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
('043642369', 'W77012639', 'W77012639', 'UT01', 'Ferguson MD PC, Daniel R', 'Daniel', 'R', 'Ferguson', 'MD', 'Obstetrics and Gynecology', NULL, NULL, NULL, 'B', 'PO Box 126', 'Tooele', 'Tooele', 'UT', '84074', '4358339111', '4358339888', NULL, NULL, '', NULL, NULL, '', '', 'USTDOBG', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2003-04-01', '2006-10-31', 0, 0, 0, 'Brigham City Community Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1194802991', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('043814907', 'W77012640', 'W77012640', 'UT01', 'East Layton Internal Medicine', 'Sheldon', 'L', 'Jackson', 'PA', 'Nurse Practitioner ', NULL, NULL, NULL, 'B', 'PO Box 403944', 'Atlanta', 'Fulton', 'GA', '30384', '8017711331', '8017711330', NULL, NULL, '', NULL, NULL, '', '', 'USTDINT', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2006-09-21', '2006-09-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '993725', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('043814907', 'W77012641', 'W77012641', 'UT01', 'East Layton Internal Medicine', 'Sheldon', 'L', 'Jackson', 'PA', 'Nurse Practitioner ', NULL, NULL, NULL, 'O', '1240 E Highway 193 Ste G1', 'Layton', 'Davis', 'UT', '84040', '8017711331', '8017711330', NULL, NULL, '', NULL, NULL, '', '', 'USTDINT', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2006-09-21', '2006-09-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '993725', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('201645672', 'W77012642', 'W77012642', 'UT01', 'Riverwoods Interventional Radiology', 'Wendell', 'A', 'Gibby', 'MD', 'Radiologist', NULL, NULL, NULL, 'O', '280 River Park Dr Ste 100', 'Provo', 'Utah', 'UT', '84604', '8014374895', NULL, NULL, NULL, '', NULL, NULL, '', '', 'URURAL', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2006-01-01', '2006-12-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1992802235', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('204905185', 'W77012643', 'W77012643', 'UT01', 'Clark, Gary W', 'Gary', 'W', 'Clark', 'DPM', 'Podiatry', NULL, NULL, NULL, 'B', '166 W 1325 N Ste 300', 'Cedar City', 'Iron', 'UT', '84720', '4358678521', '4355864073', NULL, NULL, '', NULL, NULL, '', '', 'USTDPOD', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2006-03-24', '2006-08-31', 0, 0, 0, 'Valley View Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1609861152', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('204905185', 'W77012645', 'W77012645', 'UT01', 'Gary W Clark DPM', 'Gary', 'W', 'Clark', 'DPM', 'Podiatry', NULL, NULL, NULL, 'O', '444 S Main St', 'Milford', 'Beaver', 'UT', '84751', '8884373668', NULL, NULL, NULL, '', NULL, NULL, '', '', 'USTDPOD', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2006-03-24', '2006-08-31', 0, 0, 0, 'Valley View Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1609861152', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('204905185', 'W77012646', 'W77012646', 'UT01', 'Gary W Clark DPM', 'Gary', 'W', 'Clark', 'DPM', 'Podiatry', NULL, NULL, NULL, 'O', '55 N 400 E', 'Beaver', 'Beaver', 'UT', '84713', '8884373668', NULL, NULL, NULL, '', NULL, NULL, '', '', 'USTDPOD', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2006-03-24', '2006-08-31', 0, 0, 0, 'Valley View Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1609861152', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('205328802', 'W77012647', 'W77012647', 'UT01', NULL, 'Joseph', 'M', 'Johnson', 'MD', 'Pediatrics', NULL, NULL, NULL, 'O', '1675 N Freedom Blvd Ste 9C', 'Provo', 'Utah', 'UT', '84604', '8013774800', NULL, NULL, NULL, '', NULL, NULL, '', '', 'UUVPN', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2005-07-29', '2006-12-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1427126192', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('621560557', 'W77012648', 'W77012648', 'UT01', 'South Ogden Center For Family Medicine', 'Smitha', NULL, 'Sadiq', 'MD', 'Internal Medicine', 'Pediatrics', 'Family Practice', NULL, 'B', '5740 Crestwood Dr', 'Ogden', 'Weber', 'UT', '84405', '8014797792', '8014797795', NULL, NULL, '', NULL, NULL, '', '', 'USTDNEUR', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2005-02-25', '2006-06-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1962490201', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('621560557', 'W77012649', 'W77012649', 'UT01', 'Morgan Health Center', 'Smitha', NULL, 'Sadiq', 'MD', 'Internal Medicine', 'Pediatrics', 'Family Practice', NULL, 'O', '166 N State St', 'Morgan', 'Morgan', 'UT', '84050', '8018293426', NULL, NULL, NULL, '', NULL, NULL, '', '', 'USTDNEUR', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2005-02-25', '2006-06-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1962490201', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('621795215', 'W77012650', 'W77012650', 'UT01', 'Jordan Valley Hospital Holdings', 'Helen', 'Highsmith', 'Hollingsworth', 'MD', 'Internal Medicine', 'Hospitalist', NULL, NULL, 'B', 'PO Box 95970', 'South Jordan', 'Salt Lake', 'UT', '84095', '8013529500', '8013527976', NULL, NULL, '', NULL, NULL, '', '', 'USTDSURG', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2006-02-01', '2006-09-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '963019', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('621801973', 'W77012651', 'W77012651', 'UT01', 'Pioneer Valley Hospital Physicians', 'Jonathan', 'W', 'Blanch', 'MD', 'Internal Medicine', 'Hospitalist', NULL, NULL, 'B', 'PO Box 95970', 'South Jordan', 'Salt Lake', 'UT', '84095', '8013529500', '8019699028', NULL, NULL, '', NULL, NULL, '', '', 'USTDINT', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2003-11-07', '2006-09-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1295757573', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('621801973', 'W77012652', 'W77012652', 'UT01', 'Internal Medicine Specialist - Hospitalists', 'Jonathan', 'W', 'Blanch', 'MD', 'Internal Medicine', 'Hospitalist', NULL, NULL, 'O', '3460 Pioneer Pkwy', 'Salt Lake City', 'Salt Lake', 'UT', '84120', '8019643101', NULL, NULL, NULL, '', NULL, NULL, '', '', 'USTDINT', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2003-11-07', '2006-09-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1295757573', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('710885968', 'W77012653', 'W77012653', 'UT01', 'Pain Management Physicians Group', 'Lorene', 'S', 'Johnson', 'NP', 'Nurse Anesthetist', NULL, NULL, NULL, 'B', 'PO Box 581053', 'Salt Lake City', 'Salt Lake', 'UT', '84158', '8012367778', NULL, NULL, NULL, '', NULL, NULL, '', '', 'UUUMG', NULL, NULL, '0.00', '25.00', NULL, 3, '2006-09-01', '2006-09-02', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '999908', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('710885968', 'W77012654', 'W77012654', 'UT01', 'Pain Management Physicians Group', 'Lorene', 'S', 'Johnson', 'NP', 'Nurse Anesthetist', NULL, NULL, NULL, 'O', '546 Chipeta Way Ste 220', 'Salt Lake City', 'Salt Lake', 'UT', '84108', '8015817246', NULL, NULL, NULL, '', NULL, NULL, '', '', 'UUUMG', NULL, NULL, '0.00', '25.00', NULL, 3, '2006-09-01', '2006-09-02', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '999908', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('743134273', 'W77012655', 'W77012655', 'UT01', 'Pediatric Bone Marrow Transplant Dept University of Utah', 'Tennille', 'C', 'Hensley', 'PA', 'Nurse Practitioner ', NULL, NULL, NULL, 'B', 'PO Box 581100', 'Salt Lake City', 'Salt Lake', 'UT', '84158', '8012367726', NULL, NULL, NULL, '', NULL, NULL, '', '', 'UUMGPED', NULL, NULL, '0.00', '15.00', NULL, 3, '2006-09-01', '2006-12-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1811001290', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('743134273', 'W77012656', 'W77012656', 'UT01', 'Pediatric Bone Marrow Transplant Dept University of Utah', 'Tennille', 'C', 'Hensley', 'PA', 'Nurse Practitioner ', NULL, NULL, NULL, 'O', '100 N Medical Dr', 'Salt Lake City', 'Salt Lake', 'UT', '84132', '8015882000', NULL, NULL, NULL, '', NULL, NULL, '', '', 'UUMGPED', NULL, NULL, '0.00', '15.00', NULL, 3, '2006-09-01', '2006-12-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1811001290', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870218917', 'W77012657', 'W77012657', 'UT01', 'Tanner Memorial Clinic', 'Arif', 'A', 'Chowdhury', 'MD', 'Neurology', NULL, NULL, NULL, 'B', 'PO Box 337', 'Layton', 'Davis', 'UT', '84041', '8017734840', '8015258151', NULL, NULL, '', NULL, NULL, '', '', 'USTDNEUR', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2002-04-01', '2006-06-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1225055023', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870218917', 'W77012658', 'W77012658', 'UT01', 'Tanner Memorial Clinic', 'Arif', 'A', 'Chowdhury', 'MD', 'Neurology', NULL, NULL, NULL, 'O', '2121 Robins Dr', 'Layton', 'Davis', 'UT', '84041', '8017734840', '8015258151', NULL, NULL, '', NULL, NULL, '', '', 'USTDNEUR', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2002-04-01', '2006-06-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1225055023', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870395551', 'W77012659', 'W77012659', 'UT01', 'Chiropractic Health Plan', 'Jeffrey', 'T', 'Owens', 'DC', 'Chiropractic', NULL, NULL, NULL, 'B', '9135 S Monroe St Ste B', 'Sandy', 'Salt Lake', 'UT', '84070', '8013527270', '8013527024', NULL, NULL, '', NULL, NULL, '', '', 'SELECT', NULL, '      2303', '0.00', NULL, NULL, 3, '2006-08-09', '2006-08-09', 1, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1033277025', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870395551', 'W77012660', 'W77012660', 'UT01', 'Jeffrey Owens DC', 'Jeffrey', 'T', 'Owens', 'DC', 'Chiropractic', NULL, NULL, NULL, 'O', '2040 Murray Holladay Rd Ste 206', 'Salt Lake City', 'Salt Lake', 'UT', '84117', '8012777120', '8012777146', NULL, NULL, '', NULL, NULL, '', '', 'SELECT', NULL, '      2303', '0.00', NULL, NULL, 3, '2006-08-09', '2006-08-09', 1, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1033277025', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870395551', 'W77012661', 'W77012661', 'UT01', 'Chiropractic Health Plan', 'Cynthia', 'K', 'Daw', 'DC', 'Chiropractic', NULL, NULL, NULL, 'B', '9135 S Monroe St Ste B', 'Sandy', 'Salt Lake', 'UT', '84070', '8013527270', '8013527024', NULL, NULL, '', NULL, NULL, '', '', 'SELECT', NULL, '      2303', '0.00', NULL, NULL, 3, '2006-09-01', '2006-09-01', 1, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1972616894', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870395551', 'W77012662', 'W77012662', 'UT01', 'Discover Systems', 'Cynthia', 'K', 'Daw', 'DC', 'Chiropractic', NULL, NULL, NULL, 'O', '1401 E 3900 S Ste 208', 'Salt Lake City', 'Salt Lake', 'UT', '84124', '8017271403', NULL, NULL, NULL, '', NULL, NULL, '', '', 'SELECT', NULL, '      2303', '0.00', NULL, NULL, 3, '2006-09-01', '2006-09-01', 1, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1972616894', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870395551', 'W77012663', 'W77012663', 'UT01', 'Chiropractic Health Plan', 'Erik', 'S', 'Horsley', 'DC', 'Chiropractic', NULL, NULL, NULL, 'B', '9135 S Monroe St Ste B', 'Sandy', 'Salt Lake', 'UT', '84070', '8013527270', '8013527024', NULL, NULL, '', NULL, NULL, '', '', 'SELECT', NULL, '      2303', '0.00', NULL, NULL, 3, '2006-08-01', '2006-08-01', 1, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1952341802', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870395551', 'W77012664', 'W77012664', 'UT01', 'Horsley Chiropractic', 'Erik', 'S', 'Horsley', 'DC', 'Chiropractic', NULL, NULL, NULL, 'O', '3855 W 7800 S', 'West Jordan', 'Salt Lake', 'UT', '84088', '8012825952', '8012825951', NULL, NULL, '', NULL, NULL, '', '', 'SELECT', NULL, '      2303', '0.00', NULL, NULL, 3, '2006-08-01', '2006-08-01', 1, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1952341802', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870442845', 'W77012665', 'W77012665', 'UT01', 'Huntsman Cancer Institute', 'Tennille', 'C', 'Hensley', 'PA', 'Nurse Practitioner ', NULL, NULL, NULL, 'B', 'PO Box 581700', 'Salt Lake City', 'Salt Lake', 'UT', '84158', '8015850124', NULL, NULL, NULL, '', NULL, NULL, '', '', 'UUUMG', NULL, NULL, '0.00', '25.00', NULL, 3, '2006-09-01', '2006-12-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1811001290', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870442845', 'W77012666', 'W77012666', 'UT01', 'Huntsman Cancer Institute', 'Tennille', 'C', 'Hensley', 'PA', 'Nurse Practitioner ', NULL, NULL, NULL, 'O', '50 N Medical Dr', 'Salt Lake City', 'Salt Lake', 'UT', '84132', '8015853229', NULL, NULL, NULL, '', NULL, NULL, '', '', 'UUUMG', NULL, NULL, '0.00', '25.00', NULL, 3, '2006-09-01', '2006-12-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1811001290', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870460977', 'W77012667', 'W77012667', 'UT01', 'U Of U Vascular Lab', 'Daniel', 'V', 'Kinikini', 'MD', 'Pediatric Orthopedic Surgery', 'Vascular Surgery', NULL, NULL, 'B', 'PO Box 58163', 'Salt Lake City', 'Salt Lake', 'UT', '84158', '8012386618', NULL, NULL, NULL, '', NULL, NULL, '', '', 'UUUMG', NULL, NULL, '0.00', '25.00', NULL, 3, '2006-08-08', '2006-12-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1043264070', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870460977', 'W77012668', 'W77012668', 'UT01', 'U Of U Vascular Lab', 'Daniel', 'V', 'Kinikini', 'MD', 'Pediatric Orthopedic Surgery', 'Vascular Surgery', NULL, NULL, 'O', '50 N Medical Dr', 'Salt Lake City', 'Salt Lake', 'UT', '84132', '8015853551', NULL, NULL, NULL, '', NULL, NULL, '', '', 'UUUMG', NULL, NULL, '0.00', '25.00', NULL, 3, '2006-08-08', '2006-12-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1043264070', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870476269', 'W77012669', 'W77012669', 'UT01', 'U Of U Dept Of Pediatrics', 'Daniel', 'V', 'Kinikini', 'MD', 'Pediatric Orthopedic Surgery', 'Vascular Surgery', NULL, NULL, 'B', 'PO Box 581100', 'Salt Lake City', 'Salt Lake', 'UT', '84158', '8015882360', NULL, NULL, NULL, '', NULL, NULL, '', '', 'UUUMG', NULL, NULL, '0.00', '25.00', NULL, 3, '2006-08-08', '2006-12-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1043264070', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870476269', 'W77012670', 'W77012670', 'UT01', 'U Of U Pediatrics - PCMC', 'Daniel', 'V', 'Kinikini', 'MD', 'Pediatric Orthopedic Surgery', 'Vascular Surgery', NULL, NULL, 'O', '100 N Medical Dr', 'Salt Lake City', 'Salt Lake', 'UT', '84113', '8015812321', NULL, NULL, NULL, '', NULL, NULL, '', '', 'UUUMG', NULL, NULL, '0.00', '25.00', NULL, 3, '2006-08-08', '2006-12-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1043264070', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870479370', 'W77012672', 'W77012672', 'UT01', 'Mountain West Cardiovascular Associates', 'Paul', 'S', 'Gilmore', 'MD', 'Cardiovascular Disease', NULL, NULL, NULL, 'O', '1160 E 3900 S Ste 2000', 'Salt Lake City', 'Salt Lake', 'UT', '84124', '8012663418', '8012664174', '1160 E 3900 S', 'Salt Lake City', '', 'UT', '84124', '', '', 'USTDCARD', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2006-09-21', '2006-09-21', 0, 0, 0, 'St Marks Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1487621389', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870479370', 'W77012673', 'W77012673', 'UT01', 'The Heart Center', 'Paul', 'S', 'Gilmore', 'MD', 'Cardiovascular Disease', NULL, NULL, NULL, 'O', '3725 W 4100 S', 'West Valley', 'Salt Lake', 'UT', '84120', '8019681818', NULL, '1160 E 3900 S', 'Salt Lake City', '', 'UT', '84124', '', '', 'USTDCARD', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2006-09-21', '2006-09-21', 0, 0, 0, 'St Marks Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1487621389', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870483582', 'W77012674', 'W77012674', 'UT01', 'University of Utah Orthopedic Consultants', 'Robert', 'Zaray', 'Tashjian', 'MD', 'Orthopedic Surgery', NULL, NULL, NULL, 'B', 'PO Box 58108', 'Salt Lake City', 'Salt Lake', 'UT', '84158', '8015813998', NULL, NULL, NULL, '', NULL, NULL, '', '', 'UUUMG', NULL, NULL, '0.00', '25.00', NULL, 3, '2006-08-30', '2006-12-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1659300044', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870483582', 'W77012675', 'W77012675', 'UT01', 'University Orthopedic Center', 'Robert', 'Zaray', 'Tashjian', 'MD', 'Orthopedic Surgery', NULL, NULL, NULL, 'O', '590 Wakara Way', 'Salt Lake City', 'Salt Lake', 'UT', '84108', '8015877100', NULL, NULL, NULL, '', NULL, NULL, '', '', 'UUUMG', NULL, NULL, '0.00', '25.00', NULL, 3, '2006-08-30', '2006-12-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1659300044', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870483582', 'W77012676', 'W77012676', 'UT01', 'University of Utah Orthopedic Consultants', 'Michael', 'D', 'Daubs', 'MD', 'Orthopedic Surgery', 'Pediatric Orthopedic Surgery', NULL, NULL, 'B', 'PO Box 58108', 'Salt Lake City', 'Salt Lake', 'UT', '84158', '8015813998', NULL, NULL, NULL, '', NULL, NULL, '', '', 'UUUMG', NULL, NULL, '0.00', '25.00', NULL, 3, '2006-08-10', '2006-12-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1275528416', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870483582', 'W77012677', 'W77012677', 'UT01', 'University Orthopedic Center', 'Michael', 'D', 'Daubs', 'MD', 'Orthopedic Surgery', 'Pediatric Orthopedic Surgery', NULL, NULL, 'O', '590 Wakara Way', 'Salt Lake City', 'Salt Lake', 'UT', '84108', '8015877100', NULL, NULL, NULL, '', NULL, NULL, '', '', 'UUUMG', NULL, NULL, '0.00', '25.00', NULL, 3, '2006-08-10', '2006-12-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1275528416', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
