foye', 'SP', 'Speech Therapy', '', '', NULL, 'B', 'Po Box 58896', 'Salt Lake City', 'Salt Lake', 'UT', '84158', '8012133800', NULL, 'Po Box 58896', 'Salt Lake City', 'Salt Lake', 'UT', '84158', '8012133800', '          ', 'WUUUMG5', 'WUSTDHCPC5', '', '0.00', '25.00', '0.00', 3, '2006-08-01', '2012-09-18', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1063591535', 0, 'N', 0, '2012-09-19', NULL, NULL, 0, 0, NULL, NULL),
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('412144134', 'U77000221', 'U77000221', 'UT01', 'ARUP Pathology Associates', 'Xinjian', '', 'Chen', 'MD', 'Pathology', 'Anatomic Pathology', 'Clinical Pathology', NULL, 'B', 'PO Box 413037', 'Salt Lake City', 'Salt Lake', 'UT', '84141', '8012133800', NULL, 'PO Box 413037', 'Salt Lake City', 'Salt Lake', 'UT', '84141', '8012133800', '          ', 'WUUUMG5', 'WUSTDHCPC5', '', '0.00', '25.00', '0.00', 3, '2006-08-01', '2011-12-31', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1902996598', 0, 'N', 0, '2012-03-06', NULL, NULL, 0, 0, NULL, NULL),
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('412144134', 'U77000226', 'U77000226', 'UT01', 'ARUP Pathology Associates', 'Lyska', 'L', 'Emerson', 'MD', 'Pathology', 'Anatomic Pathology', NULL, NULL, 'B', 'PO Box 413037', 'Salt Lake City', 'Salt Lake', 'UT', '84141', '8012133800', NULL, 'PO Box 413037', 'Salt Lake City', 'Salt Lake', 'UT', '84141', '8012133800', '          ', 'WUUUMG5', 'WUSTDHCPC5', '', '0.00', '25.00', '0.00', 3, '2006-08-01', '2011-12-31', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1770673360', 0, 'N', 0, '2012-03-06', NULL, NULL, 0, 0, NULL, NULL),
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('412144134', 'U77000228', 'U77000228', 'UT01', 'ARUP Pathology Associates', 'Ronald', 'M', 'Harris', 'MD', 'Dermatology', 'Pathology', 'Anatomic Pathology', NULL, 'B', 'PO Box 413037', 'Salt Lake City', 'Salt Lake', 'UT', '84141', '8012133800', NULL, 'PO Box 413037', 'Salt Lake City', 'Salt Lake', 'UT', '84141', '8012133800', '          ', 'WUUUMG5', 'WUSTDHCPC5', '', '0.00', '25.00', '0.00', 3, '2006-08-01', '2011-12-31', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1215033501', 0, 'N', 0, '2012-03-06', NULL, NULL, 0, 0, NULL, NULL),
('412144134', 'U77000229', 'U77000229', 'UT01', 'ARUP Pathology Associates', 'Harry', 'R', 'Hill', 'MD', 'Pediatric Immunology and Rheumatology', 'Immunology', 'Pathology', NULL, 'B', 'PO Box 413037', 'Salt Lake City', 'Salt Lake', 'UT', '84141', '8012133800', NULL, 'PO Box 413037', 'Salt Lake City', 'Salt Lake', 'UT', '84141', '8012133800', '          ', 'WUUUMG5', 'WUSTDHCPC5', '', '0.00', '25.00', '0.00', 3, '2006-08-01', '2011-12-31', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1366532962', 0, 'N', 0, '2012-03-06', NULL, NULL, 0, 0, NULL, NULL),
('412144134', 'U77000230', 'U77000230', 'UT01', 'ARUP Pathology Associates', 'Joseph', 'A', 'Holden', 'MD, PhD', 'Pathology', 'Anatomic Pathology', NULL, NULL, 'B', 'PO Box 581054', 'Salt Lake City', 'Salt Lake', 'UT', '84158', '8012133800', NULL, NULL, NULL, '', NULL, NULL, '', '', 'WUUUMG5', 'WUSTDHCPC5', NULL, '0.00', '25.00', '0.00', 3, '2006-08-01', '2009-03-28', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1629168224', 0, 'y', 0, '2007-02-07', NULL, NULL, 0, 0, NULL, NULL),