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('529661977', 'WY0000007', 'WY0000007', 'WY01', 'South Lincoln Medical Center', 'Paul', 'N', 'Daniels', 'DPM', 'Podiatry', '', '', NULL, 'O', '711 Onyx St', 'Kemmerer', 'Lincoln', 'WY', '83101', '3078774496', NULL, '711 Onyx St', 'Kemmerer', 'Lincoln', 'WY', '83101', '3078774496', '', 'wystd', 'wyhcpcs', NULL, '0.00', '35.00', '0.00', 3, '2006-12-01', NULL, 0, 0, 0, 'Evanston Regional Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1760499180', 0, 'N', 0, '2013-07-10', NULL, NULL, 41.7896, -110.54, NULL, NULL),
('205701046', 'WY0000008', 'WY0000008', 'WY01', NULL, 'David', 'J', 'Harbrecht', 'MD', 'Ear, Nose and Throat', '', '', NULL, 'O', '196 Arrowhead Ste 5', 'Evanston', 'Uinta', 'WY', '82930', '3077838364', NULL, '196 Arrowhead Ste 5', 'Evanston', 'Uinta', 'WY', '82930', '3077838364', '', 'wystd', 'wyhcpcs', NULL, '0.00', '35.00', '0.00', 3, '2006-12-01', NULL, 0, 0, 0, 'Lakeview Hospital', '', '', '', 'HCFA|UB|', '1245312784', 0, 'N', 0, '2013-11-11', NULL, NULL, 41.2435, -110.998, NULL, NULL),
('481269523', 'WY0000009', 'WY0000009', 'WY01', 'Sweetwater Foot Care', 'David', 'A', 'Duckwitz', 'DPM', 'Podiatry', '', '', NULL, 'O', '2631 Foothill Blvd Ste C', 'Rock Springs', 'Sweetwater', 'WY', '82901', '3073629545', NULL, '2631 Foothill Blvd Ste C', 'Rock Springs', 'Sweetwater', 'WY', '82901', '3073629545', '', 'wystd', 'wyhcpcs', NULL, '0.00', '35.00', '0.00', 3, '2006-12-01', NULL, 0, 0, 0, 'Memorial Hospital of Sweetwater County', '', '', '', 'HCFA|UB|', '1447421904', 0, 'N', 0, '2014-03-24', NULL, NULL, 41.5823, -109.258, NULL, NULL),
('223887117', 'WY0000010', 'WY0000010', 'WY01', 'Mountain Valley Eye Institute', 'John', 'B', 'Fassio', 'MD', 'Ophthalmology', NULL, NULL, NULL, 'O', '196 Arrowhead Dr Ste 5', 'Evanston', 'Uinta', 'WY', '82930', '8015341360', NULL, '1471 Hwy 40', 'Heber City', '', 'UT', '84032', '', '', 'WISESTD', 'WUSTDHCPC5', NULL, '0.00', '35.00', NULL, 6, '2000-01-01', '2000-01-01', 0, NULL, 0, 'Evanston Regional Hospital', 'Heber Valley Medical Center', NULL, NULL, 'HCFA|UB|', '1689671638', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('223887117', 'WY0000011', 'WY0000011', 'WY01', 'Mt Valley Eye Institute', 'John', 'B', 'Fassio', 'MD', 'Ophthalmology', NULL, NULL, NULL, 'B', 'PO Box 27688', 'Salt Lake City', 'Salt Lake', 'UT', '84127', '8015341360', NULL, '1471 Hwy 40', 'Heber City', '', 'UT', '84032', '', '', 'wystd', 'wyhcpcs', NULL, '0.00', '35.00', NULL, 3, '2006-12-01', '2006-12-01', 0, NULL, 0, 'Evanston Regional Hospital', 'Heber Valley Medical Center', NULL, NULL, 'HCFA|UB|', '1689671638', 0, 'y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
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('529661977', 'WY0000013', 'WY0000013', 'WY01', NULL, 'Paul', 'N', 'Daniels', 'DPM', 'Podiatry', '', '', NULL, 'O', '1101 Ctr St Ste 1326', 'Evanston', 'Uinta', 'WY', '82931', '3077898292', NULL, '1101 Ctr St Ste 1326', 'Evanston', 'Uinta', 'WY', '82931', '3077898292', '', 'wystd', 'wyhcpcs', NULL, '0.00', '35.00', '0.00', 3, '2006-12-01', NULL, 0, 0, 0, 'Evanston Regional Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1760499180', 0, 'N', 0, '2013-07-10', NULL, NULL, 41.2678, -110.968, NULL, NULL),
('529661977', 'WY0000014', 'WY0000014', 'WY01', NULL, 'Paul', 'N', 'Daniels', 'DPM', 'Podiatry', '', '', NULL, 'B', '1449 E 3300 S', 'Salt Lake City', 'Salt Lake', 'UT', '84106', '8014831015', NULL, '1449 E 3300 S', 'Salt Lake City', 'Salt Lake', 'UT', '84106', '8014831015', '', 'wystd', 'wyhcpcs', NULL, '0.00', '35.00', '0.00', 3, '2006-12-01', NULL, 0, 0, 0, 'Evanston Regional Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1760499180', 0, 'y', 0, '2013-07-10', NULL, NULL, 0, 0, NULL, NULL),
('830291722', 'WY0000015', 'WY0000015', 'WY01', '', 'Michael', 'D', 'Adams', 'MD', 'Family Practice', '', '', NULL, 'O', '75 Yellow Creek Rd Ste 102', 'Evanston', 'Uinta', 'WY', '82930', '3077898290', NULL, '75 Yellow Creek Rd Ste 102', 'Evanston', 'Uinta', 'WY', '82930', '3077898290', '          ', 'wystd', 'wyhcpcs', '', '0.00', '35.00', '0.00', 3, '2006-12-01', NULL, 0, 0, 0, 'Evanston Regional Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1922005347', 0, 'N', 0, '2013-03-07', NULL, NULL, 41.2591, -110.967, NULL, NULL),
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('830267172', 'WY0000026', 'WY0000026', 'WY01', 'South Lincoln Medical Clinic', 'S', 'D', 'George', 'MD', 'Obstetrics and Gynecology', '', '', NULL, 'O', '711 Onyx St', 'Kemmerer', 'Lincoln', 'WY', '83101', '3078774401', NULL, '711 Onyx St', 'Kemmerer', 'Lincoln', 'WY', '83101', '3078774401', '          ', 'wystd', 'wyhcpcs', '', '0.00', '35.00', '0.00', 3, '2006-12-01', NULL, 1, 0, 0, 'South Lincoln Medical Center', '', '', '', 'HCFA|UB|', '1043392863', 0, 'N', 0, '2012-08-14', NULL, NULL, 41.7896, -110.54, 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
('830267172', 'WY0000027', 'WY0000027', 'WY01', 'South Lincoln Medical Clinic', 'Paul', 'N', 'Daniels', 'DPM', 'Podiatry', '', '', NULL, 'O', '711 Onyx St', 'Kemmerer', 'Lincoln', 'WY', '83101', '3078774401', NULL, '711 Onyx St', 'Kemmerer', 'Lincoln', 'WY', '83101', '3078774401', '', 'wystd', 'wyhcpcs', NULL, '0.00', '35.00', '0.00', 3, '2006-12-01', NULL, 0, 0, 0, 'Evanston Regional Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1760499180', 0, 'N', 0, '2013-07-10', NULL, NULL, 41.7896, -110.54, NULL, NULL),
('830267172', 'WY0000028', 'WY0000028', 'WY01', 'South Lincoln Medical Clinic', 'Gregory', 'M', 'Yasuda', 'MD', 'General Surgery', '', '', NULL, 'B', 'PO Box 390', 'Kemmerer', 'Lincoln', 'WY', '83101', '3078774401', NULL, 'PO Box 390', 'Kemmerer', 'Lincoln', 'WY', '83101', '3078774401', '', 'wystd', 'wyhcpcs', NULL, '0.00', '35.00', '0.00', 3, '2006-12-01', NULL, 0, 0, 0, 'South Lincoln Medical Center', '', '', '', 'HCFA|UB|', '1841391349', 0, 'y', 0, '2014-04-17', NULL, NULL, 0, 0, NULL, NULL),
('830267172', 'WY0000029', 'WY0000029', 'WY01', 'South Lincoln Medical Clinic', 'George', 'C', 'Krell', 'MD', 'Family Practice', '', '', NULL, 'B', 'PO Box 390', 'Kemmerer', 'Lincoln', 'WY', '83101', '3078774401', NULL, 'PO Box 390', 'Kemmerer', 'Lincoln', 'WY', '83101', '3078774401', '', 'wystd', 'wyhcpcs', NULL, '0.00', '35.00', '0.00', 3, '2006-12-01', NULL, 0, 0, 0, 'South Lincoln Medical Center', '', '', '', 'HCFA|UB|', '1750482527', 0, 'y', 0, '2014-04-16', NULL, NULL, 0, 0, NULL, NULL),
('830267172', 'WY0000030', 'WY0000030', 'WY01', 'South Lincoln Medical Clinic', 'Jeremy', 'C', 'Starr', 'DO', 'Family Practice', '', '', NULL, 'B', 'PO Box 390', 'Kemmerer', 'Lincoln', 'WY', '83101', '3078774401', NULL, 'PO Box 390', 'Kemmerer', 'Lincoln', 'WY', '83101', '3078774401', '', 'wystd', 'wyhcpcs', NULL, '0.00', '35.00', '0.00', 3, '2006-12-01', NULL, 0, 0, 0, 'South Lincoln Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1699876987', 0, 'y', 0, '2011-12-29', NULL, NULL, 0, 0, NULL, NULL),
('830267172', 'WY0000031', 'WY0000031', 'WY01', 'South Lincoln Medical Clinic', 'Vince', 'H', 'Hinshaw', 'MD', 'Family Practice', '', '', NULL, 'B', 'PO Box 390', 'Kemmerer', 'Lincoln', 'WY', '83101', '3078774401', NULL, 'PO Box 390', 'Kemmerer', 'Lincoln', 'WY', '83101', '3078774401', '', 'wystd', 'wyhcpcs', NULL, '0.00', '35.00', '0.00', 3, '2006-12-01', NULL, 0, 0, 0, 'South Lincoln Medical Center', '', '', '', 'HCFA|UB|', '1346286671', 0, 'y', 0, '2014-04-16', NULL, NULL, 0, 0, NULL, NULL),
('830267172', 'WY0000032', 'WY0000032', 'WY01', 'South Lincoln Medical Clinic', 'Fred', 'A', 'Baldwin', 'PA', 'Family Practice', 'Emergency Medicine', '', NULL, 'B', 'PO Box 390', 'Kemmerer', 'Lincoln', 'WY', '83101', '3078774401', NULL, 'PO Box 390', 'Kemmerer', 'Lincoln', 'WY', '83101', '3078774401', '', 'wystd', 'wyhcpcs', NULL, '0.00', '35.00', '0.00', 3, '2006-12-01', NULL, 0, 0, 0, 'Evanston Regional Hospital', 'South Lincoln Medical Center', NULL, NULL, 'HCFA|UB|', '1033290978', 0, 'y', 0, '2011-06-15', NULL, NULL, 0, 0, NULL, NULL),
('830267172', 'WY0000033', 'WY0000033', 'WY01', 'South Lincoln Medical Clinic', 'Melissa', 'A', 'Foster', 'FNP', 'Family Practice', '', '', NULL, 'B', 'PO Box 390', 'Kemmerer', 'Lincoln', 'WY', '83101', '3078774401', NULL, 'PO Box 390', 'Kemmerer', 'Lincoln', 'WY', '83101', '3078774401', '          ', 'wystd', 'wyhcpcs', '', '0.00', '35.00', '0.00', 3, '2006-12-01', '2012-04-01', 0, 0, 0, 'Evanston Regional Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1205928108', 0, 'N', 0, '2012-04-02', NULL, NULL, 0, 0, NULL, NULL),
('830267172', 'WY0000034', 'WY0000034', 'WY01', 'South Lincoln Medical Clinic', 'Robert', 'L', 'Darr', 'PA', 'Family Practice', '', '', NULL, 'B', 'PO Box 390', 'Kemmerer', 'Lincoln', 'WY', '83101', '3078774401', NULL, 'PO Box 390', 'Kemmerer', 'Lincoln', 'WY', '83101', '3078774401', '', 'wystd', 'wyhcpcs', '', '0.00', '35.00', '0.00', 3, '2006-12-01', '2008-03-05', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1942301254', 0, 'y', 0, '2014-06-25', NULL, NULL, 0, 0, NULL, NULL),
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('870519172', 'WY0000109', 'WY0000109', 'WY01', 'Utah Heart Clinic', 'Peter', 'J', 'Casterella', 'MD', 'Cardiovascular Disease', '', '', NULL, 'O', '150 Arrowhead Dr', 'Evanston', 'Uinta', 'WY', '82930', '3077890524', NULL, '5169 S Cottonwood', 'Murray', '', 'UT', '84107', '', '', 'WUSTDCARD5', 'WUSTDHCPC5', NULL, '0.00', '35.00', '0.00', 3, '2006-12-01', '2008-05-04', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1063480655', 0, 'N', 0, '2009-02-02', NULL, NULL, 0, 0, NULL, NULL),
('870503202', 'WY0000110', 'WY0000110', 'WY01', 'Mountain West Ear Nose and Throat', 'Curt', 'R', 'Stock', 'MD', 'Ear, Nose and Throat', '', '', NULL, 'O', '901 Adams St', 'Afton', 'Lincoln', 'WY', '83110', '3078855800', NULL, '901 Adams St', 'Afton', 'Lincoln', 'WY', '83110', '3078855800', '', 'WiseStd', 'WUSTDHCPC5', NULL, '0.00', '35.00', '0.00', 3, '2006-12-01', NULL, 0, 0, 0, 'Davis Hospital', 'Lakeview Hospital', 'Primary Childrens Medical Center', 'Star Valley Medical Center', 'HCFA|UB|', '1275681686', 0, 'N', 0, '2013-08-16', NULL, NULL, 42.719, -110.931, NULL, NULL),
('830183531', 'WY0000111', 'WY0000111', 'WY01', '', 'Orson', 'D', 'Perkes', 'MD', 'Family Practice', '', '', NULL, 'O', '110 Hospital Ln', 'Afton', 'Lincoln', 'WY', '83110', '3078855837', NULL, '110 Hospital Ln', 'Afton', 'Lincoln', 'WY', '83110', '3078855837', '          ', 'wystd', 'wyhcpcs', '', '0.00', '35.00', '0.00', 3, '2006-12-01', '2012-11-15', 0, 0, 0, 'Star Valley Medical Center', '', '', '', 'HCFA|UB|', '0000008137', 0, 'N', 0, '2012-11-20', NULL, NULL, 0, 0, NULL, NULL),
('830183531', 'WY0000112', 'WY0000112', 'WY01', '', 'Orson', 'D', 'Perkes', 'MD', 'Family Practice', '', '', NULL, 'B', 'PO Box 399', 'Afton', 'Lincoln', 'WY', '83110', '3078855837', NULL, 'PO Box 399', 'Afton', 'Lincoln', 'WY', '83110', '3078855837', '          ', 'wystd', 'wyhcpcs', '', '0.00', '35.00', '0.00', 3, '2006-12-01', '2012-11-15', 0, 0, 0, 'Star Valley Medical Center', '', '', '', 'HCFA|UB|', '0000008137', 0, 'N', 0, '2012-11-20', NULL, NULL, 0, 0, NULL, NULL),
('830327475', 'WY0000113', 'WY0000113', 'WY01', 'Evanston Regional Hospital', 'Victor', 'R', 'Judd', 'PT', '', '', '', NULL, 'O', '196 Arrowhead Dr', 'Evanston', 'Uinta', 'WY', '82930', '3077838220', NULL, '196 Arrowhead Dr', 'Evanston', 'Uinta', 'WY', '82930', '3077838220', '          ', '', '', '', '0.00', '0.00', '100.00', 6, '2006-12-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '0000007010', 0, 'N', 0, '2011-06-10', NULL, NULL, 41.2435, -110.998, NULL, NULL),
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('870395551', 'WY0000116', 'WY0000116', 'UT01', 'Hoover Chiropractic Clinic', 'Lance', NULL, 'Walker', 'DC', 'Chiropractic', NULL, NULL, NULL, 'O', '545 Cheyenne Dr Ste A', 'Evanston', 'Uinta', 'WY', '82930', '3077890043', '3077890044', '867 E 9400 S', 'Sandy', '', 'UT', '84094', '', '', 'WLABRAD', 'WUSTDHCPC5', NULL, '0.00', '0.00', '55.46', 3, '2006-12-01', '2010-10-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '0000009488', 0, 'N', 0, '2007-01-11', NULL, NULL, 0, 0, NULL, NULL),
('870395551', 'WY0000117', 'WY0000117', 'UT01', 'Hoover Chiropractic Clinic', 'Todd', 'E', 'Hoover', 'DC', 'Chiropractic', NULL, NULL, NULL, 'O', '313 Sapphire', 'Kemmerer', 'Lincoln', 'WY', '83101', '3078289526', NULL, '867 E 9400 S', 'Sandy', '', 'UT', '84094', '', '', 'WLABRAD', 'WUSTDHCPC5', NULL, '0.00', '0.00', '55.46', 3, '2006-12-01', '2010-10-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1992869358', 0, 'N', 0, '2007-01-11', NULL, NULL, 0, 0, NULL, NULL),
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('200425381', 'WY0000119', 'WY0000119', 'WY01', 'Advanced Eyecare Center', 'William', 'F', 'Atkinson', 'OD', 'Optometry', '', '', NULL, 'O', '547 Cheyenne Dr', 'Evanston', 'Uinta', 'WY', '82930', '3077893937', NULL, '547 Cheyenne Dr', 'Evanston', 'Uinta', 'WY', '82930', '3077893937', '          ', 'wystd', 'wyhcpcs', '', '0.00', '35.00', '0.00', 3, '2006-12-01', '2014-02-24', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1518007517', 0, 'N', 0, '2014-03-03', NULL, NULL, 41.2563, -110.967, NULL, NULL),
('542172261', 'WY0000120', 'WY0000120', 'WY01', NULL, 'Jason', 'C', 'Levitre', 'DPM', 'Podiatry', '', '', NULL, 'B', '6604 Elvedon Dr Ste 100', 'DALLAS', 'Dallas', 'TX', '75248', '3072898997', NULL, '6604 Elvedon Dr Ste 100', 'DALLAS', 'Dallas', 'TX', '75248', '3072898997', '', 'wystd', 'wyhcpcs', NULL, '0.00', '35.00', '0.00', 3, '2006-12-01', NULL, 0, 0, 0, 'Evanston Regional Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1326017179', 0, 'y', 0, '2014-01-24', NULL, NULL, 0, 0, NULL, NULL),
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('204011364', 'WY0000122', 'WY0000122', 'WY01', 'Independent Family Practice', 'Donald', 'J', 'Kirk', 'MD', 'Family Practice', '', '', NULL, 'O', '122 Peterson Pkwy', 'Thayne', 'Lincoln', 'WY', '83127', '3078834437', '', '122 Peterson Pkwy', 'Thayne', 'Lincoln', 'WY', '83127', '3078834437', '', 'wystd', 'wyhcpcs', '', '0.00', '35.00', '0.00', 3, '2006-12-01', NULL, 0, 0, 0, 'Star Valley Medical Center', '', '', '', 'HCFA|UB|', '1861447971', 0, 'N', 0, '2014-07-25', NULL, NULL, 42.944, -111.008, NULL, NULL),
('204011364', 'WY0000123', 'WY0000123', 'WY01', 'Independent Family Practice', 'Edward', '', 'Henry', 'FNP', 'Family Practice', '', '', NULL, 'O', '122 Peterson Pkwy', 'Thayne', 'Lincoln', 'WY', '83127', '3078834437', NULL, '122 Peterson Pkwy', 'Thayne', 'Lincoln', 'WY', '83127', '3078834437', '          ', 'wystd', 'wyhcpcs', '', '0.00', '35.00', '0.00', 3, '2006-12-01', '2011-05-24', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '0000006675', 0, 'N', 0, '2011-05-24', NULL, NULL, 0, 0, NULL, NULL);
INSERT INTO `providers_new` (`Provider_Tax_ID`, `Provider_Suffix`, `Provider_Network_ID`, `Provider_Region`, `Provider_Name`, `Provider_Doctor_First_Name`, `Provider_Doctor_Middle_Name`, `Provider_Doctor_Last_Name`, `Provider_Doctor_Degree`, `Provider_Specialty_1`, `Provider_Specialty_2`, `Provider_Specialty_3`, `Provider_Specialty_4`, `Provider_Address_Type`, `Provider_Address`, `Provider_City`, `Provider_County`, `Provider_State`, `Provider_Zip`, `Provider_Phone`, `Provider_Fax`, `Provider_Mailing_Address`, `Provider_Mailing_City`, `Provider_Mailing_County`, `Provider_Mailing_State`, `Provider_Mailing_Zip`, `Provider_Mailing_Phone`, `Provider_Mailing_Fax`, `Provider_Primary_Schedule`, `Provider_Secondary_Schedule`, `Provider_Rate_Sheet`, `Provider_Anes_Rate`, `Provider_Default_Rate`, `Provider_Max_DOS`, `Provider_Min_Match_Value`, `Provider_Effective_Date`, `Provider_Term_Date`, `Provider_Pend`, `Provider_Anes_Minutes`, `Provider_PPO`, `Provider_Hospital_1`, `Provider_Hospital_2`, `Provider_Hospital_3`, `Provider_Hospital_4`, `Provider_Type`, `Provider_NPI`, `Provider_Check_Override`, `Exclude_Dir`, `Audit_Status`, `Last_Change_Date`, `Medicare_ID`, `Provider_Lang`, `Provider_Latitude`, `Provider_Longitude`, `Provider_school`, `Provider_cert`) VALUES