('412144134', 'U77000231', 'U77000231', 'UT01', 'ARUP Pathology Associates', 'Jorge', 'C', 'Isaac', 'MD', 'Anatomic Pathology', 'Anatomic Pathology', NULL, 'Pathology', 'B', 'PO Box 581054', 'Salt Lake City', 'Salt Lake', 'UT', '84158', '8012133800', NULL, NULL, NULL, '', NULL, NULL, '', '', 'WUUUMG5', 'WUSTDHCPC5', NULL, '0.00', '25.00', NULL, 3, '2006-08-01', '2006-12-31', 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', NULL, 0, 'y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
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('412144134', 'U77000233', 'U77000233', 'UT01', 'ARUP Pathology Associates', 'Carl', 'R', 'Kjeldsberg', 'MD', 'Pathology', 'Anatomic Pathology', NULL, NULL, 'B', 'PO Box 413037', 'Salt Lake City', 'Salt Lake', 'UT', '84141', '8012133800', NULL, 'PO Box 413037', 'Salt Lake City', 'Salt Lake', 'UT', '84141', '8012133800', '          ', 'WUUUMG5', 'WUSTDHCPC5', '', '0.00', '25.00', '0.00', 3, '2006-08-01', '2011-12-31', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1417047028', 0, 'N', 0, '2012-03-06', NULL, NULL, 0, 0, NULL, NULL),
('412144134', 'U77000234', 'U77000234', 'UT01', 'ARUP Pathology Associates', 'Lester', 'J', 'Layfield', 'MD', 'Pathology', 'Anatomic Pathology', NULL, NULL, 'B', 'PO Box 413037', 'Salt Lake City', 'Salt Lake', 'UT', '84141', '8012133800', NULL, 'PO Box 413037', 'Salt Lake City', 'Salt Lake', 'UT', '84141', '8012133800', '          ', 'WUUUMG5', 'WUSTDHCPC5', '', '0.00', '25.00', '0.00', 3, '2006-08-01', '2011-12-31', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1033209648', 0, 'N', 0, '2012-03-06', NULL, NULL, 0, 0, NULL, NULL),
('412144134', 'U77000235', 'U77000235', 'UT01', 'ARUP Pathology Associates', 'Megan', 'S', 'Lim', 'MD', 'Clinical Pathology', 'Clinical Pathology', NULL, 'Pathology', 'B', 'PO Box 581054', 'Salt Lake City', 'Salt Lake', 'UT', '84158', '8012133800', NULL, NULL, NULL, '', NULL, NULL, '', '', 'WUUUMG5', 'WUSTDHCPC5', NULL, '0.00', '25.00', NULL, 3, '2006-08-01', '2006-12-31', 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', NULL, 0, 'y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
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('412144134', 'U77000237', 'U77000237', 'UT01', 'ARUP Pathology Associates', 'Sherrie', 'L', 'Perkins', 'MD, PhD', 'Pathology', 'Anatomic Pathology', NULL, NULL, 'B', 'PO Box 413037', 'Salt Lake City', 'Salt Lake', 'UT', '84141', '8012133800', NULL, 'PO Box 413037', 'Salt Lake City', 'Salt Lake', 'UT', '84141', '8012133800', '          ', 'WUUUMG5', 'WUSTDHCPC5', '', '0.00', '25.00', '0.00', 3, '2006-08-01', '2011-12-31', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1598855116', 0, 'N', 0, '2012-03-06', NULL, NULL, 0, 0, NULL, NULL),
('412144134', 'U77000238', 'U77000238', 'UT01', 'ARUP Pathology Associates', 'Cathy', 'A', 'Petti', 'MD', 'Pathology', 'Clinical Pathology', 'Infectious Disease', NULL, 'B', 'PO Box 413037', 'Salt Lake City', 'Salt Lake', 'UT', '84141', '8012133800', NULL, 'PO Box 413037', 'Salt Lake City', 'Salt Lake', 'UT', '84141', '8012133800', '', 'WUUUMG5', 'WUSTDHCPC5', NULL, '0.00', '25.00', '0.00', 3, '2006-08-01', '2009-09-16', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1134219751', 0, 'y', 0, '2012-03-06', NULL, NULL, 0, 0, NULL, NULL),