('204011364', 'WY0000124', 'WY0000124', 'WY01', 'Independent Family Practice', 'Scott', NULL, 'Bennett', 'DO', 'Family Practice', NULL, NULL, NULL, 'O', '122 Peterson Pkwy', 'Thayne', 'Lincoln', 'WY', '83127', '3078834437', NULL, '122 Peterson Pkwy', 'Thayne', '', 'WY', '83127', '', '', 'wystd', 'wyhcpcs', NULL, '0.00', '35.00', '0.00', 3, '2006-12-01', '2008-11-01', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '0000005261', 0, 'N', 0, '2007-01-11', NULL, NULL, 0, 0, NULL, NULL),
('830324911', 'WY0000125', 'WY0000125', 'WY01', 'Uinta Physical Therapy', 'Mark', 'Z', 'Brinkerhoff', 'PT', 'Physical Therapy', '', '', NULL, 'O', '170 Yellow Creek Rd Ste D', 'Evanston', 'Uinta', 'WY', '82930', '3077838068', NULL, '170 Yellow Creek Rd Ste D', 'Evanston', 'Uinta', 'WY', '82930', '3077838068', '', 'wystd', 'wyhcpcs', NULL, '0.00', '35.00', '0.00', 3, '2007-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1750433918', 0, 'N', 0, '2011-06-10', NULL, NULL, 41.258, -110.967, NULL, NULL),
('202299593', 'WY0000126', 'WY0000126', 'WY01', 'Wyoming Range Medical', 'William', 'D', 'Burnett', 'MD', 'Family Practice', '', '', NULL, 'O', '630 Piney Dr', 'Big Piney', 'Sublette', 'WY', '83113', '3072764700', NULL, '630 Piney Dr', 'Big Piney', 'Sublette', 'WY', '83113', '3072764700', '', '', '', '', '0.00', '7.50', '0.00', 3, '2007-01-01', '2011-09-22', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1760579023', 0, 'N', 0, '2014-04-01', NULL, NULL, 0, 0, NULL, NULL),
('202299593', 'WY0000127', 'WY0000127', 'WY01', 'Wyoming Range Medical', 'Darcy', '', 'Turner', 'MD', 'Family Practice', '', '', NULL, 'O', '630 Piney Dr', 'Big Piney', 'Sublette', 'WY', '83113', '3072764700', NULL, '630 Piney Dr', 'Big Piney', 'Sublette', 'WY', '83113', '3072764700', '', '', NULL, '', '0.00', '7.50', '0.00', 3, '2007-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1487741658', 0, 'N', 0, '2014-06-25', NULL, NULL, 42.5404, -110.116, NULL, NULL),
('202299593', 'WY0000128', 'WY0000128', 'WY01', 'Wyoming Range Medical', 'Lorri', '', 'Turner', 'FNP', 'Family Practice', '', '', NULL, 'O', '630 Piney Dr', 'Big Piney', 'Sublette', 'WY', '83113', '3072764700', NULL, '630 Piney Dr', 'Big Piney', 'Sublette', 'WY', '83113', '3072764700', '', '', NULL, NULL, '0.00', '7.50', '0.00', 3, '2007-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1518054782', 0, 'N', 0, '2011-09-20', NULL, NULL, 42.5404, -110.116, NULL, NULL),
('202299593', 'WY0000129', 'WY0000129', 'WY01', 'Red Desert InstaCare', 'Rich', '', 'Anderson', 'PA-C', 'Family Practice', '', '', NULL, 'O', '2761 Commercial Way', 'Rock Springs', 'Sweetwater', 'WY', '82901', '3073823064', NULL, '2761 Commercial Way', 'Rock Springs', 'Sweetwater', 'WY', '82901', '3073823064', '', '', NULL, NULL, '0.00', '7.50', '0.00', 3, '2007-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1811084080', 0, 'N', 0, '2011-10-11', NULL, NULL, 41.5825, -109.254, NULL, NULL),
('202299593', 'WY0000130', 'WY0000130', 'WY01', 'Wyoming Range Medical', 'Jonathan', '', 'Said', 'PA-C', 'Family Practice', '', '', NULL, 'B', 'PO Box 130', 'Big Piney', 'Sublette', 'WY', '83113', '3073823064', NULL, 'PO Box 130', 'Big Piney', 'Sublette', 'WY', '83113', '3073823064', '', '', NULL, NULL, '0.00', '7.50', '0.00', 3, '2007-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '0000008532', 0, 'Y', 0, '2011-06-30', NULL, NULL, 0, 0, NULL, NULL),
('202299593', 'WY0000131', 'WY0000131', 'WY01', 'Red Desert InstaCare', 'William', 'D', 'Burnett', 'MD', 'Family Practice', '', '', NULL, 'O', '2761 Commercial Way', 'Rock Springs', 'Sweetwater', 'WY', '82901', '3073823064', NULL, '2761 Commercial Way', 'Rock Springs', 'Sweetwater', 'WY', '82901', '3073823064', '', '', '', '', '0.00', '7.50', '0.00', 3, '2007-01-01', '2011-09-22', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1760579023', 0, 'N', 0, '2014-04-01', NULL, NULL, 0, 0, NULL, NULL),
('202299593', 'WY0000132', 'WY0000132', 'WY01', 'Red Desert InstaCare', 'Darcy', '', 'Turner', 'MD', 'Family Practice', '', '', NULL, 'O', '2761 Commercial Way', 'Rock Springs', 'Sweetwater', 'WY', '82901', '3073823064', NULL, '2761 Commercial Way', 'Rock Springs', 'Sweetwater', 'WY', '82901', '3073823064', '', '', NULL, '', '0.00', '7.50', '0.00', 3, '2007-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1487741658', 0, 'N', 0, '2014-06-25', NULL, NULL, 41.5825, -109.254, NULL, NULL),
('202299593', 'WY0000133', 'WY0000133', 'WY01', 'Wyoming Range Medical', 'Lorri', '', 'Turner', 'FNP', 'Family Practice', '', '', NULL, 'B', 'PO Box 130', 'Big Piney', 'Sublette', 'WY', '83113', '3073823064', NULL, 'PO Box 130', 'Big Piney', 'Sublette', 'WY', '83113', '3073823064', '', '', NULL, NULL, '0.00', '7.50', '0.00', 3, '2007-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1518054782', 0, 'Y', 0, '2011-09-20', NULL, NULL, 0, 0, NULL, NULL),
('202299593', 'WY0000134', 'WY0000134', 'WY01', 'Wyoming Range Medical', 'Rich', '', 'Anderson', 'PA-C', 'Family Practice', '', '', NULL, 'B', 'PO Box 130', 'Big Piney', 'Sublette', 'WY', '83113', '3072764700', NULL, 'PO Box 130', 'Big Piney', 'Sublette', 'WY', '83113', '3072764700', '', '', NULL, NULL, '0.00', '7.50', '0.00', 3, '2007-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1811084080', 0, 'Y', 0, '2011-10-11', NULL, NULL, 0, 0, NULL, NULL),
('202299593', 'WY0000135', 'WY0000135', 'WY01', 'Red Desert InstaCare', 'Jonathan', '', 'Said', 'PA-C', 'Family Practice', '', '', NULL, 'O', '2761 Commercial Way', 'Rock Springs', 'Sweetwater', 'WY', '82901', '3073823064', NULL, '2761 Commercial Way', 'Rock Springs', 'Sweetwater', 'WY', '82901', '3073823064', '', '', NULL, NULL, '0.00', '7.50', '0.00', 3, '2007-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '0000008532', 0, 'N', 0, '2011-06-30', NULL, NULL, 41.5825, -109.254, NULL, NULL),
('830267172', 'WY0000138', 'WY0000138', 'WY01', 'South Lincoln Medical Clinic', 'Gregory', 'M', 'Yasuda', 'MD', 'General Surgery', '', '', NULL, 'O', '711 Onyx St', 'Kemmerer', 'Lincoln', 'WY', '83101', '3078774401', NULL, '711 Onyx St', 'Kemmerer', 'Lincoln', 'WY', '83101', '3078774401', '', 'wystd', 'wyhcpcs', NULL, '0.00', '35.00', '0.00', 3, '2006-12-01', NULL, 0, 0, 0, 'South Lincoln Medical Center', '', '', '', 'HCFA|UB|', '1841391349', 0, 'N', 0, '2014-04-17', NULL, NULL, 41.7896, -110.54, NULL, NULL),
('870519172', 'WY0000139', 'WY0000139', 'WY01', 'Utah Heart Clinic', 'James', 'Lee', 'Burke', 'MD', 'Cardiovascular Disease', '', '', NULL, 'O', '110 Hospital Ln', 'Afton', 'Lincoln', 'WY', '83110', '3078855800', NULL, '110 Hospital Ln', 'Afton', 'Lincoln', 'WY', '83110', '3078855800', '', 'WUSTDCARD5', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 3, '2006-12-01', '2008-05-04', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1154399459', 0, 'N', 0, '2014-05-19', NULL, NULL, 0, 0, NULL, NULL),
('830324512', 'WY0000140', 'WY0000140', 'WY01', 'Evanston Internal Medicine', 'Ardella', 'M', 'Kemmler', 'MD', 'Internal Medicine', 'Rheumatology', '', NULL, 'O', '150 Arrowhead Dr', 'Evanston', 'Uinta', 'WY', '82930', '3077890524', NULL, '150 Arrowhead Dr', 'Evanston', 'Uinta', 'WY', '82930', '3077890524', '', 'WYSTD8', 'wyhcpcs', NULL, '0.00', '35.00', '0.00', 3, '2007-01-01', NULL, 0, 0, 0, 'Evanston Regional Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1346316221', 0, 'N', 0, '2012-01-03', NULL, NULL, 41.2425, -110.995, NULL, NULL),
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('870393111', 'WY0000142', 'WY0000142', 'WY01', 'Sweetwater Audiology', 'Stephen', 'B', 'Harward', 'AUD', 'Audiology', '', '', NULL, 'B', '425 E 5350 S Ste 120', 'Ogden', 'Weber', 'UT', '84405', '8014793346', NULL, '425 E 5350 S Ste 120', 'Ogden', 'Weber', 'UT', '84405', '8014793346', '', 'WISESTD', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 3, '2006-12-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1609899459', 0, 'Y', 0, '2014-06-04', NULL, NULL, 0, 0, NULL, NULL),
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('592852900', 'WY3000015', 'WY3000015', 'WY01', 'Lincare', '', '', 'Lincare', 'GROUP', 'Durable Medical Equipment', '', '', NULL, 'O', '80 Yellow Creek Rd', 'Evanston', 'Uinta', 'WY', '82930', '3077896621', NULL, '80 Yellow Creek Rd', 'Evanston', 'Uinta', 'WY', '82930', '3077896621', '          ', 'LINCAREWY', '', '', '0.00', '20.00', '0.00', 8, '2007-01-01', NULL, 1, 0, 0, '', '', '', '', 'HCFA|UB|', '0000007285', 0, 'N', 0, '2013-06-18', NULL, NULL, 0, 0, NULL, NULL),
('592852900', 'WY3000016', 'WY3000016', 'WY01', 'Lincare', '', '', 'Lincare', 'GROUP', 'Durable Medical Equipment', '', '', NULL, 'O', '709 W 8th St Ste 2', 'Gillette', 'Campbell', 'WY', '82716', '3076870501', NULL, '709 W 8th St Ste 2', 'Gillette', 'Campbell', 'WY', '82716', '3076870501', '          ', 'LINCAREWY', '', '', '0.00', '20.00', '0.00', 8, '2007-01-01', NULL, 1, 0, 0, '', '', '', '', 'HCFA|UB|', '0000007285', 0, 'N', 0, '2013-06-18', NULL, NULL, 44.2875, -105.513, NULL, NULL),
('592852900', 'WY3000017', 'WY3000017', 'WY01', 'Lincare', '', '', 'Lincare', 'GROUP', 'Durable Medical Equipment', '', '', NULL, 'O', '555 E Broadway Ste 108', 'Jackson', 'Teton', 'WY', '83001', '3077339737', NULL, '555 E Broadway Ste 108', 'Jackson', 'Teton', 'WY', '83001', '3077339737', '          ', 'LINCAREWY', '', '', '0.00', '20.00', '0.00', 8, '2007-01-01', NULL, 1, 0, 0, '', '', '', '', 'HCFA|UB|', '0000007285', 0, 'N', 0, '2013-06-18', NULL, NULL, 43.48, -110.765, NULL, NULL),
('592852900', 'WY3000018', 'WY3000018', 'WY01', 'Lincare', '', '', 'Lincare', 'GROUP', 'Durable Medical Equipment', '', '', NULL, 'O', '1363 N 4th St Ste B', 'Laramie', 'Albany', 'WY', '82072', '3077214992', NULL, '1363 N 4th St Ste B', 'Laramie', 'Albany', 'WY', '82072', '3077214992', '          ', 'LINCAREWY', '', '', '0.00', '20.00', '0.00', 8, '2007-01-01', NULL, 1, 0, 0, '', '', '', '', 'HCFA|UB|', '0000007285', 0, 'N', 0, '2013-06-18', NULL, NULL, 0, 0, NULL, NULL),
('592852900', 'WY3000019', 'WY3000019', 'WY01', 'Lincare', '', '', 'Lincare', 'GROUP', 'Durable Medical Equipment', '', '', NULL, 'O', '1121 Washington Ste 2', 'Newcastle', 'Weston', 'WY', '82701', '3077462281', NULL, '1121 Washington Ste 2', 'Newcastle', 'Weston', 'WY', '82701', '3077462281', '          ', 'LINCAREWY', '', '', '0.00', '20.00', '0.00', 8, '2007-01-01', NULL, 1, 0, 0, '', '', '', '', 'HCFA|UB|', '0000007285', 0, 'N', 0, '2013-06-18', NULL, NULL, 0, 0, NULL, NULL),
('592852900', 'WY3000020', 'WY3000020', 'WY01', 'Lincare', '', '', 'Lincare', 'GROUP', 'Durable Medical Equipment', '', '', NULL, 'O', '1408 E Murray St', 'Rawlins', 'Carbon', 'WY', '82301', '3073242117', NULL, '1408 E Murray St', 'Rawlins', 'Carbon', 'WY', '82301', '3073242117', '          ', 'LINCAREWY', '', '', '0.00', '20.00', '0.00', 8, '2007-01-01', NULL, 1, 0, 0, '', '', '', '', 'HCFA|UB|', '0000007285', 0, 'N', 0, '2013-06-18', NULL, NULL, 0, 0, NULL, NULL),
('592852900', 'WY3000021', 'WY3000021', 'WY01', 'Lincare', '', '', 'Lincare', 'GROUP', 'Durable Medical Equipment', '', '', NULL, 'O', '702 E Monroe', 'Riverton', 'Fremont', 'WY', '82501', '3078567562', NULL, '702 E Monroe', 'Riverton', 'Fremont', 'WY', '82501', '3078567562', '          ', 'LINCAREWY', '', '', '0.00', '20.00', '0.00', 8, '2007-01-01', NULL, 1, 0, 0, '', '', '', '', 'HCFA|UB|', '0000007285', 0, 'N', 0, '2013-06-18', NULL, NULL, 0, 0, NULL, NULL),
('592852900', 'WY3000022', 'WY3000022', 'WY01', 'Lincare', '', '', 'Lincare', 'GROUP', 'Durable Medical Equipment', '', '', NULL, 'O', '2734 Commercial Way', 'Rock Springs', 'Sweetwater', 'WY', '82901', '3073827703', NULL, '2734 Commercial Way', 'Rock Springs', 'Sweetwater', 'WY', '82901', '3073827703', '          ', 'LINCAREWY', '', '', '0.00', '20.00', '0.00', 8, '2007-01-01', NULL, 1, 0, 0, '', '', '', '', 'HCFA|UB|', '0000007285', 0, 'N', 0, '2013-06-18', NULL, NULL, 0, 0, NULL, NULL),
('592852900', 'WY3000023', 'WY3000023', 'WY01', 'Lincare', '', '', 'Lincare', 'GROUP', 'Durable Medical Equipment', '', '', NULL, 'O', '655 Broadway St', 'Sheridan', 'Sheridan', 'WY', '82801', '3076720073', NULL, '655 Broadway St', 'Sheridan', 'Sheridan', 'WY', '82801', '3076720073', '          ', 'LINCAREWY', '', '', '0.00', '20.00', '0.00', 8, '2007-01-01', NULL, 1, 0, 0, '', '', '', '', 'HCFA|UB|', '0000007285', 0, 'N', 0, '2013-06-18', NULL, NULL, 0, 0, NULL, NULL),
('592852900', 'WY3000024', 'WY3000024', 'WY01', 'Lincare', '', '', 'Lincare', 'GROUP', 'Durable Medical Equipment', '', '', NULL, 'O', '3317 W C St', 'Torrington', 'Goshen', 'WY', '82240', '3075323283', NULL, '3317 W C St', 'Torrington', 'Goshen', 'WY', '82240', '3075323283', '          ', 'LINCAREWY', '', '', '0.00', '20.00', '0.00', 8, '2007-01-01', NULL, 1, 0, 0, '', '', '', '', 'HCFA|UB|', '0000007285', 0, 'N', 0, '2013-06-18', NULL, NULL, 0, 0, NULL, NULL),
('592852900', 'WY3000025', 'WY3000025', 'WY01', 'Lincare', '', '', 'Lincare', 'GROUP', 'Durable Medical Equipment', '', '', NULL, 'O', '228 N 10th St', 'Worland', 'Washakie', 'WY', '82401', '3073472674', NULL, '228 N 10th St', 'Worland', 'Washakie', 'WY', '82401', '3073472674', '          ', 'LINCAREWY', '', '', '0.00', '20.00', '0.00', 8, '2007-01-01', NULL, 1, 0, 0, '', '', '', '', 'HCFA|UB|', '0000007285', 0, 'N', 0, '2013-06-18', NULL, NULL, 0, 0, NULL, NULL),
('830215583', 'WY3000026', 'WY3000026', 'WY01', 'Uinta Home Health & Hospice', '', '', 'Uinta Home Health & Hospice', 'GROUP', 'Hospice', 'Home Health Agency', '', NULL, 'O', '1229 Uinta St', 'Evanston', 'Uinta', 'WY', '82930', '3077897712', NULL, '1229 Uinta St', 'Evanston', 'Uinta', 'WY', '82930', '3077897712', '', '', NULL, '3', '0.00', '100.00', '0.00', 6, '2006-12-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '0000009264', 0, 'N', 0, '2011-06-28', NULL, NULL, 0, 0, NULL, NULL),
('830215583', 'WY3000027', 'WY3000027', 'WY01', 'Uinta Home Health & Hospice', '', '', 'Uinta Home Health & Hospice', 'GROUP', 'Hospice', 'Home Health Agency', '', NULL, 'B', 'PO Box 728', 'Evanston', 'Uinta', 'WY', '82930', '3077897712', NULL, 'PO Box 728', 'Evanston', 'Uinta', 'WY', '82930', '3077897712', '', '', NULL, '4', '0.00', '100.00', '0.00', 6, '2006-12-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '0000009264', 0, 'Y', 0, '2011-06-28', NULL, NULL, 0, 0, NULL, NULL),
('830327475', 'WY3000028', 'WY3000028', 'WY01', 'Evanston Regional Hospital', '', '', 'Evanston Regional Hospital', 'GROUP', 'Hospital', '', '', NULL, 'O', '190 Arrowead Dr', 'Evanston', 'Uinta', 'WY', '82930', '3077893636', NULL, '190 Arrowead Dr', 'Evanston', 'Uinta', 'WY', '82930', '3077893636', '', '', NULL, NULL, '0.00', '20.00', '0.00', 6, '2006-12-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1639140015', 0, 'N', 0, '2012-03-26', NULL, NULL, 41.2433, -110.998, NULL, NULL),
('330363116', 'WY3000029', 'WY3000029', 'WY01', 'Metwest dba Quest Diagnostics', NULL, '', 'Metwest Inc dba Quest Diagnostics', 'GROUP', 'Laboratory', NULL, NULL, NULL, 'B', '2032 Collection Ctr Dr ', 'CHICAGO', NULL, 'IL', NULL, NULL, NULL, '695 S Broadway', 'Denver', '', 'CO', '80209', '', '', 'WUQUEST5', NULL, NULL, '0.00', '20.00', NULL, 3, '2006-12-01', '2006-12-01', 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', NULL, 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('330363116', 'WY3000030', 'WY3000030', 'WY01', 'Metwest Inc dba Quest Diagnostics', '', '', 'Metwest Inc dba Quest Diagnostic', 'GROUP', 'Laboratory', '', '', NULL, 'B', '2032 Collection Ctr Dr', 'CHICAGO', NULL, 'IL', NULL, NULL, NULL, '2032 Collection Ctr Dr', 'CHICAGO', '', 'IL', '', '', '', 'WUQUEST5', NULL, '', '0.00', '20.00', '0.00', 3, '2006-12-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '0000831976', 0, 'Y', 0, '2014-07-11', NULL, NULL, 0, 0, NULL, NULL),
('411694999', 'WY3000031', 'WY3000031', 'WY01', 'Disetronic Medical Systems', NULL, '', 'Disetronic Medical Systems', 'GROUP', 'DME', NULL, NULL, NULL, 'B', 'PO Box 86 SDS 12-2207', 'Minneapolis', 'Hennepin', 'MN', '55486', '8002807801', '8888100758', '11800 Exit 5 Pkwy', 'Fisher', '', 'IN', '46037', '', '', 'WDISETR', NULL, NULL, '0.00', '30.00', NULL, 3, '2006-12-01', '2006-12-01', 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1710980156', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('411694999', 'WY3000032', 'WY3000032', 'WY01', 'Disetronic Medical Systems', NULL, '', 'Disetronic Medical Systems', 'GROUP', 'DME', NULL, NULL, NULL, 'b', '11800 Exit 5 Pkwy Ste 120', 'Fishers', 'Hamilton', 'IN', '46037', '8002807801', '8888100758', '11800 Exit 5 Pkwy', 'Fisher', '', 'IN', '46037', '', '', 'WDISETR', NULL, NULL, '0.00', '30.00', NULL, 3, '2006-12-01', '2006-12-01', 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1710980156', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('043115329', 'WY3000033', 'WY3000033', 'WY01', 'Critical Care Systems Utah/Wyoming', '', '', 'Critical Care Systems Utah/Wy', 'GROUP', 'Home IV Infusion Agency', NULL, NULL, NULL, 'O', '2233 Presidents Dr Ste B130', 'Salt Lake City', NULL, 'UT', NULL, '8669789600', NULL, '61 Spit Brook Rd', 'Nashua', '', 'NH', '03060', '', '', NULL, NULL, NULL, '0.00', NULL, NULL, 3, '2006-12-01', '2006-12-01', 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1588692164', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('522212112', 'WY3000034', 'WY3000034', 'WY01', 'LifeWatch', '', '', 'LifeWatch Inc', 'GROUP', 'Cardiac Monitoring', '', '', NULL, 'O', '1351 Abbott Ct', 'Buffalo Grove', 'Lake', 'IL', '60089', '8777749846', NULL, '1351 Abbott Ct', 'Buffalo Grove', 'Lake', 'IL', '60089', '8777749846', '          ', 'WCSTLWI5', '', '', '0.00', '100.00', '0.00', 3, '2006-12-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1255367843', 0, 'N', 0, '2013-06-18', NULL, NULL, 0, 0, NULL, NULL),
('522212112', 'WY3000035', 'WY3000035', 'WY01', 'Lifewatch Incorporated', '', '', 'Lifewatch Incorporated', 'GROUP', 'Cardiac Monitoring', '', '', NULL, 'B', '1161 Paysphere Cir', 'Chicago', 'Cook', 'IL', '60674', '8777202100', NULL, '1161 Paysphere Cir', 'Chicago', 'Cook', 'IL', '60674', '8777202100', '', 'WCSTLWI5', NULL, NULL, '0.00', '100.00', '0.00', 3, '2006-12-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '0000007278', 0, 'Y', 0, '2011-06-10', NULL, NULL, 0, 0, NULL, NULL),
('411310335', 'WY3000036', 'WY3000036', 'WY01', 'Empi Inc (Neuromuscular Stimulator)', '', '', 'Empi Inc (Neuromuscular Stimulator)', 'GROUP', 'Durable Medical Equipment', '', '', NULL, 'O', '599 Cardigan Rd', 'St Paul', 'Ramsey', 'MN', '55126', '8003282536', NULL, '599 Cardigan Rd', 'Saint Paul', 'Ramsey', 'MN', '55126', '8003282536', '', 'WCSTEMPIWY', 'DME90', NULL, '0.00', '15.00', '0.00', 3, '2006-12-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1174574032', 0, 'y', 0, '2012-09-24', NULL, NULL, 0, 0, NULL, NULL),
('521262870', 'WY3000037', 'WY3000037', 'WY01', 'Dynasplint Systems Inc  (Custom Braces)', '', '', 'Dynasplint Systems Inc  (Custom Braces)', 'GROUP', 'Durable Medical Equipment', 'Custom Splints', '', NULL, 'O', '770 Ritchie Hwy Ste W 21', 'Severna Park', NULL, 'MD', NULL, '8006386771', NULL, '770 Ritchie Hwy Ste W 21', 'Severna Park', '', 'MD', '', '8006386771', '', 'WCSTDSS5', NULL, NULL, '0.00', '100.00', '0.00', 3, '2006-12-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1386643856', 0, 'Y', 0, '2012-09-24', NULL, NULL, 0, 0, NULL, NULL),
('541707322', 'WY3000038', 'WY3000038', 'WY01', 'Care Rehab and Orthopedic Products  (Muscle Stimulators)', '', '', 'Care Rehab and Orthopedic Products  (Muscle Stimulators)', 'GROUP', 'Durable Medical Equipment', '', '', NULL, 'B', 'PO Box 716', 'Keysville', 'Charlotte', 'VA', '23947', '8004879644', NULL, 'PO Box 716', 'Keysville', 'Charlotte', 'VA', '23947', '8004879644', '', 'WCSTCROP5', NULL, NULL, '0.00', '20.00', '0.00', 3, '2006-12-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1578562468', 0, 'y', 0, '2012-09-24', NULL, NULL, 0, 0, NULL, NULL),
('752608036', 'WY3000039', 'WY3000039', 'WY01', 'Orthofix (Bone Growth Stimulators Physicians Only)', '', '', 'Orthofix', 'GROUP', 'Durable Medical Equipment', '', '', NULL, 'B', 'PO Box 849806', 'Dallas', '', 'TX', '', '8005270404', '          ', 'PO Box 849806', 'Dallas', '', 'TX', '', '8005270404', '          ', 'WCSTORFIX5', '', '', '0.00', '100.00', '0.00', 3, '2006-12-01', '2014-06-18', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '0000007988', 0, 'Y', 0, '2014-06-19', NULL, NULL, 0, 0, NULL, NULL),
('752608036', 'WY3000040', 'WY3000040', 'WY01', 'Orthofix Inc (Bone Growth Stimulators Physicians Only)', '', '', 'Orthofix Inc (Bone Growth Stimulators Physicians Only)', 'GROUP', 'Durable Medical Equipment', '', '', NULL, 'O', '3451 Plano Pkwy', 'Lewisville', 'Dallas', 'TX', '75284', '8005270404', '          ', '3451 Plano Pkwy', 'Lewisville', 'Dallas', 'TX', '75284', '8005270404', '          ', 'WCSTORFIX5', '', '', '0.00', '100.00', '0.00', 3, '2006-12-01', '2014-06-30', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1235136060', 0, 'Y', 0, '2014-07-23', NULL, NULL, 0, 0, NULL, NULL),
('911490213', 'WY3000041', 'WY3000041', 'WY01', 'RS Medical', '', '', 'RS Medical', 'GROUP', 'Durable Medical Equipment', '', '', NULL, 'B', 'PO Box 872650', 'Vancouver', 'Clark', 'WA', '98687', '8006830353', NULL, 'PO Box 872650', 'Vancouver', 'Clark', 'WA', '98687', '8006830353', '', 'WCSTRSMED5', NULL, NULL, '0.00', '25.00', '0.00', 3, '2006-12-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '0000008499', 0, 'Y', 0, '2011-08-25', NULL, NULL, 0, 0, NULL, NULL),
('911490213', 'WY3000042', 'WY3000042', 'WY01', 'RS Medical (Muscle Stimulators)', '', '', 'RS Medical (Muscle Stimulators)', 'GROUP', 'Durable Medical Equipment', '', '', NULL, 'O', '14401 SE 1st St', 'Vancouver', 'Clark', 'WA', '98684', '8006830353', NULL, '14401 SE 1st St', 'Vancouver', 'Clark', 'WA', '98684', '8006830353', '', 'WCSTRSMED5', NULL, NULL, '0.00', '25.00', '0.00', 3, '2006-12-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1992791230', 0, 'Y', 0, '2012-09-24', NULL, NULL, 0, 0, NULL, NULL),
('330892907', 'WY3000043', 'WY3000043', 'WY01', 'Nufactor', '', '', 'Nufactor', 'GROUP', 'Infusion Agency', '', '', NULL, 'B', '41093 County Ctr Dr', 'Temecula', 'Riverside', 'CA', '92591', '8003236832', NULL, '41093 County Ctr Dr', 'Temecula', 'Riverside', 'CA', '92591', '8003236832', '          ', '', '', '1001', '0.00', '0.00', '0.00', 3, '2006-12-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1861599540', 0, 'N', 0, '2013-06-18', NULL, NULL, 0, 0, NULL, NULL),
('133757370', 'WY3000044', 'WY3000044', 'WY01', 'LabCorp of America Holdings', '', '', 'LabCorp of America Holdings', 'GROUP', 'Laboratory', NULL, NULL, NULL, 'B', 'PO Box 2270 ', 'BURLINGTON', NULL, 'NC', NULL, NULL, NULL, '5626 Oberlin Dr', 'San Diego', '', 'CA', '92121', '', '', 'WULABCORP5', 'WUSTDHCPC5', NULL, '0.00', '35.00', NULL, 3, '2000-01-01', '2000-01-01', 0, NULL, 0, '', NULL, NULL, NULL, 'HCFA|UB|', '1902809940', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('133757370', 'WY3000045', 'WY3000045', 'WY01', 'LabCorp of America Holdings', '', '', 'LabCorp of America Holdings', 'GROUP', 'Laboratory', NULL, NULL, NULL, 'B', 'PO Box 2270 ', 'BURLINGTON', NULL, 'NC', NULL, NULL, NULL, '5626 Oberlin Dr', 'San Diego', '', 'CA', '92121', '', '', 'WULABCORP5', 'WUSTDHCPC5', NULL, '0.00', '35.00', NULL, 3, '2000-01-01', '2000-01-01', 0, NULL, 0, '', NULL, NULL, NULL, 'HCFA|UB|', '1902809940', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('840611484', 'WY3000046', 'WY3000046', 'WY01', 'LabCorp of America Holdings', '', '', 'LabCorp of America Holdings', 'GROUP', 'Laboratory', '', '', NULL, 'B', 'PO Box 8018', 'Burlington', 'Alamance', 'NC', '27216', '          ', NULL, 'PO Box 8018', 'Burlington', 'Alamance', 'NC', '27216', '          ', '          ', 'WULABCORP5', '', '', '0.00', '35.00', '0.00', 3, '2006-12-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1104829159', 0, 'Y', 0, '2013-10-30', NULL, NULL, 0, 0, NULL, NULL),
('840611484', 'WY3000047', 'WY3000047', 'WY01', 'LabCorp of America Holdings', '', '', 'LabCorp of America Holdings', 'GROUP', 'Laboratory', '', '', NULL, 'B', 'PO Box 2270', 'Burlington', 'Alamance', 'NC', '27216', '          ', NULL, 'PO Box 2270', 'Burlington', 'Alamance', 'NC', '27216', '          ', '          ', 'WULABCORP5', '', '', '0.00', '35.00', '0.00', 3, '2006-12-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1104829159', 0, 'Y', 0, '2013-10-30', NULL, NULL, 0, 0, NULL, NULL),
('341650951', 'WY3000048', 'WY3000048', 'WY01', 'Edgepark', '', '', 'Edgepark', 'GROUP', 'Durable Medical Equipment', '', '', NULL, 'B', '1810 Summit Commerce', 'Twinsburg', 'Lorain', 'OH', '44039', '8003075930', NULL, '1810 Summit Commerce', 'Twinsburg', 'Lorain', 'OH', '44039', '8003075930', '          ', 'WCSTEPSI5', 'DME80', '', '0.00', '35.00', '0.00', 3, '2006-12-01', '2012-03-31', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1609858729', 0, 'Y', 0, '2014-01-27', NULL, NULL, 0, 0, NULL, NULL),
('770254359', 'WY3000049', 'WY3000049', 'WY01', 'Healthtronics Wyoming Medical Center', '', '', 'Healthtronics Inc', 'GROUP', 'Lithotriptor', '', '', NULL, 'O', '1233 E 2nd St', 'CASPER', 'Natrona', 'WY', '82601', '8663144242', NULL, '1233 E 2nd St', 'CASPER', 'Natrona', 'WY', '82601', '8663144242', '          ', '', '', '6', '0.00', '100.00', '0.00', 3, '2006-12-01', '2011-06-24', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '0000006635', 0, 'Y', 0, '2011-06-24', NULL, NULL, 0, 0, NULL, NULL),
('770254359', 'WY3000050', 'WY3000050', 'WY01', 'Healthtronics Sheridan Memorial Hospital', '', '', 'Healthtronics Inc', 'GROUP', 'Lithotriptor', '', '', NULL, 'O', '1401 W 5th St', 'SHERIDAN', 'Sheridan', 'WY', '82801', '8663144242', NULL, '1401 W 5th St', 'SHERIDAN', 'Sheridan', 'WY', '82801', '8663144242', '          ', '', '', '6', '0.00', '100.00', '0.00', 3, '2006-12-01', '2011-06-24', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '0000006635', 0, 'Y', 0, '2011-06-24', NULL, NULL, 0, 0, NULL, NULL),
('770254359', 'WY3000051', 'WY3000051', 'WY01', 'Healthtronics Riverton Memorial Hospital', '', '', 'Healthtronics Inc', 'GROUP', 'Lithotriptor', '', '', NULL, 'O', '2100 W Sunset', 'RIVERTON', 'Fremont', 'WY', '82501', '8663144242', NULL, '2100 W Sunset', 'RIVERTON', 'Fremont', 'WY', '82501', '8663144242', '          ', '', '', '6', '0.00', '100.00', '0.00', 3, '2006-12-01', '2011-06-24', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '0000006635', 0, 'Y', 0, '2011-06-24', NULL, NULL, 0, 0, NULL, NULL),
('770254359', 'WY3000052', 'WY3000052', 'WY01', 'Healthtronics Ivinson Memorial Hospital', '', '', 'Healthtronics Inc', 'GROUP', 'Lithotriptor', '', '', NULL, 'O', '255 N 30th St', 'LARAMIE', 'Albany', 'WY', '82070', '8663144242', NULL, '255 N 30th St', 'LARAMIE', 'Albany', 'WY', '82070', '8663144242', '          ', '', '', '6', '0.00', '100.00', '0.00', 3, '2006-12-01', '2011-06-24', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '0000006635', 0, 'Y', 0, '2011-06-24', NULL, NULL, 0, 0, NULL, NULL),
('770254359', 'WY3000053', 'WY3000053', 'WY01', 'Healthtronics Sheridan Surgical Center', '', '', 'Healthtronics Inc', 'GROUP', 'Lithotriptor', '', '', NULL, 'O', '425 W 5th St', 'SHERIDAN', 'Sheridan', 'WY', '82801', '8663144242', NULL, '425 W 5th St', 'SHERIDAN', 'Sheridan', 'WY', '82801', '8663144242', '          ', '', '', '6', '0.00', '100.00', '0.00', 3, '2006-12-01', '2011-06-24', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '0000006635', 0, 'Y', 0, '2011-06-24', NULL, NULL, 0, 0, NULL, NULL),
('742909001', 'WY3000054', 'WY3000054', 'WY01', 'Healthtronics Memorial Hospital of Sweetwater County', '', '', 'Healthtronics Inc', 'GROUP', 'Lithotriptor', '', '', NULL, 'O', '1200 Colledge Dr', 'ROCK SPRINGS', 'Sweetwater', 'WY', '82901', '8663144242', NULL, '1200 Colledge Dr', 'ROCK SPRINGS', 'Sweetwater', 'WY', '82901', '8663144242', '          ', '', '', '6', '0.00', '100.00', '0.00', 3, '2006-12-01', '2011-06-24', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '0000006635', 0, 'Y', 0, '2011-06-24', NULL, NULL, 0, 0, NULL, NULL),
('742909001', 'WY3000055', 'WY3000055', 'WY01', 'Healthtronics Memorial Hospital of Sheridan County', '', '', 'Healthtronics Inc', 'GROUP', 'Lithotriptor', '', '', NULL, 'O', '1401 W 5th St', 'SHERIDAN', 'Sheridan', 'WY', '82801', '8663144242', NULL, '1401 W 5th St', 'SHERIDAN', 'Sheridan', 'WY', '82801', '8663144242', '          ', '', '', '6', '0.00', '100.00', '0.00', 3, '2006-12-01', '2011-06-24', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '0000006635', 0, 'Y', 0, '2011-06-24', NULL, NULL, 0, 0, NULL, NULL),
('742909001', 'WY3000056', 'WY3000056', 'WY01', 'Healthtronics Riverton Memorial Hospital', '', '', 'Healthtronics Inc', 'GROUP', 'Lithotriptor', '', '', NULL, 'O', '2100 W Sunset', 'RIVERTON', 'Fremont', 'WY', '82501', '8663144242', NULL, '2100 W Sunset', 'RIVERTON', 'Fremont', 'WY', '82501', '8663144242', '          ', '', '', '6', '0.00', '100.00', '0.00', 3, '2006-12-01', '2011-06-24', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '0000006635', 0, 'Y', 0, '2011-06-24', NULL, NULL, 0, 0, NULL, NULL),
('742909001', 'WY3000057', 'WY3000057', 'WY01', 'Healthtronics St Johns Hospital', '', '', 'Healthtronics Inc', 'GROUP', 'Lithotriptor', '', '', NULL, 'O', '625 E Broadway St', 'JACKSON', 'Teton', 'WY', '83001', '8663144242', NULL, '625 E Broadway St', 'JACKSON', 'Teton', 'WY', '83001', '8663144242', '          ', '', '', '6', '0.00', '100.00', '0.00', 3, '2006-12-01', '2011-06-24', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '0000006635', 0, 'Y', 0, '2011-06-24', NULL, NULL, 0, 0, NULL, NULL),
('742909001', 'WY3000058', 'WY3000058', 'WY01', 'Healthtronics United Medical Center', '', '', 'Healthtronics Inc', 'GROUP', 'Lithotriptor', '', '', NULL, 'O', '2600 E 18th St', 'CHEYENNE', 'Laramie', 'WY', '82001', '8663144242', NULL, '2600 E 18th St', 'CHEYENNE', 'Laramie', 'WY', '82001', '8663144242', '          ', '', '', '6', '0.00', '100.00', '0.00', 3, '2006-12-01', '2011-06-24', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '0000006635', 0, 'Y', 0, '2011-06-24', NULL, NULL, 0, 0, NULL, NULL),
('061287427', 'WY3000059', 'WY3000059', 'WY01', 'Raytel Cardiac Services Inc', '', '', 'Raytel Cardiac Services Inc', 'GROUP', 'Cardiac Monitoring', '', '', NULL, 'O', '7 Waterside Crossing', 'Windsor', NULL, 'CT', NULL, '8003670300', NULL, '7 Waterside Crossing', 'Windsor', '', 'CT', '', '8003670300', '', 'WCSTRCS5', NULL, NULL, '0.00', '100.00', '0.00', 3, '2006-12-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1194776518', 0, 'y', 0, '2011-12-19', 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
('061287427', 'WY3000060', 'WY3000060', 'WY01', 'Raytel Cardiac Services Inc', '', '', 'Raytel Cardiac Services Inc', 'GROUP', 'Cardiac Monitoring', '', '', NULL, 'B', 'PO Box 727', 'Windsor', NULL, 'CT', NULL, '8003670300', NULL, 'PO Box 727', 'Windsor', '', 'CT', '', '8003670300', '', 'WCSTRCS5', NULL, NULL, '0.00', '100.00', '0.00', 3, '2006-12-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '0000008335', 0, 'Y', 0, '2011-06-10', NULL, NULL, 0, 0, NULL, NULL),
('830301302', 'WY3000061', 'WY3000061', 'WY01', 'Rocky Mountain Care', '', '', 'Rocky Mountain Care', 'GROUP', 'Skilled Nursing Facility', '', '', NULL, 'O', '475 Yellow Creek Rd', 'Evanston', 'Uinta', 'WY', '82930', '3077890726', NULL, '475 Yellow Creek Rd', 'Evanston', 'Uinta', 'WY', '82930', '3077890726', '', '', NULL, '7', '0.00', '100.00', '0.00', 3, '2006-12-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '0000008437', 0, 'N', 0, '2011-06-28', NULL, NULL, 41.2542, -110.969, NULL, NULL),
('870468543', 'WY3000062', 'WY3000062', 'WY01', 'Rocky Mountain Home Care', '', '', 'Rocky Mountain Home Care', 'GROUP', 'Home Health Agency', 'Hospice', '', NULL, 'O', '535 Uinta Dr', 'Green River', 'Sweetwater', 'WY', '82935', '3078758990', NULL, '535 Uinta Dr', 'Green River', 'Sweetwater', 'WY', '82935', '3078758990', '', '', NULL, '4', '0.00', '100.00', '0.00', 3, '2006-12-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1386642965', 0, 'N', 0, '2011-06-28', NULL, NULL, 0, 0, NULL, NULL),
('061128081', 'WY3000063', 'WY3000063', 'WY01', 'Dianon Systems Inc', '', '', 'Dianon Systems Inc', 'GROUP', 'Laboratory', '', '', NULL, 'B', 'PO Box 8005', 'Burlington', 'Alamance', 'NC', '27216', '8003282666', NULL, 'PO Box 8005', 'Burlington', 'Alamance', 'NC', '27216', '8003282666', '', 'WDIANON', NULL, NULL, '0.00', '35.00', '0.00', 3, '2006-12-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1003819020', 0, 'Y', 0, '2012-02-27', NULL, NULL, 0, 0, NULL, NULL),
('431850570', 'WY3000064', 'WY3000064', 'WY01', 'Choice Source Therapeutics', NULL, '', 'Choice Source Therapeutics', 'GROUP', 'Home IV Infusion Agency', NULL, NULL, NULL, 'B', '21316 Network Pl ', 'CHICAGO', NULL, 'IL', NULL, '8007804295', NULL, '2211 Sanders Rd', 'Northbrook', '', 'IL', '60673', '', '', NULL, NULL, '1001', '0.00', NULL, NULL, 3, '2006-12-01', '2006-12-01', 1, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1164403069', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('431850570', 'WY3000065', 'WY3000065', 'WY01', 'Choice Source Therapeutics', NULL, '', 'Choice Source Therapeutics', 'GROUP', 'Home IV Infusion Agency', NULL, NULL, NULL, 'O', '20333 State Highway 249 Ste 450', 'HOUSTON', NULL, 'TX', NULL, '8007804295', NULL, '2211 Sanders Rd', 'Northbrook', '', 'IL', '60673', '', '', NULL, NULL, '1001', '0.00', NULL, NULL, 3, '2006-12-01', '2006-12-01', 1, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1164403069', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('836000295', 'WY3000066', 'WY3000066', 'WY01', 'Memorial Hospital of Sweetwater County', '', '', 'Memorial Hospital of Sweetwater County', 'GROUP', 'Hospital', '', '', NULL, 'O', '1200 College Dr', 'Rock Springs', 'Sweetwater', 'WY', '82901', '3073623711', NULL, '1200 College Dr', 'Rock Springs', 'Sweetwater', 'WY', '82901', '3073623711', '', '', '', '', '0.00', '5.00', '0.00', 3, '2006-12-01', '2014-02-09', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '0000007562', 0, 'N', 0, '2014-05-02', NULL, NULL, 41.5816, -109.236, NULL, NULL),