('412144134', 'U77000239', 'U77000239', 'UT01', 'ARUP Pathology Associates', 'William', 'L', 'Roberts', 'MD, PhD', 'Pathology', 'Clinical Pathology', '', NULL, 'B', 'PO Box 413037', 'Salt Lake City', 'Salt Lake', 'UT', '84141', '8012133800', NULL, 'PO Box 413037', 'Salt Lake City', 'Salt Lake', 'UT', '84141', '8012133800', '          ', 'WUUUMG5', 'WUSTDHCPC5', '', '0.00', '25.00', '0.00', 3, '2006-08-01', '2011-12-31', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1932299559', 0, 'N', 0, '2012-03-06', NULL, NULL, 0, 0, NULL, NULL),
('412144134', 'U77000240', 'U77000240', 'UT01', 'ARUP Pathology Associates', 'Louis', 'Ralph', 'Rohr', 'MD', 'Pathology', 'Anatomic Pathology', NULL, NULL, 'b', 'PO Box 581054', 'Salt Lake City', 'Salt Lake', 'UT', '84158', '8012133800', NULL, NULL, NULL, '', NULL, NULL, '', '', 'WUUUMG5', 'WUSTDHCPC5', NULL, '0.00', '25.00', NULL, 3, '2006-08-01', '2007-12-31', 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', NULL, 0, 'y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
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('611463417', 'U77000288', 'U77000288', 'UT01', 'University of Utah OB Diagnostic Center', 'Harry', 'H', 'Hatasaka, Jr', 'MD', 'Obstetrics and Gynecology', 'OB Diagnotic', NULL, NULL, 'b', 'PO Box 5889', 'Salt Lake City', 'Salt Lake', 'UT', '84158', '8015855172', NULL, NULL, NULL, '', NULL, NULL, '', '', 'WUUUMG5', 'WUSTDHCPC5', NULL, '0.00', '25.00', NULL, 3, '2006-08-01', '2007-06-30', 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', NULL, 0, 'y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
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('611463417', 'U77000290', 'U77000290', 'UT01', 'University of Utah OB Diagnostic Center', 'Gilbert', 'M', 'Jackson', 'MD', 'Maternal Fetal Medicine', 'Obstetrics and Gynecology', NULL, NULL, 'b', 'PO Box 5889', 'Salt Lake City', 'Salt Lake', 'UT', '84158', '8015855172', NULL, NULL, NULL, '', NULL, NULL, '', '', 'WUUUMG5', 'WUSTDHCPC5', NULL, '0.00', '25.00', NULL, 3, '2006-08-01', '2007-06-30', 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1356421259', 0, 'y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
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('611463417', 'U77000303', 'U77000303', 'UT01', 'University of Utah OB Diagnostic Center', 'Jennifer', 'J', 'Trauscht-Van Horn', 'MD', 'Obstetrics and Gynecology', 'Certified Nurse Midwife', NULL, NULL, 'b', 'PO Box 5889', 'Salt Lake City', 'Salt Lake', 'UT', '84158', '8015855172', NULL, NULL, NULL, '', NULL, NULL, '', '', 'WUUUMG5', 'WUSTDHCPC5', NULL, '0.00', '25.00', NULL, 3, '2006-08-01', '2007-06-30', 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1306926209', 0, 'y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('611463417', 'U77000304', 'U77000304', 'UT01', 'University of Utah OB Diagnostic Center', 'Michael', 'W', 'Varner', 'MD', 'Maternal Fetal Medicine', 'Obstetrics and Gynecology', NULL, NULL, 'b', 'PO