('836000295', 'WY3000067', 'WY3000067', 'WY01', 'Memorial Hospital of Sweetwater County', '', '', 'Memorial Hospital of Sweetwater County', 'GROUP', 'Hospital', '', '', NULL, 'B', 'PO Box 1359', 'Rock Springs', 'Sweetwater', 'WY', '82902', '3073623711', NULL, 'PO Box 1359', 'Rock Springs', 'Sweetwater', 'WY', '82902', '3073623711', '', '', NULL, NULL, '0.00', '5.00', '0.00', 3, '2006-12-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '0000007562', 0, 'y', 0, '2014-05-02', NULL, NULL, 0, 0, NULL, NULL),
('204746599', 'WY3000069', 'WY3000069', 'WY01', 'Alliance Home Health of Wyoming', '', '', 'Alliance Home Health of Wyoming', 'GROUP', 'Home Health Agency', '', '', NULL, 'O', '102293 US Hwy 89', 'Thayne', 'Lincoln', 'WY', '83127', '3078837583', NULL, '102293 US Hwy 89', 'Thayne', 'Lincoln', 'WY', '83127', '3078837583', '', '', NULL, '4', '0.00', '100.00', '0.00', 3, '2007-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '0000004979', 0, 'N', 0, '2011-07-18', NULL, NULL, 0, 0, NULL, NULL),
('204746599', 'WY3000070', 'WY3000070', 'WY01', 'Alliance Home Health of Wyoming', '', '', 'Alliance Home Health of Wyoming', 'GROUP', 'Home Health Agency', '', '', NULL, 'B', 'PO Box 1001', 'Thayne', 'Lincoln', 'WY', '83127', '3078837583', NULL, 'PO Box 1001', 'Thayne', 'Lincoln', 'WY', '83127', '3078837583', '', '', NULL, '4', '0.00', '100.00', '0.00', 3, '2007-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '0000004979', 0, 'y', 0, '2011-07-18', NULL, NULL, 0, 0, NULL, NULL),
('710952415', 'WY3000071', 'WY3000071', 'WY01', 'Hospice Alliance of Wyoming', '', '', 'Hospice Alliance of Wyoming', 'GROUP', 'Hospice', '', '', NULL, 'O', '102293 US Hwy 89 Ste 1001', 'Thayne', 'Lincoln', 'WY', '83127', '3078837583', NULL, '102293 US Hwy 89 Ste 1001', 'Thayne', 'Lincoln', 'WY', '83127', '3078837583', '          ', '', '', '3', '0.00', '100.00', '0.00', 3, '2007-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '0000006781', 0, 'N', 0, '2013-06-06', NULL, NULL, 0, 0, NULL, NULL),
('710952415', 'WY3000072', 'WY3000072', 'WY01', 'Hospice Alliance of Wyoming', '', '', 'Hospice Alliance of Wyoming', 'GROUP', 'Hospice', '', '', NULL, 'B', 'PO Box 1001', 'Thayne', 'Lincoln', 'WY', '83127', '3078837583', NULL, 'PO Box 1001', 'Thayne', 'Lincoln', 'WY', '83127', '3078837583', '          ', '', '', '3', '0.00', '100.00', '0.00', 3, '2007-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '0000006781', 0, 'N', 0, '2013-06-06', NULL, NULL, 0, 0, NULL, NULL),
('830327251', 'WY3000073', 'WY3000073', 'WY01', 'Star Valley Medical Center', '', '', 'Star Valley Medical Center', 'GROUP', 'Hospital', '', '', NULL, 'O', '901 Adams St', 'Afton', 'Lincoln', 'WY', '83110', '3078855800', NULL, '901 Adams St', 'Afton', 'Lincoln', 'WY', '83110', '3078855800', '          ', '', '', '', '0.00', '5.00', '0.00', 6, '2007-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1255376406', 0, 'N', 0, '2014-03-25', NULL, NULL, 42.719, -110.931, NULL, NULL),
('202299593', 'WY3000074', 'WY3000074', 'WY01', 'Wyoming Range Medical', '', '', 'Wyoming Range Medical', 'GROUP', 'Urgent Care', '', '', NULL, 'O', '630 Piney Dr', 'Big Piney', 'Sublette', 'WY', '83113', '3072764700', NULL, '630 Piney Drive', 'Big Piney', 'Sublette', 'WY', '83113', '3072764700', '', '', NULL, NULL, '0.00', '7.50', '0.00', 3, '2007-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '0000009692', 0, 'N', 0, '2012-03-20', NULL, NULL, 42.5404, -110.116, NULL, NULL),
('202299593', 'WY3000075', 'WY3000075', 'WY01', 'Red Desert InstaCare', '', '', 'Red Desert InstaCare', 'GROUP', 'Urgent Care', '', '', NULL, 'O', '2761 Commercial Way', 'Rock Springs', 'Sweetwater', 'WY', '82901', '3073823064', NULL, '2761 Commercial Way', 'Rock Springs', 'Sweetwater', 'WY', '82901', '3073823064', '', '', NULL, NULL, '0.00', '7.50', '0.00', 3, '2007-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '0000008342', 0, 'N', 0, '2012-03-20', NULL, NULL, 41.5825, -109.254, NULL, NULL),
('830327475', 'WY3000076', 'WY3000076', 'WY01', 'Evanston Regional Hospital - PT', '', '', 'Evanston Regional Hospital - PT', 'GROUP', 'Physical Therapy', '', '', NULL, 'O', '190 Arrowead Dr', 'Evanston', 'Uinta', 'WY', '82930', '3077893636', NULL, '190 Arrowead Dr', 'Evanston', 'Uinta', 'WY', '82930', '3077893636', '', '', NULL, NULL, '0.00', '100.00', '58.00', 6, '2006-12-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '0000006170', 0, 'y', 0, '2011-09-20', NULL, NULL, 41.2433, -110.998, NULL, NULL),
('830327475', 'WY0006', 'WY3000077', 'WY01', 'Evanston Regional Hospital - Anesthesia', '', '', 'Evanston Regional Hospital - Anesthesia', 'GROUP', '', '', '', NULL, 'O', '190 Arrowead Dr', 'Evanston', 'Uinta', 'WY', '82930', '3077893636', '          ', '190 Arrowead Dr', 'Evanston', 'Uinta', 'WY', '82930', '3077893636', '          ', '', '', '1000', '40.00', '0.00', '0.00', 6, '2006-12-01', NULL, 0, 12, 0, '', '', '', '', 'HCFA|UB|', '0000006169', 0, 'Y', 0, '2013-06-28', NULL, NULL, 0, 0, NULL, NULL),
('522165554', 'WY3000078', 'WY3000078', 'WY01', 'DJO (Orthopedic Supplies)', NULL, NULL, 'DJO (Orthopedic Supplies)', 'GROUP', 'Durable Medical Equipment', NULL, NULL, NULL, 'B', 'PO Box 515471', 'Los Angeles', 'Los Angeles', 'CA', '90051', '8008638010', NULL, '668 N 44th St', 'Pheonix', '', 'AZ', '85008', '', '', 'WUDME5', NULL, NULL, '0.00', '35.00', NULL, 3, '2007-01-01', '2007-12-31', 0, NULL, 0, '', NULL, NULL, NULL, 'HCFA|UB|', '1023296035', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('510123924', 'WY3000079', 'WY3000079', 'WY01', 'Smith Nephew Inc (Muscle Stimulators)', '', '', 'Smith Nephew Inc (Muscle Stimulators)', 'GROUP', 'Durable Medical Equipment', '', '', NULL, 'O', '1450 Brooks Road', 'Memphis', 'Shelby', 'TN', '38116', '8006374391', NULL, '1450 Brooks Road', 'Memphis', 'Shelby', 'TN', '38116', '8006374391', '', '', NULL, '1002', '0.00', '30.00', '0.00', 3, '2007-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1568532901', 0, 'Y', 0, '2012-09-24', NULL, NULL, 0, 0, NULL, NULL),
('770254359', 'WY3000080', 'WY3000080', 'WY01', 'Healthtronics Inc Wyoming Medical Center', '', '', 'Healthtronics Inc Wyoming Medical Center', 'GROUP', 'Lithotriptor', '', '', NULL, 'O', '1233 E 2nd St', 'CASPER', 'Natrona', 'WY', '82601', '8663144242', NULL, '1233 E 2nd St', 'CASPER', 'Natrona', 'WY', '82601', '8663144242', '', '', NULL, '6', '0.00', '100.00', '0.00', 3, '2006-12-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '0000006640', 0, 'Y', 0, '2011-06-28', NULL, NULL, 42.8487, -106.309, NULL, NULL),
('770254359', 'WY3000081', 'WY3000081', 'WY01', 'Healthtronics Inc Sheridan Memorial Hospital', '', '', 'Healthtronics Inc Sheridan Memorial Hospital', 'GROUP', 'Lithotriptor', '', '', NULL, 'O', '1401 W 5th St', 'SHERIDAN', 'Sheridan', 'WY', '82801', '8663144242', NULL, '1401 W 5th St', 'SHERIDAN', 'Sheridan', 'WY', '82801', '8663144242', '', '', NULL, '6', '0.00', '100.00', '0.00', 3, '2006-12-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '0000006638', 0, 'Y', 0, '2011-06-28', NULL, NULL, 44.8074, -106.976, NULL, NULL),
('770254359', 'WY3000082', 'WY3000082', 'WY01', 'Healthtronics Inc Riverton Memorial Hospital', '', '', 'Healthtronics Inc Riverton Memorial Hospital', 'GROUP', 'Lithotriptor', '', '', NULL, 'O', '2100 W Sunset', 'RIVERTON', 'Fremont', 'WY', '82501', '8663144242', NULL, '2100 W Sunset', 'RIVERTON', 'Fremont', 'WY', '82501', '8663144242', '', '', NULL, '6', '0.00', '100.00', '0.00', 3, '2006-12-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '0000006637', 0, 'Y', 0, '2011-06-28', NULL, NULL, 43.0337, -108.418, NULL, NULL),
('770254359', 'WY3000083', 'WY3000083', 'WY01', 'Healthtronics Inc Ivinson Memorial Hospital', '', '', 'Healthtronics Inc Ivinson Memorial Hospital', 'GROUP', 'Lithotriptor', '', '', NULL, 'O', '255 N 30th St', 'LARAMIE', 'Albany', 'WY', '82070', '8663144242', NULL, '255 N 30th St', 'LARAMIE', 'Albany', 'WY', '82070', '8663144242', '', '', NULL, '6', '0.00', '100.00', '0.00', 3, '2006-12-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '0000006636', 0, 'Y', 0, '2011-06-28', NULL, NULL, 41.3127, -105.558, NULL, NULL),
('770254359', 'WY3000084', 'WY3000084', 'WY01', 'Healthtronics Inc Sheridan Surgical Center', '', '', 'Healthtronics Inc Sheridan Surgical Center', 'GROUP', 'Lithotriptor', '', '', NULL, 'O', '425 W 5th St', 'SHERIDAN', 'Sheridan', 'WY', '82801', '8663144242', NULL, '425 W 5th St', 'SHERIDAN', 'Sheridan', 'WY', '82801', '8663144242', '', '', NULL, '6', '0.00', '100.00', '0.00', 3, '2006-12-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '0000006639', 0, 'Y', 0, '2011-06-28', NULL, NULL, 0, 0, NULL, NULL),
('133757370', 'WY3000085', 'WY3000085', 'WY01', 'LabCorp of America Holdings', '', '', 'LabCorp of America Holdings', 'GROUP', 'Laboratory', '', '', NULL, 'B', 'PO Box 2270', 'BURLINGTON', 'Alamance', 'NC', '27216', '8002227566', NULL, 'PO Box 2270', 'BURLINGTON', 'Alamance', 'NC', '27216', '8002227566', '', 'WULABCORP5', 'WUSTDHCPC5', NULL, '0.00', '35.00', '0.00', 3, '2006-12-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1902809940', 0, 'Y', 0, '2014-03-21', NULL, NULL, 0, 0, NULL, NULL),
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('870675415', 'W11002271', 'W11002271', 'UT01', 'University Health Care', 'Odessa', 'R', 'Addison', 'PT', 'Physical Medicine and Rehabilitation', '', '', NULL, 'o', '520 Wakara Way', 'Salt Lake City', 'Salt Lake', 'UT', '84108', '8015852119', NULL, '520 Wakara Way', 'Salt Lake City', 'Salt Lake', 'UT', '84108', '8015852119', '          ', 'WUUUMG5', 'WUSTDHCPC5', '', '0.00', '25.00', '0.00', 3, '2007-01-01', '2012-09-18', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1396774253', 0, 'N', 0, '2012-09-19', NULL, NULL, 0, 0, NULL, NULL),
('870675415', 'W11002272', 'W11002272', 'UT01', 'University Health Care', 'Odessa', 'R', 'Addison', 'PT', 'Physical Medicine and Rehabilitation', '', '', NULL, 'B', 'PO Box 581002', 'Salt Lake City', 'Salt Lake', 'UT', '84158', '8012367749', NULL, 'PO Box 581002', 'Salt Lake City', 'Salt Lake', 'UT', '84158', '8012367749', '          ', 'WUUUMG5', 'WUSTDHCPC5', '', '0.00', '25.00', '0.00', 3, '2007-01-01', '2012-09-18', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1396774253', 0, 'Y', 0, '2012-09-19', NULL, NULL, 0, 0, NULL, NULL),
('743134262', 'W11002273', 'W11002273', 'UT01', 'University Health Care', 'Jeffrey', 'J', 'Ekstrand', 'MD', 'Pediatric Neurology', '', '', NULL, 'o', '100 N Mario Capecchi Dr', 'Salt Lake City', 'Salt Lake', 'UT', '84113', '8015882000', NULL, '100 N Mario Capecchi Dr', 'Salt Lake City', 'Salt Lake', 'UT', '84113', '8015882000', '          ', 'WUUPEDS', 'WUSTDHCPC5', '', '0.00', '15.00', '0.00', 3, '2006-08-01', '2012-07-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1477755155', 0, 'N', 0, '2012-07-31', NULL, NULL, 0, 0, NULL, NULL),
('743134262', 'W11002274', 'W11002274', 'UT01', 'University Health Care', 'Jeffrey', 'J', 'Ekstrand', 'MD', '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, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1477755155', 0, 'N', 0, '2012-07-31', NULL, NULL, 0, 0, NULL, NULL),
('870483582', 'W11002275', 'W11002275', 'UT01', 'University Health Care', 'Grace', 'A', 'Noda', 'PA', 'Orthopedic Surgery', 'Physician Assistant', '', NULL, 'o', '590 Wakara Way', 'Salt Lake City', 'Salt Lake', 'UT', '84108', '8015877100', NULL, NULL, NULL, '', NULL, NULL, '', '', 'WUUUMG5', 'WUSTDHCPC5', NULL, '0.00', '25.00', '0.00', 3, '2006-08-01', '2008-01-11', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1538357488', 0, 'N', 0, '2008-12-17', NULL, NULL, 0, 0, NULL, NULL),
('870483582', 'W11002276', 'W11002276', 'UT01', 'University Health Care', 'Grace', 'A', 'Noda', 'PA', 'Orthopedic Surgery', 'Physician Assistant', '', NULL, 'B', 'PO Box 58108', 'Salt Lake City', 'Salt Lake', 'UT', '84158', '8015813998', NULL, NULL, NULL, '', NULL, NULL, '', '', 'WUUUMG5', 'WUSTDHCPC5', NULL, '0.00', '25.00', '0.00', 3, '2006-08-01', '2008-01-11', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1538357488', 0, 'Y', 0, '2008-12-17', NULL, NULL, 0, 0, NULL, NULL),
('870616107', 'W11002277', 'W11002277', 'UT01', 'University Health Care', 'James', 'H', 'Hart', 'MD', 'Family Practice', '', '', NULL, 'o', '1525 W 2100 S', 'Salt Lake City', 'Salt Lake', 'UT', '84119', '8018872499', NULL, NULL, NULL, '', NULL, NULL, '', '', 'WISESTDU', 'WUSTDHCPC5', NULL, '0.00', '35.00', '0.00', 6, '2007-08-01', '2008-01-01', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1730168329', 0, 'N', 0, '2007-11-05', NULL, NULL, 0, 0, NULL, NULL),
('870616107', 'W11002278', 'W11002278', 'UT01', 'University Health Care', 'James', 'H', 'Hart', 'MD', 'Family Practice', '', '', NULL, 'o', '1743 W Redstone Ctr Ste 115', 'Park City', 'Summit', 'UT', '84098', '4356589200', NULL, NULL, NULL, '', NULL, NULL, '', '', 'WISESTDU', 'WUSTDHCPC5', NULL, '0.00', '35.00', '0.00', 6, '2007-08-01', '2008-01-01', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1730168329', 0, 'N', 0, '2007-11-05', NULL, NULL, 0, 0, NULL, NULL),
('870616107', 'W11002279', 'W11002279', 'UT01', 'University Health Care', 'James', 'H', 'Hart', 'MD', 'Family Practice', '', '', NULL, 'o', '26 S Main St', 'Centerville', 'Davis', 'UT', '84014', '8016937900', NULL, NULL, NULL, '', NULL, NULL, '', '', 'WISESTDU', 'WUSTDHCPC5', NULL, '0.00', '35.00', '0.00', 6, '2007-08-01', '2008-01-01', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1730168329', 0, 'N', 0, '2007-11-05', NULL, NULL, 0, 0, NULL, NULL),
('870616107', 'W11002280', 'W11002280', 'UT01', 'University Health Care', 'James', 'H', 'Hart', 'MD', 'Family Practice', '', '', NULL, 'o', '1091 W S Jordan Pkwy', 'South Jordan', 'Salt Lake', 'UT', '84095', '8012139800', NULL, NULL, NULL, '', NULL, NULL, '', '', 'WISESTDU', 'WUSTDHCPC5', NULL, '0.00', '35.00', '0.00', 6, '2007-08-01', '2008-01-01', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1730168329', 0, 'N', 0, '2007-11-05', NULL, NULL, 0, 0, NULL, NULL),
('870616107', 'W11002281', 'W11002281', 'UT01', 'University Health Care', 'James', 'H', 'Hart', 'MD', 'Family Practice', '', '', NULL, 'o', '220 Millpond Ste 100', 'Stansbury Park', 'Tooele', 'UT', '84074', '4358433000', NULL, NULL, NULL, '', NULL, NULL, '', '', 'WISESTDU', 'WUSTDHCPC5', NULL, '0.00', '35.00', '0.00', 6, '2007-08-01', '2008-01-01', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1730168329', 0, 'N', 0, '2007-11-05', NULL, NULL, 0, 0, NULL, NULL),
('870616107', 'W11002282', 'W11002282', 'UT01', 'University Health Care', 'James', 'H', 'Hart', 'MD', 'Family Practice', '', '', NULL, 'o', '3730 W 4700 S', 'West Valley', 'Salt Lake', 'UT', '84118', '8012139200', NULL, NULL, NULL, '', NULL, NULL, '', '', 'WISESTDU', 'WUSTDHCPC5', NULL, '0.00', '35.00', '0.00', 6, '2007-08-01', '2008-01-01', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1730168329', 0, 'N', 0, '2007-11-05', NULL, NULL, 0, 0, NULL, NULL),
('870616107', 'W11002283', 'W11002283', 'UT01', 'University Health Care', 'James', 'H', 'Hart', 'MD', 'Family Practice', '', '', NULL, 'o', '145 W University Pkwy', 'Orem', 'Utah', 'UT', '84058', '8012348600', NULL, NULL, NULL, '', NULL, NULL, '', '', 'WISESTDU', 'WUSTDHCPC5', NULL, '0.00', '35.00', '0.00', 6, '2007-08-01', '2008-01-01', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1730168329', 0, 'N', 0, '2007-11-05', NULL, NULL, 0, 0, NULL, NULL),
('870616107', 'W11002284', 'W11002284', 'UT01', 'University Health Care', 'James', 'H', 'Hart', 'MD', 'Family Practice', '', '', NULL, 'o', '7495 S State St', 'Midvale', 'Salt Lake', 'UT', '84047', '8012139400', NULL, NULL, NULL, '', NULL, NULL, '', '', 'WISESTDU', 'WUSTDHCPC5', NULL, '0.00', '35.00', '0.00', 6, '2007-08-01', '2008-01-01', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1730168329', 0, 'N', 0, '2007-11-05', NULL, NULL, 0, 0, NULL, NULL),
('870616107', 'W11002285', 'W11002285', 'UT01', 'University Health Care', 'James', 'H', 'Hart', 'MD', 'Family Practice', '', '', NULL, 'B', 'PO Box 510708', 'Salt Lake City', 'Salt Lake', 'UT', '84151', '8015876303', NULL, NULL, NULL, '', NULL, NULL, '', '', 'WISESTDU', 'WUSTDHCPC5', NULL, '0.00', '35.00', '0.00', 6, '2007-08-01', '2008-01-01', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1730168329', 0, 'Y', 0, '2007-11-05', NULL, NULL, 0, 0, NULL, NULL),
('870635889', 'W11002286', 'W11002286', 'UT01', 'Tooele Clinic Corp', 'Robert', 'J', 'Garr', 'DO', 'Cardiovascular Disease', 'Internal Medicine', '', NULL, 'B', '330 Franklin Rd Ste 135A-304', 'Brentwood', 'Williamson', 'TN', '37027', '8885479821', '6153457340', '330 Franklin Rd Ste 135A-304', 'Brentwood', 'Williamson', 'TN', '37027', '8885479821', '6153457340', 'WiseSTD', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 3, '2006-10-01', NULL, 0, 0, 0, 'Mountain West Medical Center', '', '', '', 'HCFA|UB|', '1225023088', 0, 'Y', 0, '2014-07-25', NULL, NULL, 0, 0, NULL, NULL),