Box 5889', 'Salt Lake City', 'Salt Lake', 'UT', '84158', '8015855172', NULL, NULL, NULL, '', NULL, NULL, '', '', 'WUUUMG5', 'WUSTDHCPC5', NULL, '0.00', '25.00', NULL, 3, '2006-08-01', '2007-06-30', 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1396783486', 0, 'y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('611463417', 'U77000305', 'U77000305', 'UT01', 'University of Utah OB Diagnostic Center', 'Jennifer', 'E', 'Warren', 'MD', 'Obstetrics and Gynecology', 'OB Diagnotic', NULL, NULL, 'b', 'PO Box 5889', 'Salt Lake City', 'Salt Lake', 'UT', '84158', '8015855172', NULL, NULL, NULL, '', NULL, NULL, '', '', 'WUUUMG5', 'WUSTDHCPC5', NULL, '0.00', '25.00', NULL, 3, '2006-08-01', '2007-06-30', 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1558315853', 0, 'y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
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('611463417', 'U77000307', 'U77000307', 'UT01', 'University of Utah OB Diagnostic Center', 'Paula', 'J', 'Woodward', 'MD', 'Obstetrics and Gynecology', 'OB Diagnotic', 'Radiologist', NULL, 'B', 'PO Box 413028', 'Salt Lake City', 'Salt Lake', 'UT', '84141', '8015855172', NULL, 'PO Box 413028', 'Salt Lake City', 'Salt Lake', 'UT', '84141', '8015855172', '          ', 'WUUUMG5', 'WUSTDHCPC5', '', '0.00', '25.00', '0.00', 3, '2006-08-01', '2012-08-19', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1003808429', 0, 'N', 0, '2012-08-20', NULL, NULL, 0, 0, NULL, NULL),
('611463417', 'U77000308', 'U77000308', 'UT01', 'University of Utah OB Diagnostic Center', 'Erin', 'B', 'Wright', 'APRN', 'Obstetrics and Gynecology', 'OB Diagnotic', NULL, NULL, 'b', 'PO Box 5889', 'Salt Lake City', 'Salt Lake', 'UT', '84158', '8015855172', NULL, NULL, NULL, '', NULL, NULL, '', '', 'WUUUMG5', 'WUSTDHCPC5', NULL, '0.00', '25.00', NULL, 3, '2006-08-01', '2007-06-30', 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1952464471', 0, 'y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('710885968', 'U77000309', 'U77000309', 'UT01', 'U of U Pain Management Physicians Group', 'Patricia', 'H', 'Berry', 'APRN', 'Anesthesiology', 'Anesthesiology', NULL, 'Nursing', 'O', '2000 Circle of Hope Ste 2100', 'Salt Lake City', 'Salt Lake', 'UT', '84112', '8015850157', NULL, NULL, NULL, '', NULL, NULL, '', '', 'WUUUMG5', 'WUSTDHCPC5', NULL, '0.00', '25.00', NULL, 3, '2006-08-01', '2006-12-31', 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1114017746', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('710885968', 'U77000310', 'U77000310', 'UT01', 'U of U Pain Management Physicians Group', 'Shane', 'E', 'Brogan', 'MD', 'Pain Management', 'Anesthesiology', NULL, 'Nursing', 'O', '2000 Circle of Hope Ste 2100', 'Salt Lake City', 'Salt Lake', 'UT', '84112', '8015850157', NULL, NULL, NULL, '', NULL, NULL, '', '', 'WUUUMG5', 'WUSTDHCPC5', NULL, '0.00', '25.00', NULL, 3, '2006-08-01', '2006-12-31', 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1851481436', 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
('710885968', 'U77000311', 'U77000311', 'UT01', 'U of U Pain Management Physicians Group', 'Christian', 'C', 'Obah', 'MD', 'Pain Management', 'Anesthesiology', NULL, 'Nursing', 'O', '2000 Circle of Hope Ste 2100', 'Salt Lake City', 'Salt Lake', 'UT', '84112', '8015850157', NULL, NULL, NULL, '', NULL, NULL, '', '', 'WUUUMG5', 'WUSTDHCPC5', NULL, '0.00', '25.00', NULL, 3, '2006-08-01', '2006-12-31', 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1912959008', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
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('743134262', 'U77000481', 'U77000481', 'UT01', 'University Health Care', 'James', 'F', 'Bale', 'MD', 'Neurology', 'Pediatric Neurology', '', NULL, 'B', 'PO Box 413021', 'Salt Lake City', 'Salt Lake', 'UT', '84141', '8012133800', NULL, 'PO Box 413021', 'Salt Lake City', 'Salt Lake', 'UT', '84141', '8012133800', '          ', 'WUUPEDS', 'WUSTDHCPC5', '', '0.00', '15.00', '0.00', 3, '2006-08-01', '2012-07-30', 0, 0, 0, 'Primary Childrens Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1750460226', 0, 'N', 0, '2012-10-16', NULL, NULL, 0, 0, NULL, NULL),
('743134262', 'U77000482', 'U77000482', 'UT01', 'University Health Care', 'Susan', 'L', 'Benedict', 'MD, MS', 'Pediatric Neurology', NULL, NULL, NULL, 'B', 'PO Box 413021', 'Salt Lake City', 'Salt Lake', 'UT', '84141', '8012133800', NULL, 'PO Box 413021', 'Salt Lake City', 'Salt Lake', 'UT', '84141', '8012133800', '          ', 'WUUPEDS', 'WUSTDHCPC5', '', '0.00', '15.00', '0.00', 3, '2006-08-01', '2012-07-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1740369214', 0, 'N', 0, '2012-07-31', NULL, NULL, 0, 0, NULL, NULL),
('743134262', 'U77000483', 'U77000483', 'UT01', 'University Health Care', 'Joshua', 'L', 'Bonkowsky', 'MD, PHD', 'Pediatric Neurology', NULL, NULL, NULL, 'B', 'PO Box 413021', 'Salt Lake City', 'Salt Lake', 'UT', '84141', '8012133800', NULL, 'PO Box 413021', 'Salt Lake City', 'Salt Lake', 'UT', '84141', '8012133800', '          ', 'WUUPEDS', 'WUSTDHCPC5', '', '0.00', '15.00', '0.00', 3, '2006-08-01', '2012-07-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1578518155', 0, 'N', 0, '2012-07-31', NULL, NULL, 0, 0, NULL, NULL),
('743134262', 'U77000484', 'U77000484', 'UT01', 'University Health Care', 'Francis', 'M', 'Filloux', 'MD', 'Pediatric Neurology', 'Neurology', NULL, NULL, 'B', 'PO Box 413021', 'Salt Lake City', 'Salt Lake', 'UT', '84141', '8012133800', NULL, 'PO Box 413021', 'Salt Lake City', 'Salt Lake', 'UT', '84141', '8012133800', '          ', 'WUUPEDS', 'WUSTDHCPC5', '', '0.00', '15.00', '0.00', 3, '2006-08-01', '2012-07-30', 0, 0, 0, 'Primary Childrens Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1942389515', 0, 'N', 0, '2012-07-31', NULL, NULL, 0, 0, NULL, NULL),
('743134262', 'U77000485', 'U77000485', 'UT01', 'University Health Care', 'Michael', 'Brian', 'Lloyd', 'MD', 'Pediatric Neurology', 'Pediatrics', '', NULL, 'B', 'PO Box 413021', 'Salt Lake City', 'Salt Lake', 'UT', '84141', '8012133800', NULL, 'PO Box 413021', 'Salt Lake City', 'Salt Lake', 'UT', '84141', '8012133800', '          ', 'WUUPEDS', 'WUSTDHCPC5', '', '0.00', '15.00', '0.00', 3, '2006-08-01', '2012-07-30', 0, 0, 0, 'Primary Childrens Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1497753354', 0, 'N', 0, '2012-07-31', NULL, NULL, 0, 0, NULL, NULL);