('870635889', 'W11002287', 'W11002287', 'UT01', 'Oquirrh Cardiology', 'Robert', 'J', 'Garr', 'DO', 'Cardiovascular Disease', 'Internal Medicine', '', NULL, 'O', '196 East 2000 North Ste 110', 'Tooele', 'Tooele', 'UT', '84074', '4358433643', '', '196 East 2000 North Ste 110', 'Tooele', 'Tooele', 'UT', '84074', '4358433643', '', 'WiseSTD', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 3, '2006-10-01', NULL, 0, 0, 0, 'Mountain West Medical Center', '', '', '', 'HCFA|UB|', '1225023088', 0, 'N', 0, '2014-07-25', NULL, NULL, 40.5656, -112.294, NULL, NULL),
('876000525', 'W11002288', 'W11002288', 'UT01', 'University of Utah Hospital', 'Jessica', 'L', 'Wright', 'PT', 'Physical Therapy', NULL, NULL, NULL, 'B', 'PO Box 510721 ', 'Salt Lake City', 'Salt Lake', 'UT', '84151', '8015812121', NULL, '50 N Medical Dr', 'Salt Lake City', '', 'UT', '84132', '', '', NULL, NULL, '1', '0.00', NULL, NULL, 6, '2006-01-01', '2006-01-01', 1, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '9685', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('876000525', 'W11002289', 'W11002289', 'UT01', 'University of Utah Hospital', 'Jessica', 'L', 'Wright', 'PT', 'Physical Therapy', NULL, NULL, NULL, 'O', '50 N Medical Dr', 'Salt Lake City', 'Salt Lake', 'UT', '84132', '8015812121', NULL, '50 N Medical Dr', 'Salt Lake City', '', 'UT', '84132', '', '', '', NULL, '1', '0.00', '0.00', '0.00', 6, '2006-01-01', NULL, 1, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|', '0000009685', 0, 'N', 0, '2007-11-06', NULL, NULL, 40.7685, -111.837, NULL, NULL),
('870542578', 'W11002290', 'W11002290', 'UT01', 'U Of U Dialysis Program', 'Terrence', 'S', 'Bjordahl', 'MD', 'Nephrology', '', '', NULL, 'O', '85 N Medical Dr Ste E201', 'Salt Lake City', 'Salt Lake', 'UT', '84112', '8015818578', NULL, '85 N Medical Dr Ste E201', 'Salt Lake City', 'Salt Lake', 'UT', '84112', '8015818578', '          ', 'WUUUMG5', 'WUSTDHCPC5', '', '0.00', '25.00', '0.00', 3, '2007-07-15', '2012-07-24', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1710006408', 0, 'N', 0, '2012-07-25', NULL, NULL, 0, 0, NULL, NULL),
('870542578', 'W11002291', 'W11002291', 'UT01', 'U Of U Dialysis Program', 'Terrence', 'S', 'Bjordahl', 'MD', 'Nephrology', '', '', NULL, 'B', 'PO Box 27071', 'Salt Lake City', 'Salt Lake', 'UT', '84127', '8015818578', NULL, 'PO Box 27071', 'Salt Lake City', 'Salt Lake', 'UT', '84127', '8015818578', '          ', 'WUUUMG5', 'WUSTDHCPC5', '', '0.00', '25.00', '0.00', 3, '2007-07-15', '2012-07-24', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1710006408', 0, 'Y', 0, '2012-07-25', NULL, NULL, 0, 0, NULL, NULL),
('870609595', 'W11002292', 'W11002292', 'UT01', 'Utah County Medical Associates', 'Frank', 'J', 'Archer', 'MD', 'Family Practice', '', '', NULL, 'O', '97 S Professional Way Ste 2', 'Payson', 'Utah', 'UT', '84651', '8014654896', NULL, '97 S Professional Way Ste 2', 'Payson', 'Utah', 'UT', '84651', '8014654896', '          ', 'WUUVPN10', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 3, '2006-01-01', '2010-07-14', 0, 0, 0, 'Mountain View Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1093710998', 0, 'N', 0, '2013-10-15', NULL, NULL, 0, 0, NULL, NULL),
('201513999', 'W11002293', 'W11002293', 'UT01', 'Timpanogos Emergency Physicians', 'Chad', NULL, 'Parrish', 'MD', 'Emergency Medicine', NULL, NULL, NULL, 'B', 'PO Box 1747', 'Orem', 'Utah', 'UT', '84059', '8003733055', NULL, 'PO Box 1747', 'Orem', '', 'UT', '84059', '', '', 'WRMER', 'WUSTDHCPC5', NULL, '0.00', '35.00', '0.00', 3, '2007-08-15', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1992990311', 0, 'Y', 0, '2007-11-06', NULL, NULL, 0, 0, NULL, NULL),
('201513999', 'W11002294', 'W11002294', 'UT01', 'Timpanogos Emergency Physicians', 'Howard', 'L', 'Garber', 'MD', 'Emergency Medicine', NULL, NULL, NULL, 'B', 'PO Box 1747', 'Orem', 'Utah', 'UT', '84059', '8003733055', NULL, 'PO Box 1747', 'Orem', '', 'UT', '84059', '', '', 'WRMER', 'WUSTDHCPC5', NULL, '0.00', '35.00', '0.00', 3, '2007-08-15', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1225051527', 0, 'Y', 0, '2007-11-06', NULL, NULL, 0, 0, NULL, NULL),
('870373083', 'W11002295', 'W11002295', 'UT01', 'Heart and Lung Institute', NULL, NULL, 'Heart And Lung Institute', 'MD', 'Cardiovascular Disease', NULL, NULL, NULL, 'O', '5121 S Cottonwood St Ste 620', 'Murray', 'Salt Lake', 'UT', '84157', '8012651200', '8012651200', '5979 S Fashion Blvd', 'Murray', '', 'UT', '84107', '', '', 'WUSTDCARD5', 'WUSTDHCPC5', NULL, '0.00', '35.00', '0.00', 3, '2006-10-01', '2008-01-14', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '0000003105', 0, 'N', 0, '2007-11-06', NULL, NULL, 0, 0, NULL, NULL),
('870373083', 'W11002296', 'W11002296', 'UT01', 'Heart and Lung Institute', 'Gary', 'P', 'Symkoviak', 'MD', 'Cardiovascular Disease', '', '', NULL, 'O', '5121 S Cottonwood St Ste 620', 'Murray', 'Salt Lake', 'UT', '84157', '8012632370', '8012651200', '5121 S Cottonwood St Ste 620', 'Murray', 'Salt Lake', 'UT', '84157', '8012632370', '8012651200', 'WUSTDCARD5', 'WUSTDHCPC5', NULL, '0.00', '35.00', '0.00', 3, '2006-10-01', '2008-01-14', 0, 0, 0, 'Dixie Regional Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1841273844', 0, 'N', 0, '2012-11-27', NULL, NULL, 0, 0, NULL, NULL),
('870373083', 'W11002297', 'W11002297', 'UT01', 'Heart and Lung Institute', 'Bard', 'R', 'Madsen', 'MD', 'Cardiovascular Disease', '', '', NULL, 'O', '5121 S Cottonwood St Ste 620', 'Murray', 'Salt Lake', 'UT', '84157', '8012632370', '8012651200', '5121 S Cottonwood St Ste 620', 'Murray', 'Salt Lake', 'UT', '84157', '8012632370', '8012651200', 'WUSTDCARD5', 'WUSTDHCPC5', NULL, '0.00', '35.00', '0.00', 3, '2006-10-01', '2008-01-14', 0, 0, 0, 'Jordan Valley Medical Center', 'Salt Lake Regional Medical Center', NULL, NULL, 'HCFA|UB|', '1497738074', 0, 'N', 0, '2014-02-10', NULL, NULL, 0, 0, NULL, NULL),
('870373083', 'W11002298', 'W11002298', 'UT01', 'Heart and Lung Institute', 'Konstantyn', 'Y', 'Szwajkun', 'MD', 'Cardiovascular Disease', '', '', NULL, 'O', '5121 S Cottonwood St Ste 620', 'Murray', 'Salt Lake', 'UT', '84157', '8012632370', '8012651200', '5121 S Cottonwood St Ste 620', 'Murray', 'Salt Lake', 'UT', '84157', '8012632370', '8012651200', 'WUSTDCARD5', 'WUSTDHCPC5', NULL, '0.00', '35.00', '0.00', 3, '2006-10-01', '2008-01-14', 0, 0, 0, 'Jordan Valley Medical Center', 'Salt Lake Regional Medical Center', NULL, NULL, 'HCFA|UB|', '1508849191', 0, 'N', 0, '2012-06-26', NULL, NULL, 0, 0, NULL, NULL),
('870373083', 'W11002299', 'W11002299', 'UT01', 'Heart and Lung Institute', 'John', 'A', 'McHenry', 'MD', 'Cardiovascular Disease', NULL, NULL, NULL, 'O', '5121 S Cottonwood St Ste 620', 'Murray', 'Salt Lake', 'UT', '84157', '8012632370', '8012651200', '5979 S Fashion Blvd', 'Murray', '', 'UT', '84107', '', '', 'WUSTDCARD5', 'WUSTDHCPC5', NULL, '0.00', '35.00', '0.00', 3, '2006-10-01', '2008-01-14', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1750365193', 0, 'N', 0, '2007-11-06', NULL, NULL, 0, 0, NULL, NULL),
('870373083', 'W11002300', 'W11002300', 'UT01', 'Heart and Lung Institute', 'Robert', 'F', 'Sprung', 'MD', 'Cardiovascular Disease', NULL, NULL, NULL, 'O', '5121 S Cottonwood St Ste 620', 'Murray', 'Salt Lake', 'UT', '84157', '8012632370', '8012651200', '5979 S Fashion Blvd', 'Murray', '', 'UT', '84107', '', '', 'WUSTDCARD5', 'WUSTDHCPC5', NULL, '0.00', '35.00', '0.00', 3, '2006-10-01', '2008-01-14', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1255314837', 0, 'N', 0, '2007-11-06', NULL, NULL, 0, 0, NULL, NULL),
('870373083', 'W11002301', 'W11002301', 'UT01', 'Heart and Lung Institute', 'George', 'K', 'Wong', 'MD', 'Cardiovascular Disease', NULL, NULL, NULL, 'O', '5121 S Cottonwood St Ste 620', 'Murray', 'Salt Lake', 'UT', '84157', '8012632370', '8012651200', '5979 S Fashion Blvd', 'Murray', '', 'UT', '84107', '', '', 'WUSTDCARD5', 'WUSTDHCPC5', NULL, '0.00', '35.00', '0.00', 3, '2006-10-01', '2008-01-14', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1316928903', 0, 'N', 0, '2007-11-06', NULL, NULL, 0, 0, NULL, NULL),
('870373083', 'W11002302', 'W11002302', 'UT01', 'Heart and Lung Institute', 'Bruce', 'R', 'Kenwood', 'DO', 'Cardiovascular Disease', NULL, NULL, NULL, 'O', '5121 S Cottonwood St Ste 620', 'Murray', 'Salt Lake', 'UT', '84157', '8012632370', '8012651200', '5121 S Cottonwood St Ste 620', 'Murray', 'Salt Lake', 'UT', '84157', '8012632370', '8012651200', 'WUSTDCARD5', 'WUSTDHCPC5', NULL, '0.00', '35.00', '0.00', 3, '2006-10-01', '2008-01-14', 0, 0, 0, 'Jordan Valley Medical Center', 'Salt Lake Regional Medical Center', NULL, NULL, 'HCFA|UB|', '1144279019', 0, 'N', 0, '2012-05-01', NULL, NULL, 0, 0, NULL, NULL),
('743003947', 'W11002303', 'W11002303', 'TX01', 'The San Antonio Orthopaedic Group', 'Lonny', 'K', 'Ramey', 'PA', 'Orthopedic Surgery', '', '', NULL, 'B', 'PO Box 2516', 'San Antonio', 'Bexar', 'TX', '78258', '8004454263', NULL, 'PO Box 2516', 'San Antonio', 'Bexar', 'TX', '78258', '8004454263', '', 'TXORTHO', 'TXHCPCS', NULL, '0.00', '50.00', '0.00', 3, '2007-01-01', '2009-07-11', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1720098411', 0, 'Y', 0, '2010-07-13', 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
('743003947', 'W11002304', 'W11002304', 'TX01', 'The San Antonio Orthopaedic Group', 'Lonny', 'K', 'Ramey', 'PA', 'Orthopedic Surgery', '', '', NULL, 'O', '400 Concord Plaza Dr Ste 300', 'San Antonio', 'Bexar', 'TX', '78216', '2108045530', NULL, '400 Concord Plaza Dr Ste 300', 'San Antonio', 'Bexar', 'TX', '78216', '2108045530', '', 'TXORTHO', 'TXHCPCS', NULL, '0.00', '50.00', '0.00', 3, '2007-01-01', '2009-07-11', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1720098411', 0, 'N', 0, '2010-07-13', NULL, NULL, 29.5058, -98.4805, NULL, NULL),
('743003947', 'W11002305', 'W11002305', 'TX01', 'The San Antonio Orthopaedic Group', 'Lonny', 'K', 'Ramey', 'PA', 'Orthopedic Surgery', '', '', NULL, 'O', '150 E Sonterra Blvd Ste 300', 'San Antonio', 'Bexar', 'TX', '78258', '2104942297', NULL, '150 E Sonterra Blvd Ste 300', 'San Antonio', 'Bexar', 'TX', '78258', '2104942297', '          ', 'TXORTHO', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2007-01-01', '2009-07-11', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1720098411', 0, 'Y', 0, '2010-07-13', NULL, NULL, 29.6152, -98.4924, NULL, NULL),
('743003947', 'W11002306', 'W11002306', 'TX01', 'The San Antonio Orthopaedic Group', 'Lonny', 'K', 'Ramey', 'PA', 'Orthopedic Surgery', '', '', NULL, 'O', '1200 Brooklyn Ste 320', 'San Antonio', 'Bexar', 'TX', '78212', '2103965345', NULL, '1200 Brooklyn Ste 320', 'San Antonio', 'Bexar', 'TX', '78212', '2103965345', '          ', 'TXORTHO', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2007-01-01', '2009-07-11', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1720098411', 0, 'Y', 0, '2010-07-13', NULL, NULL, 29.4403, -98.4903, NULL, NULL),
('743003947', 'W11002307', 'W11002307', 'TX01', 'The San Antonio Orthopaedic Group', 'Lonny', 'K', 'Ramey', 'PA', 'Orthopedic Surgery', '', '', NULL, 'O', '2829 Babcock Ste 700', 'San Antonio', 'Bexar', 'TX', '78229', '2106151616', NULL, '2829 Babcock Ste 700', 'San Antonio', 'Bexar', 'TX', '78229', '2106151616', '          ', 'TXORTHO', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2007-01-01', '2009-07-11', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1720098411', 0, 'Y', 0, '2010-07-13', NULL, NULL, 29.5139, -98.5907, NULL, NULL),
('743003947', 'W11002308', 'W11002308', 'TX01', 'The San Antonio Orthopaedic Group', 'Lonny', 'K', 'Ramey', 'PA', 'Orthopedic Surgery', '', '', NULL, 'O', '4243 E Southcross Blvd Ste 204', 'San Antonio', 'Bexar', 'TX', '78222', '2103375785', NULL, '4243 E Southcross Blvd Ste 204', 'San Antonio', 'Bexar', 'TX', '78222', '2103375785', '', 'TXORTHO', 'TXHCPCS', NULL, '0.00', '50.00', '0.00', 3, '2007-01-01', '2009-07-11', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1720098411', 0, 'N', 0, '2010-07-13', NULL, NULL, 0, 0, NULL, NULL),
('743003947', 'W11002309', 'W11002309', 'TX01', 'The San Antonio Orthopaedic Group', 'Jennifer', '', 'Ramirez', 'PT', 'Physical Therapy', '', '', NULL, 'B', 'PO Box 2516', 'San Antonio', 'Bexar', 'TX', '78258', '8004454263', '          ', 'PO Box 2516', 'San Antonio', 'Bexar', 'TX', '78258', '8004454263', '          ', 'TXORTHO', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2007-01-01', '2014-07-16', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1437347119', 0, 'Y', 0, '2014-07-18', NULL, NULL, 0, 0, NULL, NULL),
('621795215', 'W11002310', 'W11002310', 'UT01', 'Center of Orthopedic & Rehabilitation Excellence', 'Jane', 'M', 'Porretta', 'MD', 'General Surgery', 'Orthopedic Surgery', NULL, NULL, 'O', '3584 W 9000 S Ste 304', 'West Jordan', 'Salt Lake', 'UT', '84088', '8015623150', '8015623149', '3584 W 9000 S Ste 304', 'West Jordan', 'Salt Lake', 'UT', '84088', '8015623150', '8015623149', 'WUSTDSURG5', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 6, '2007-02-01', '2011-11-14', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1710923966', 0, 'N', 0, '2011-11-14', NULL, NULL, 0, 0, NULL, NULL),
('621795215', 'W11002311', 'W11002311', 'UT01', 'Center of Orthopedic & Rehabilitation Excellence', 'Jane', 'M', 'Porretta', 'MD', 'General Surgery', 'Orthopedic Surgery', NULL, NULL, 'B', 'PO Box 150', 'West Jordan', 'Salt Lake', 'UT', '84084', '8013529500', NULL, 'PO Box 150', 'West Jordan', 'Salt Lake', 'UT', '84084', '8013529500', '          ', 'WUSTDSURG5', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 6, '2007-02-01', '2011-11-14', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1710923966', 0, 'Y', 0, '2011-11-14', NULL, NULL, 0, 0, NULL, NULL),
('201513999', 'W11002312', 'W11002312', 'UT01', 'Timpanogos Emergency Physicians', 'Blake', '', 'Rapier', 'PA', 'Family Practice', '', '', NULL, 'B', 'PO Box 1747', 'Orem', 'Utah', 'UT', '84059', '8012220191', NULL, 'PO Box 1747', 'Orem', 'Utah', 'UT', '84059', '8012220191', '', 'WRMER', 'WUSTDHCPC5', NULL, '0.00', '35.00', '0.00', 3, '2007-08-15', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1285856658', 0, 'Y', 0, '2014-03-07', NULL, NULL, 0, 0, NULL, NULL),
('201513999', 'W11002313', 'W11002313', 'UT01', 'Timpanogos Emergency Physicians', 'Sarah', 'K', 'Parker', 'APRN', 'Emergency Medicine', NULL, NULL, NULL, 'B', 'PO Box 1747', 'Orem', 'Utah', 'UT', '84059', '8003733055', '          ', 'PO Box 1747', 'Orem', 'Utah', 'UT', '84059', '8003733055', '          ', 'WRMER', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 3, '2007-08-15', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1700802279', 0, 'Y', 0, '2014-04-08', NULL, NULL, 0, 0, NULL, NULL),
('870628514', 'W11002314', 'W11002314', 'UT01', 'Avec Eye Center', 'Stella', 'Y', 'Chou', 'MD', 'Ophthalmology', '', '', NULL, 'B', 'PO Box 95970', 'South Jordan', 'Salt Lake', 'UT', '84095', '8013529500', '8019433876', 'PO Box 95970', 'South Jordan', 'Salt Lake', 'UT', '84095', '8013529500', '8019433876', 'WiseSTD', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 3, '2006-12-01', '2010-10-15', 0, 0, 0, 'Salt Lake Regional Medical Center', '', '', '', 'HCFA|UB|', '1851478606', 0, 'Y', 0, '2010-10-08', NULL, NULL, 0, 0, NULL, NULL),
('870395551', 'W11002315', 'W11002315', 'UT01', NULL, 'Nate', NULL, 'Evans', 'DC', 'Chiropractic', NULL, NULL, NULL, 'B', '9135 S Monroe St Ste B', 'Sandy', 'Salt Lake', 'UT', '84070', '8013527270', '8013527024', '9135 S Monroe', 'Sandy', '', 'UT', '84070', '', '', 'WLABRAD', 'WUSTDHCPC5', NULL, '0.00', NULL, '55.46', 3, '2006-04-01', '2007-12-31', 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1760413256', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870395551', 'W11002316', 'W11002316', 'ID02', NULL, 'John', 'C', 'Downey', 'DC', 'Chiropractic', NULL, NULL, NULL, 'B', '9135 S Monroe St Ste B', 'Sandy', 'Salt Lake', 'UT', '84070', '8013527270', '8013527024', '9135 S Monroe', 'Sandy', '', 'UT', '84070', '', '', 'WLABRAD', 'WUSTDHCPC5', NULL, '0.00', NULL, '55.46', 3, '2006-04-01', '2007-12-31', 0, NULL, 1, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1750419180', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870395551', 'W11002317', 'W11002317', 'UT01', NULL, 'Craig', 'B', 'Lords', 'DC', 'Chiropractic', NULL, NULL, NULL, 'B', '9135 S Monroe St Ste B', 'Sandy', 'Salt Lake', 'UT', '84070', '8013527270', '8013527024', '9135 S Monroe', 'Sandy', '', 'UT', '84070', '', '', 'WLABRAD', 'WUSTDHCPC5', NULL, '0.00', NULL, '55.46', 3, '2006-04-01', '2007-12-31', 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1447399076', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870395551', 'W11002318', 'W11002318', 'UT01', NULL, 'Shawn', 'S', 'Hatch', 'DC', 'Chiropractic', NULL, NULL, NULL, 'B', '9135 S Monroe St Ste B', 'Sandy', 'Salt Lake', 'UT', '84070', '8013527270', '8013527024', '9135 S Monroe', 'Sandy', '', 'UT', '84070', '', '', 'WLABRAD', 'WUSTDHCPC5', NULL, '0.00', NULL, '55.46', 3, '2006-04-01', '2007-12-31', 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1043400823', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870395551', 'W11002319', 'W11002319', 'UT01', NULL, 'Jason', 'L', 'Smith', 'DC', 'Chiropractic', NULL, NULL, NULL, 'B', '9135 S Monroe St Ste B', 'Sandy', 'Salt Lake', 'UT', '84070', '8013527270', '8013527024', '9135 S Monroe', 'Sandy', '', 'UT', '84070', '', '', 'WLABRAD', 'WUSTDHCPC5', NULL, '0.00', NULL, '55.46', 3, '2006-04-01', '2007-12-31', 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1558391169', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870395551', 'W11002320', 'W11002320', 'UT01', NULL, 'Nate', NULL, 'Evans', 'DC', 'Chiropractic', NULL, NULL, NULL, 'O', '2010 Flandro', 'Pocatello', 'Bannock', 'ID', '83202', '2082380600', '2082380603', '867 E 9400 S', 'Sandy', '', 'UT', '84094', '', '', 'WLABRAD', 'WUSTDHCPC5', NULL, '0.00', '0.00', '55.46', 3, '2006-04-01', '2008-09-21', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1760413256', 0, 'N', 0, '2007-11-07', NULL, NULL, 0, 0, NULL, NULL),
('870395551', 'W11002321', 'W11002321', 'ID02', NULL, 'John', 'C', 'Downey', 'DC', 'Chiropractic', NULL, NULL, NULL, 'O', '104 E Pine St', 'Caldwell', 'Canyon', 'ID', '83605', '2084594354', '2084599438', '867 E 9400 S', 'Sandy', '', 'UT', '84094', '', '', 'WLABRAD', 'WUSTDHCPC5', NULL, '0.00', '0.00', '55.46', 3, '2006-04-01', '2010-10-31', 0, 0, 1, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1750419180', 0, 'N', 0, '2010-02-11', NULL, NULL, 0, 0, NULL, NULL),
('870395551', 'W11002322', 'W11002322', 'UT01', NULL, 'Craig', 'B', 'Lords', 'DC', 'Chiropractic', NULL, NULL, NULL, 'O', '335 River Pkwy', 'Idaho Falls', 'Bonneville', 'ID', '83402', '2085295656', '2085235005', '867 E 9400 S', 'Sandy', '', 'UT', '84094', '', '', 'WLABRAD', 'WUSTDHCPC5', NULL, '0.00', '0.00', '55.46', 3, '2006-04-01', '2010-10-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1447399076', 0, 'N', 0, '2007-11-07', NULL, NULL, 0, 0, NULL, NULL),
('870395551', 'W11002323', 'W11002323', 'UT01', NULL, 'Shawn', 'S', 'Hatch', 'DC', 'Chiropractic', NULL, NULL, NULL, 'O', '619 S Bluff St Ste 400', 'St George', 'Washington', 'UT', '84770', '4356560234', '4356562622', '867 E 9400 S', 'Sandy', '', 'UT', '84094', '', '', 'WLABRAD', 'WUSTDHCPC5', NULL, '0.00', '0.00', '55.46', 3, '2006-04-01', '2009-05-01', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1043400823', 0, 'N', 0, '2007-11-07', NULL, NULL, 0, 0, NULL, NULL),
('870395551', 'W11002324', 'W11002324', 'UT01', '', 'Jason', 'L', 'Smith', 'DC', 'Chiropractic', '', '', NULL, 'O', '425 S Medical Dr Ste 216', 'Bountiful', 'Davis', 'UT', '84010', '8012924400', '8013353209', '425 S Medical Dr Ste 216', 'Bountiful', 'Davis', 'UT', '84010', '8012924400', '8013353209', 'WLABRAD', 'WUSTDHCPC5', '', '0.00', '0.00', '55.46', 3, '2006-04-01', '2010-10-31', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1558391169', 0, 'N', 0, '2014-06-24', NULL, NULL, 0, 0, NULL, NULL),
('870395551', 'W11002325', 'W11002325', 'UT01', 'Bond Chiropractic', 'Roger', 'A', 'Bond', 'DC', 'Chiropractic', NULL, NULL, NULL, 'O', '1684 Reunion Ave Ste 250', 'South Jordan', 'Salt Lake', 'UT', '84095', '8015620363', '8015620347', '867 E 9400 S', 'Sandy', '', 'UT', '84094', '', '', 'WLABRAD', 'WUSTDHCPC5', NULL, '0.00', '0.00', '55.46', 3, '2007-11-01', '2010-10-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1750475810', 0, 'N', 0, '2007-11-07', NULL, NULL, 0, 0, NULL, NULL),
('870519172', 'W11002326', 'W11002326', 'UT01', 'Utah Heart Clinic', NULL, NULL, 'Utah Heart Clinic', 'GROUP', 'Cardiovascular Disease', NULL, NULL, NULL, 'O', '5169 S Cottonwood St Ste B-510', 'Murray', 'Salt Lake', 'UT', '84157', '8015073500', '8014083909', '5169 S Cottonwood', 'Murray', '', 'UT', '84107', '', '', 'WUSTDCARD5', 'WUSTDHCPC5', NULL, '0.00', '35.00', '0.00', 3, '2006-06-01', '2008-05-04', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '0000009350', 0, 'N', 0, '2007-11-07', NULL, NULL, 0, 0, NULL, NULL),
('870519172', 'W11002327', 'W11002327', 'UT01', 'Utah Heart Clinic', 'James', 'Lee', 'Burke', 'MD', 'Cardiovascular Disease', '', '', NULL, 'O', '5169 S Cottonwood St Ste 520', 'Murray', 'Salt Lake', 'UT', '84107', '8015073500', '8014083909', '5169 S Cottonwood St Ste 520', 'Murray', 'Salt Lake', 'UT', '84107', '8015073500', '8014083909', 'WUSTDCARD5', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 3, '2006-06-01', '2008-05-04', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1154399459', 0, 'N', 0, '2014-05-19', NULL, NULL, 0, 0, NULL, NULL),
('870519172', 'W11002328', 'W11002328', 'UT01', 'Utah Heart Clinic', 'Peter', 'J', 'Casterella', 'MD', 'Cardiovascular Disease', '', '', NULL, 'O', '5169 S Cottonwood St Ste B-510', 'Murray', 'Salt Lake', 'UT', '84157', '8015073500', '8014083909', '5169 S Cottonwood', 'Murray', '', 'UT', '84107', '', '', 'WUSTDCARD5', 'WUSTDHCPC5', NULL, '0.00', '35.00', '0.00', 3, '2006-06-01', '2008-05-04', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1063480655', 0, 'N', 0, '2009-02-02', NULL, NULL, 0, 0, NULL, NULL),
('870519172', 'W11002329', 'W11002329', 'UT01', 'Utah Heart Clinic', 'Brian', 'G', 'Crandall', 'MD', 'Cardiovascular Disease', '', '', NULL, 'O', '5169 S Cottonwood St Ste B-510', 'Murray', 'Salt Lake', 'UT', '84157', '8015073500', '8014083909', '5169 S Cottonwood St Ste B-510', 'Murray', 'Salt Lake', 'UT', '84157', '8015073500', '8014083909', 'WUSTDCARD5', 'WUSTDHCPC5', NULL, '0.00', '35.00', '0.00', 3, '2006-06-01', '2008-05-04', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1669440269', 0, 'N', 0, '2011-02-16', NULL, NULL, 0, 0, NULL, NULL),
('870519172', 'W11002330', 'W11002330', 'UT01', 'Utah Heart Clinic', 'John', 'D', 'Day', 'MD', 'Cardiovascular Disease', '', '', NULL, 'O', '5169 S Cottonwood St Ste B-510', 'Murray', 'Salt Lake', 'UT', '84157', '8015073500', '8014083909', '5169 S Cottonwood St Ste B-510', 'Murray', 'Salt Lake', 'UT', '84157', '8015073500', '8014083909', 'WUSTDCARD5', 'WUSTDHCPC5', NULL, '0.00', '35.00', '0.00', 3, '2006-06-01', '2008-05-04', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1811965122', 0, 'N', 0, '2011-06-29', NULL, NULL, 0, 0, NULL, NULL),
('870519172', 'W11002331', 'W11002331', 'UT01', 'Utah Heart Clinic', 'Steven', 'Curtis', 'Horton', 'MD', 'Cardiovascular Disease', 'Internal Medicine', '', NULL, 'O', '5169 S Cottonwood St Ste B-510', 'Murray', 'Salt Lake', 'UT', '84157', '8015073500', '8014083909', '5169 S Cottonwood St Ste B-510', 'Murray', 'Salt Lake', 'UT', '84157', '8015073500', '8014083909', 'WUSTDCARD5', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 3, '2006-06-01', '2008-05-04', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1043288640', 0, 'N', 0, '2014-05-19', NULL, NULL, 0, 0, NULL, NULL),
('870519172', 'W11002332', 'W11002332', 'UT01', 'Utah Heart Clinic', 'Donald', 'Lewis', 'Lappe', 'MD', 'Cardiovascular Disease', 'Internal Medicine', '', NULL, 'O', '5169 S Cottonwood St Ste B-510', 'Murray', 'Salt Lake', 'UT', '84157', '8015073500', '8014083909', '5169 S Cottonwood St Ste B-510', 'Murray', 'Salt Lake', 'UT', '84157', '8015073500', '8014083909', 'WUSTDCARD5', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 3, '2006-06-01', '2008-05-04', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1669440277', 0, 'N', 0, '2014-05-22', NULL, NULL, 0, 0, NULL, NULL),
('870519172', 'W11002333', 'W11002333', 'UT01', 'Utah Heart Clinic', 'Dean', 'A', 'Mayer', 'MD', 'Hospitalist', '', '', NULL, 'O', '5169 S Cottonwood St Ste B-510', 'Murray', 'Salt Lake', 'UT', '84157', '8015073500', '8014083909', '5169 S Cottonwood St Ste B-510', 'Murray', 'Salt Lake', 'UT', '84157', '8015073500', '8014083909', 'WUSTDCARD5', 'WUSTDHCPC5', NULL, '0.00', '35.00', '0.00', 3, '2006-06-01', '2008-05-04', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1316915432', 0, 'N', 0, '2011-09-26', NULL, NULL, 0, 0, NULL, NULL),
('870519172', 'W11002334', 'W11002334', 'UT01', 'Utah Heart Clinic', 'Jeffrey', 'S', 'Osborn', 'MD', 'Cardiovascular Disease', '', '', NULL, 'O', '5169 S Cottonwood St Ste B-510', 'Murray', 'Salt Lake', 'UT', '84157', '8015073500', '8014083909', '5169 S Cottonwood St Ste B-510', 'Murray', 'Salt Lake', 'UT', '84157', '8015073500', '8014083909', 'WUSTDCARD5', 'WUSTDHCPC5', NULL, '0.00', '35.00', '0.00', 3, '2006-06-01', '2008-05-04', 0, 0, 0, 'Salt Lake Regional Medical Center', '', '', '', 'HCFA|UB|', '1043288368', 0, 'N', 0, '2011-02-16', NULL, NULL, 0, 0, NULL, NULL),
('870519172', 'W11002335', 'W11002335', 'UT01', 'Utah Heart Clinic', 'James', 'R', 'Revenaugh', 'MD', 'Cardiovascular Disease', '', '', NULL, 'O', '5169 S Cottonwood St Ste B-510', 'Murray', 'Salt Lake', 'UT', '84157', '8015073500', '8014083909', '5169 S Cottonwood St Ste B-510', 'Murray', 'Salt Lake', 'UT', '84157', '8015073500', '8014083909', 'WUSTDCARD5', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 3, '2006-06-01', '2008-05-04', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1316915952', 0, 'N', 0, '2014-05-19', NULL, NULL, 0, 0, NULL, NULL),
('870519172', 'W11002336', 'W11002336', 'UT01', 'Utah Heart Clinic', 'Kevin', 'J', 'Walsh', 'MD', 'Cardiovascular Disease', '', '', NULL, 'O', '5169 S Cottonwood St Ste B-510', 'Murray', 'Salt Lake', 'UT', '84157', '8015073500', '8014083909', '5169 S Cottonwood St Ste B-510', 'Murray', 'Salt Lake', 'UT', '84157', '8015073500', '8014083909', 'WUSTDCARD5', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 3, '2006-06-01', '2008-05-04', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1609845734', 0, 'N', 0, '2014-05-19', NULL, NULL, 0, 0, NULL, NULL),
('870519172', 'W11002337', 'W11002337', 'UT01', 'Utah Heart Clinic', 'J Peter', '', 'Weiss', 'MD', 'Cardiovascular Disease', '', '', NULL, 'O', '5169 S Cottonwood St Ste B-510', 'Murray', 'Salt Lake', 'UT', '84157', '8015073500', '8014083909', '5169 S Cottonwood St Ste B-510', 'Murray', 'Salt Lake', 'UT', '84157', '8015073500', '8014083909', 'WUSTDCARD5', 'WUSTDHCPC5', NULL, '0.00', '35.00', '0.00', 3, '2006-06-01', '2008-05-04', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1528036654', 0, 'N', 0, '2011-06-29', NULL, NULL, 0, 0, NULL, NULL),
('870519172', 'W11002338', 'W11002338', 'UT01', 'Utah Heart Clinic', 'Brian', 'K', 'Whisenant', 'MD', 'Cardiovascular Disease', '', '', NULL, 'O', '5169 S Cottonwood St Ste B-510', 'Murray', 'Salt Lake', 'UT', '84157', '8015073500', '8014083909', '5169 S Cottonwood St Ste B-510', 'Murray', 'Salt Lake', 'UT', '84157', '8015073500', '8014083909', 'WUSTDCARD5', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 3, '2006-06-01', '2008-05-04', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1750359253', 0, 'N', 0, '2014-06-20', NULL, NULL, 0, 0, NULL, NULL),
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INSERT INTO `providers_new` (`Provider_Tax_ID`, `Provider_Suffix`, `Provider_Network_ID`, `Provider_Region`, `Provider_Name`, `Provider_Doctor_First_Name`, `Provider_Doctor_Middle_Name`, `Provider_Doctor_Last_Name`, `Provider_Doctor_Degree`, `Provider_Specialty_1`, `Provider_Specialty_2`, `Provider_Specialty_3`, `Provider_Specialty_4`, `Provider_Address_Type`, `Provider_Address`, `Provider_City`, `Provider_County`, `Provider_State`, `Provider_Zip`, `Provider_Phone`, `Provider_Fax`, `Provider_Mailing_Address`, `Provider_Mailing_City`, `Provider_Mailing_County`, `Provider_Mailing_State`, `Provider_Mailing_Zip`, `Provider_Mailing_Phone`, `Provider_Mailing_Fax`, `Provider_Primary_Schedule`, `Provider_Secondary_Schedule`, `Provider_Rate_Sheet`, `Provider_Anes_Rate`, `Provider_Default_Rate`, `Provider_Max_DOS`, `Provider_Min_Match_Value`, `Provider_Effective_Date`, `Provider_Term_Date`, `Provider_Pend`, `Provider_Anes_Minutes`, `Provider_PPO`, `Provider_Hospital_1`, `Provider_Hospital_2`, `Provider_Hospital_3`, `Provider_Hospital_4`, `Provider_Type`, `Provider_NPI`, `Provider_Check_Override`, `Exclude_Dir`, `Audit_Status`, `Last_Change_Date`, `Medicare_ID`, `Provider_Lang`, `Provider_Latitude`, `Provider_Longitude`, `Provider_school`, `Provider_cert`) VALUES
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('565154242', 'W11002406', 'W11002406', 'UT01', NULL, 'Lisa', 'B', 'Hughes', 'LCSW', 'Mental Health', 'Social Worker', '', NULL, 'O', '14 N Main', 'Springville', 'Utah', 'UT', '84663', '8014890124', NULL, '14 N Main', 'Springville', 'Utah', 'UT', '84663', '8014890124', '', 'MA', NULL, '', '0.00', '100.00', '0.00', 3, '2007-11-01', '2008-06-30', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1730237249', 0, 'n', 0, '2014-05-08', NULL, NULL, 0, 0, NULL, NULL),
('561966094', 'W11002407', 'W11002407', 'UT01', NULL, 'Jennifer', 'E', 'JAMES', 'LCSW', 'Mental Health', 'Social Worker', '', NULL, 'O', '9263 S Redwood Rd Ste 8B', 'West Jordan', 'Salt Lake', 'UT', '84088', '8015660749', NULL, '9263 S Redwood Rd Ste 8B', 'West Jordan', 'Salt Lake', 'UT', '84088', '8015660749', '', 'MA', NULL, NULL, '0.00', '100.00', '0.00', 3, '2007-11-01', '2008-06-30', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1720131899', 0, 'n', 0, '2012-01-18', NULL, NULL, 0, 0, NULL, NULL),
('870557015', 'W11002408', 'W11002408', 'UT01', NULL, 'Penny', 'B', 'Jameson', 'PHD', 'Mental Health', 'Psychology', '', NULL, 'O', '505 E 200 S', 'Salt Lake City', 'Salt Lake', 'UT', '84102', '8013500118', NULL, '505 E 200 S', 'Salt Lake City', 'Salt Lake', 'UT', '84102', '8013500118', '', 'PHD', NULL, NULL, '0.00', '100.00', '0.00', 3, '2006-05-01', '2008-06-30', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1334125776', 0, 'N', 0, '2014-03-24', NULL, NULL, 0, 0, NULL, NULL),
('565695832', 'W11002409', 'W11002409', 'UT01', NULL, 'Tod', 'A', 'Johnson', 'LCSW', 'Mental Health', NULL, NULL, NULL, 'O', '9263 S Redwood Rd Ste 8B', 'West Jordan', 'Tooele', 'UT', '84074', '8015660749', NULL, NULL, NULL, '', NULL, NULL, '', '', 'MA', NULL, NULL, '0.00', '100.00', '0.00', 3, '2007-11-01', '2008-06-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '0000006977', 0, 'n', 0, '2007-11-20', NULL, NULL, 0, 0, NULL, NULL),
('519544720', 'W11002410', 'W11002410', 'UT01', NULL, 'Kayne', 'K', 'Kishiyama', 'MD', 'Mental Health', NULL, NULL, NULL, 'O', '1522 Elk Creek Dr', 'Idaho Falls', 'Bonneville', 'ID', '83404', '2085520920', NULL, NULL, NULL, '', NULL, NULL, '', '', 'MD', NULL, NULL, '0.00', '100.00', '0.00', 3, '2007-11-01', '2008-06-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1568405405', 0, 'n', 0, '2007-11-20', NULL, NULL, 0, 0, NULL, NULL),
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('742768427', 'W11002497', 'W11002497', 'TX01', 'Institute for Womens Health', 'Jose', 'M', 'Ruiz III', 'MD', 'Obstetrics and Gynecology', '', '', NULL, 'O', '7940 Floyd Curl Dr Ste 900', 'San Antonio', 'Bexar', 'TX', '78229', '2106141000', NULL, '7940 Floyd Curl Dr Ste 900', 'San Antonio', 'Bexar', 'TX', '78229', '2106141000', '', 'TXOBG', 'TXHCPCS', NULL, '0.00', '50.00', '0.00', 3, '2007-11-15', '2010-01-01', 0, 0, 0, 'St Lukes Baptist Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1093705089', 0, 'N', 0, '2013-03-12', NULL, NULL, 29.5117, -98.5756, NULL, NULL),
('742768427', 'W11002498', 'W11002498', 'TX01', 'Institute for Womens Health', 'Vincenzo', '', 'Sabella', 'MD', 'Obstetrics and Gynecology', '', '', NULL, 'O', '7950 Floyd Curl Dr Ste 600', 'San Antonio', 'Bexar', 'TX', '78229', '2106158585', NULL, '7950 Floyd Curl Dr Ste 600', 'San Antonio', 'Bexar', 'TX', '78229', '2106158585', '', 'TXOBG', 'TXHCPCS', NULL, '0.00', '50.00', '0.00', 3, '2007-11-15', '2010-01-01', 0, 0, 0, 'St Lukes Baptist Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1780601773', 0, 'N', 0, '2013-08-28', NULL, NULL, 29.5128, -98.5757, 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
('742768427', 'W11002499', 'W11002499', 'TX01', 'Institute for Womens Health', 'Ronald', 'A', 'Valdez', 'MD', 'Obstetrics and Gynecology', '', '', NULL, 'O', '7940 Floyd Curl Dr Ste 900', 'San Antonio', 'Bexar', 'TX', '78229', '2106141000', NULL, '7940 Floyd Curl Dr Ste 900', 'San Antonio', 'Bexar', 'TX', '78229', '2106141000', '', 'TXOBG', 'TXHCPCS', NULL, '0.00', '50.00', '0.00', 3, '2007-11-15', '2010-01-01', 0, 0, 0, 'St Lukes Baptist Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1841280849', 0, 'N', 0, '2013-09-27', NULL, NULL, 29.5117, -98.5756, NULL, NULL),
('742768427', 'W11002500', 'W11002500', 'TX01', 'Institute for Womens Health', 'Daniel', 'A', 'Calderon', 'MD', 'Obstetrics and Gynecology', '', '', NULL, 'O', '540 Madison Oak Dr Ste 450', 'San Antonio', 'Bexar', 'TX', '78258', '2104942000', NULL, '540 Madison Oak Dr Ste 450', 'San Antonio', 'Bexar', 'TX', '78258', '2104942000', '', 'TXOBG', 'TXHCPCS', NULL, '0.00', '50.00', '0.00', 3, '2007-11-15', '2010-01-01', 0, 0, 0, 'North Central Baptist Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1083603252', 0, 'N', 0, '2013-04-24', NULL, NULL, 29.6203, -98.4928, NULL, NULL),
('742768427', 'W11002501', 'W11002501', 'TX01', 'Institute for Womens Health', 'Carlos', 'A', 'Cardenas', 'MD', 'Obstetrics and Gynecology', '', '', NULL, 'O', '540 Madison Oak Dr Ste 450', 'San Antonio', 'Bexar', 'TX', '78258', '2104942000', NULL, '540 Madison Oak Dr Ste 450', 'San Antonio', 'Bexar', 'TX', '78258', '2104942000', '', 'TXOBG', 'TXHCPCS', NULL, '0.00', '50.00', '0.00', 3, '2007-11-15', '2010-01-01', 0, 0, 0, 'North Central Baptist Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1487643664', 0, 'N', 0, '2014-03-18', NULL, NULL, 29.6203, -98.4928, NULL, NULL),
('742768427', 'W11002502', 'W11002502', 'TX01', 'Institute for Womens Health', 'Elisa', 'F', 'Carroll', 'MD', 'Obstetrics and Gynecology', '', '', NULL, 'O', '540 Madison Oak Dr Ste 450', 'San Antonio', 'Bexar', 'TX', '78258', '2104942000', NULL, '540 Madison Oak Dr Ste 450', 'San Antonio', 'Bexar', 'TX', '78258', '2104942000', '', 'TXOBG', 'TXHCPCS', NULL, '0.00', '50.00', '0.00', 3, '2007-11-15', '2010-01-01', 0, 0, 0, 'North Central Baptist Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1962491159', 0, 'N', 0, '2013-04-24', NULL, NULL, 29.6203, -98.4928, NULL, NULL),
('742768427', 'W11002503', 'W11002503', 'TX01', 'Institute for Womens Health', 'Victor', 'L', 'Casiano', 'MD', 'Obstetrics and Gynecology', '', '', NULL, 'O', '540 Madison Oak Dr Ste 450', 'San Antonio', 'Bexar', 'TX', '78258', '2104942000', NULL, '540 Madison Oak Dr Ste 450', 'San Antonio', 'Bexar', 'TX', '78258', '2104942000', '', 'TXOBG', 'TXHCPCS', NULL, '0.00', '50.00', '0.00', 3, '2007-11-15', '2010-01-01', 0, 0, 0, 'North Central Baptist Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1679562862', 0, 'N', 0, '2013-04-24', NULL, NULL, 29.6203, -98.4928, NULL, NULL),
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('742768427', 'W11002505', 'W11002505', 'TX01', 'Institute for Womens Health', 'Orlando', 'J', 'Suris', 'MD', 'Obstetrics and Gynecology', '', '', NULL, 'O', '540 Madison Oak Dr Ste 450', 'San Antonio', 'Bexar', 'TX', '78258', '2104942000', NULL, '540 Madison Oak Dr Ste 450', 'San Antonio', 'Bexar', 'TX', '78258', '2104942000', '', 'TXOBG', 'TXHCPCS', NULL, '0.00', '50.00', '0.00', 3, '2007-11-15', '2010-01-01', 0, 0, 0, 'North Central Baptist Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1760471825', 0, 'N', 0, '2013-08-26', NULL, NULL, 29.6203, -98.4928, NULL, NULL),
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('742768427', 'W11002507', 'W11002507', 'TX01', 'Institute for Womens Health', 'Daniel', 'A', 'Calderon', 'MD', 'Obstetrics and Gynecology', '', '', NULL, 'O', '1303 McCullough Ave Ste GL70', 'San Antonio', 'Bexar', 'TX', '78212', '2102234555', NULL, '1303 McCullough Ave Ste GL70', 'San Antonio', 'Bexar', 'TX', '78212', '2102234555', '', 'TXOBG', 'TXHCPCS', NULL, '0.00', '50.00', '0.00', 3, '2007-11-15', '2010-01-01', 0, 0, 0, 'North Central Baptist Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1083603252', 0, 'N', 0, '2013-04-24', NULL, NULL, 29.4412, -98.4924, NULL, NULL),
('742768427', 'W11002508', 'W11002508', 'TX01', 'Institute for Womens Health', 'Carlos', 'A', 'Cardenas', 'MD', 'Obstetrics and Gynecology', '', '', NULL, 'O', '1303 McCullough Ave Ste GL70', 'San Antonio', 'Bexar', 'TX', '78212', '2102269705', NULL, '1303 McCullough Ave Ste GL70', 'San Antonio', 'Bexar', 'TX', '78212', '2102269705', '', 'TXOBG', 'TXHCPCS', NULL, '0.00', '50.00', '0.00', 3, '2007-11-15', '2010-01-01', 0, 0, 0, 'North Central Baptist Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1487643664', 0, 'N', 0, '2014-03-18', NULL, NULL, 29.4412, -98.4924, NULL, NULL),
('742768427', 'W11002509', 'W11002509', 'TX01', 'Institute for Womens Health', 'Elisa', 'F', 'Carroll', 'MD', 'Obstetrics and Gynecology', '', '', NULL, 'O', '1303 McCullough Ave Ste GL70', 'San Antonio', 'Bexar', 'TX', '78212', '2102269705', NULL, '1303 McCullough Ave Ste GL70', 'San Antonio', 'Bexar', 'TX', '78212', '2102269705', '', 'TXOBG', 'TXHCPCS', NULL, '0.00', '50.00', '0.00', 3, '2007-11-15', '2010-01-01', 0, 0, 0, 'North Central Baptist Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1962491159', 0, 'N', 0, '2013-04-24', NULL, NULL, 29.4412, -98.4924, NULL, NULL),
('742768427', 'W11002510', 'W11002510', 'TX01', 'Institute for Womens Health', 'Victor', 'L', 'Casiano', 'MD', 'Obstetrics and Gynecology', '', '', NULL, 'O', '1303 McCullough Ave Ste GL70', 'San Antonio', 'Bexar', 'TX', '78212', '2102269705', NULL, '1303 McCullough Ave Ste GL70', 'San Antonio', 'Bexar', 'TX', '78212', '2102269705', '', 'TXOBG', 'TXHCPCS', NULL, '0.00', '50.00', '0.00', 3, '2007-11-15', '2010-01-01', 0, 0, 0, 'North Central Baptist Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1679562862', 0, 'N', 0, '2013-04-24', NULL, NULL, 29.4412, -98.4924, NULL, NULL),
('742768427', 'W11002511', 'W11002511', 'TX01', 'Institute for Womens Health', 'Michelle', 'P', 'Foote', 'MD', 'Obstetrics and Gynecology', NULL, NULL, NULL, 'O', '1303 McCullough Ave Ste GL70', 'San Antonio', 'Bexar', 'TX', '78212', '2102269705', NULL, '367 E Ramsey', 'San Antonio', '', 'TX', '78216', '', '', 'TXOBG', 'TXHCPCS', NULL, '0.00', '50.00', '0.00', 3, '2008-01-01', '2008-02-15', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1427038819', 0, 'N', 0, '2007-12-07', NULL, NULL, 29.4412, -98.4924, NULL, NULL),
('742768427', 'W11002512', 'W11002512', 'TX01', 'Institute for Womens Health', 'Evangeline', '', 'Ramos-Gonzales', 'MD', 'Obstetrics and Gynecology', '', '', NULL, 'O', '1303 McCullough Ave Ste GL70', 'San Antonio', 'Bexar', 'TX', '78212', '2102269705', NULL, '1303 McCullough Ave Ste GL70', 'San Antonio', 'Bexar', 'TX', '78212', '2102269705', '', 'TXOBG', 'TXHCPCS', NULL, '0.00', '50.00', '0.00', 3, '2007-11-15', '2010-01-01', 0, 0, 0, 'North Central Baptist Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1922097070', 0, 'N', 0, '2013-04-24', NULL, NULL, 29.4412, -98.4924, NULL, NULL),
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('742768427', 'W11002516', 'W11002516', 'TX01', 'Institute for Womens Health', 'Rebecca', 'C', 'Cavazos', 'MD', 'Obstetrics and Gynecology', NULL, NULL, NULL, 'O', '8715 Village Dr Ste 418', 'San Antonio', 'Bexar', 'TX', '78217', '2106563040', NULL, '367 E Ramsey', 'San Antonio', '', 'TX', '78216', '', '', 'TXOBG', 'TXHCPCS', NULL, '0.00', '50.00', '0.00', 3, '2007-11-15', '2008-01-01', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1245229434', 0, 'N', 0, '2007-12-07', NULL, NULL, 29.5187, -98.4281, NULL, NULL),
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('742768427', 'W11002518', 'W11002518', 'TX01', 'Institute for Womens Health', 'Eduardo', '', 'Raez', 'MD', 'Obstetrics and Gynecology', '', '', NULL, 'O', '8715 Village Dr Ste 418', 'San Antonio', 'Bexar', 'TX', '78217', '2106563040', NULL, '8715 Village Dr Ste 418', 'San Antonio', 'Bexar', 'TX', '78217', '2106563040', '', 'TXOBG', 'TXHCPCS', NULL, '0.00', '50.00', '0.00', 3, '2007-11-15', '2010-01-01', 0, 0, 0, 'North East Baptist Hospital', '', '', '', 'HCFA|UB|', '1255320404', 0, 'N', 0, '2014-04-11', NULL, NULL, 29.5187, -98.4281, NULL, NULL),
('742768427', 'W11002519', 'W11002519', 'TX01', 'Institute for Womens Health', 'Michelle', 'P', 'Foote', 'MD', 'Obstetrics and Gynecology', NULL, NULL, NULL, 'O', '4610 E Southcross Blvd Ste 100', 'San Antonio', 'Bexar', 'TX', '78222', '2106485000', NULL, '367 E Ramsey', 'San Antonio', '', 'TX', '78216', '', '', 'TXOBG', 'TXHCPCS', NULL, '0.00', '50.00', '0.00', 3, '2008-01-01', '2008-02-15', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1427038819', 0, 'N', 0, '2007-12-07', NULL, NULL, 0, 0, NULL, NULL),
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('742768427', 'W11002521', 'W11002521', 'TX01', 'Institute for Womens Health', 'Cesar', '', 'Reyes', 'MD', 'Obstetrics and Gynecology', '', '', NULL, 'O', '7616 Culebra Rd Ste 124', 'San Antonio', 'Bexar', 'TX', '78251', '2105208484', NULL, '7616 Culebra Rd Ste 124', 'San Antonio', 'Bexar', 'TX', '78251', '2105208484', '', 'TXOBG', 'TXHCPCS', NULL, '0.00', '50.00', '0.00', 3, '2007-11-15', '2010-01-01', 0, 0, 0, 'St Lukes Baptist Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1801885959', 0, 'N', 0, '2013-04-11', NULL, NULL, 0, 0, NULL, NULL),
('742768427', 'W11002522', 'W11002522', 'TX01', 'Institute for Womens Health', 'Jose', 'M', 'Ruiz III', 'MD', 'Obstetrics and Gynecology', '', '', NULL, 'O', '7616 Culebera Rd Ste 124', 'San Antonio', 'Bexar', 'TX', '78251', '2105208484', NULL, '7616 Culebera Rd Ste 124', 'San Antonio', 'Bexar', 'TX', '78251', '2105208484', '', 'TXOBG', 'TXHCPCS', NULL, '0.00', '50.00', '0.00', 3, '2007-11-15', '2010-01-01', 0, 0, 0, 'St Lukes Baptist Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1093705089', 0, 'N', 0, '2013-03-12', NULL, NULL, 29.4592, -98.6397, NULL, NULL),
('743003947', 'W11002524', 'W11002524', 'TX01', 'The San Antonio Orthopaedic Group', 'Melissa', 'G', 'Hernandez', 'FNP', 'Orthopedic Surgery', '', '', NULL, 'B', 'PO Box 2516', 'San Antonio', 'Bexar', 'TX', '78258', '8004454263', NULL, 'PO Box 2516', 'San Antonio', 'Bexar', 'TX', '78258', '8004454263', '', 'TXORTHO', 'TXHCPCS', NULL, '0.00', '50.00', '0.00', 3, '2007-01-01', '2012-08-19', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '0000006687', 0, 'Y', 0, '2013-05-23', NULL, NULL, 0, 0, NULL, NULL),
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('870659348', 'W11002526', 'W11002526', 'UT01', 'University Pathology Associates', 'Josef', 'T', 'Prchal', 'MD', 'Hematology and Oncology', 'Oncology', '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|', '1427008341', 0, 'N', 0, '2012-03-06', NULL, NULL, 0, 0, NULL, NULL),
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('364598541', 'W11002529', 'W11002529', 'UT01', 'University of Utah Hospital Surgical ICU', 'Stephen', 'E', 'Morris', 'MD', 'General Surgery', '', '', NULL, 'O', '50 N Medical Dr', 'Salt Lake City', 'Salt Lake', 'UT', '84132', '8015812121', NULL, '50 N Medical Dr', 'Salt Lake City', 'Salt Lake', 'UT', '84132', '8015812121', '          ', 'WUUUMG5', 'WUSTDHCPC5', '', '0.00', '25.00', '0.00', 3, '2006-08-01', '2012-09-16', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1083704696', 0, 'N', 0, '2012-09-17', NULL, NULL, 0, 0, NULL, NULL),
('870442845', 'W11002530', 'W11002530', 'UT01', 'Huntsman Cancer Institute', 'Karen', NULL, 'Hauenstein', 'PA', 'Hematology and Oncology', NULL, NULL, NULL, 'B', 'PO Box 581700', 'Salt Lake City', 'Salt Lake', 'UT', '84158', '8012133800', NULL, NULL, NULL, '', NULL, NULL, '', '', 'WUUUMG5', 'WUSTDHCPC5', NULL, '0.00', '25.00', '0.00', 3, '2007-07-01', '2008-04-18', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1558316349', 0, 'y', 0, '2007-12-17', NULL, NULL, 0, 0, NULL, NULL),
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('870645895', 'W11002544', 'W11002544', 'UT01', 'U of U Pediatric Orthopedics', 'Angela', 'A', 'Wang', 'MD', 'Orthopedic Surgery', 'Pediatric Orthopedic Surgery', '', NULL, 'B', 'PO Box 413026', 'Salt Lake City', 'Salt Lake', 'UT', '84141', '8012133800', NULL, 'PO Box 413026', 'Salt Lake City', 'Salt Lake', 'UT', '84141', '8012133800', '          ', 'WUUPEDS', 'WUSTDHCPC5', '', '0.00', '15.00', '0.00', 3, '2006-08-01', '2012-08-01', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1922198514', 0, 'N', 0, '2012-08-02', NULL, NULL, 0, 0, NULL, NULL),
('870645895', 'W11002545', 'W11002545', 'UT01', 'University Health Care', 'Angela', 'A', 'Wang', 'MD', 'Orthopedic Surgery', 'Pediatric Orthopedic Surgery', '', NULL, 'O', '100 N Mario Capecchi Dr Ste 4550', 'Salt Lake City', 'Salt Lake', 'UT', '84158', '8016625600', NULL, '100 N Mario Capecchi Dr Ste 4550', 'Salt Lake City', 'Salt Lake', 'UT', '84158', '8016625600', '          ', 'WUUPEDS', 'WUSTDHCPC5', '', '0.00', '15.00', '0.00', 3, '2006-08-01', '2012-08-01', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1922198514', 0, 'N', 0, '2012-08-02', NULL, NULL, 0, 0, NULL, NULL),
('870640775', 'W11002546', 'W11002546', 'UT01', 'U of U Hospitals and Clinics - FPO', 'Angela', 'A', 'Wang', 'MD', 'Orthopedic Surgery', 'Pediatric Orthopedic Surgery', NULL, NULL, 'b', 'PO Box 510708', 'Salt Lake City', 'Salt Lake', 'UT', '84151', '8015876600', NULL, NULL, NULL, '', NULL, NULL, '', '', 'WISESTDU', 'WUSTDHCPC5', NULL, '0.00', '35.00', NULL, 3, '2007-08-01', '2007-08-01', 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1922198514', 0, 'y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870640775', 'W11002547', 'W11002547', 'UT01', 'University Health Care', 'Angela', 'A', 'Wang', 'MD', 'Orthopedic Surgery', 'Pediatric Orthopedic Surgery', NULL, NULL, 'O', '1525 W 2100 S', 'Salt Lake City', 'Salt Lake', 'UT', '84119', '8012139900', NULL, NULL, NULL, '', NULL, NULL, '', '', 'WISESTDU', 'WUSTDHCPC5', NULL, '0.00', '35.00', NULL, 3, '2007-08-01', '2007-08-01', 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1922198514', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
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('870645661', 'W11002588', 'W11002588', 'UT01', NULL, 'Lisa', 'M', 'Steed', 'LCSW', 'Mental Health', '', '', NULL, 'O', '94 E Pages Ln Ste A', 'Centerville', 'Davis', 'UT', '84014', '8012318914', NULL, '94 E Pages Ln Ste A', 'Centerville', 'Davis', 'UT', '84014', '8012318914', '', 'MA', NULL, NULL, '0.00', '100.00', '0.00', 3, '2007-11-01', '2008-06-30', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1164562328', 0, 'n', 0, '2013-02-27', NULL, NULL, 0, 0, NULL, NULL),
('529134235', 'W11002589', 'W11002589', 'UT01', NULL, 'Nancy', NULL, 'Stoddard', 'LCSW', 'Mental Health', NULL, NULL, NULL, 'O', '286 S 600 E Ste C', 'Provo', 'Utah', 'UT', '84606', '8013778232', NULL, NULL, NULL, '', NULL, NULL, '', '', 'MA', NULL, NULL, '0.00', '100.00', '0.00', 3, '2007-12-01', '2008-06-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1437185634', 0, 'n', 0, '2007-12-27', NULL, NULL, 0, 0, NULL, NULL),
('232137951', 'W11002590', 'W11002590', 'UT01', NULL, 'Claire', 'R', 'Stoecker', 'LCSW', 'Mental Health', 'Social Worker', '', NULL, 'O', '2040 E Murray Holladay Rd', 'Salt Lake City', 'Salt Lake', 'UT', '84117', '8014554535', NULL, '2040 E Murray Holladay Rd', 'Salt Lake City', 'Salt Lake', 'UT', '84117', '8014554535', '', 'MA', NULL, NULL, '0.00', '100.00', '0.00', 3, '2007-12-01', '2008-06-30', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1093735565', 0, 'n', 0, '2013-09-03', NULL, NULL, 0, 0, NULL, NULL),
('529628952', 'W11002591', 'W11002591', 'UT01', NULL, 'Paul', NULL, 'Stratton', 'PHD', 'Mental Health', NULL, NULL, NULL, 'O', '1208 E 3300 S', 'Salt Lake City', 'Salt Lake', 'UT', '84106', '8014831600', NULL, NULL, NULL, '', NULL, NULL, '', '', 'PHD', NULL, NULL, '0.00', '100.00', '0.00', 3, '2007-12-01', '2008-06-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1730122358', 0, 'n', 0, '2007-12-27', NULL, NULL, 0, 0, NULL, NULL),
('530297630', 'W11002592', 'W11002592', 'UT01', NULL, 'Melissa', 'A', 'Sundell', 'LCSW', 'Mental Health', NULL, NULL, NULL, 'O', '1255 N 1200 W', 'Orem', 'Utah', 'UT', '84057', '8012291181', NULL, NULL, NULL, '', NULL, NULL, '', '', 'MA', NULL, NULL, '0.00', '100.00', '0.00', 3, '2007-12-01', '2008-06-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1730158528', 0, 'n', 0, '2007-12-27', NULL, NULL, 0, 0, NULL, NULL),
('870642142', 'W11002593', 'W11002593', 'UT01', NULL, 'Jeffrey', NULL, 'Tesch', 'LMFT', 'Mental Health', NULL, NULL, NULL, 'O', '1525 Lincoln Ave', 'Ogden', 'Weber', 'UT', '84404', '8016216510', NULL, NULL, NULL, '', NULL, NULL, '', '', 'MA', NULL, NULL, '0.00', '100.00', '0.00', 3, '2007-12-01', '2008-06-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1346304599', 0, 'n', 0, '2007-12-27', NULL, NULL, 0, 0, NULL, NULL),
('528111562', 'W11002594', 'W11002594', 'UT01', NULL, 'Richard', 'L', 'Tucker', 'LCSW', 'Mental Health', 'Social Worker', '', NULL, 'O', '2092 N 250 W Sunset', 'Clearfield', 'Davis', 'UT', '84015', '8016216510', NULL, '2092 N 250 W Sunset', 'Clearfield', 'Davis', 'UT', '84015', '8016216510', '', 'MA', NULL, NULL, '0.00', '100.00', '0.00', 3, '2007-12-01', '2008-06-30', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1417984485', 0, 'n', 0, '2013-02-27', NULL, NULL, 0, 0, NULL, NULL),
('528111562', 'W11002595', 'W11002595', 'UT01', NULL, 'Richard', 'L', 'Tucker', 'LCSW', 'Mental Health', 'Social Worker', '', NULL, 'O', '1525 Lincoln Ave', 'Ogden', 'Weber', 'UT', '84404', '8016216510', NULL, '1525 Lincoln Ave', 'Ogden', 'Weber', 'UT', '84404', '8016216510', '', 'MA', NULL, NULL, '0.00', '100.00', '0.00', 3, '2007-12-01', '2008-06-30', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1417984485', 0, 'n', 0, '2013-02-27', 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
('810422536', 'W11002596', 'W11002596', 'WY01', 'Yellowstone Pathologists PC', 'Duane', 'A', 'Schultz', 'MD', 'Pathology', '', '', NULL, 'O', '1008 Cody Ave', 'Cody', 'Park', 'WY', '82414', '4062386363', NULL, '1008 Cody Ave', 'Cody', 'Park', 'WY', '82414', '4062386363', '          ', 'WYSTD', 'Wyhcpcs', '', '0.00', '35.00', '0.00', 3, '2007-12-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1770585903', 0, 'Y', 0, '2013-06-27', NULL, NULL, 44.5227, -109.068, NULL, NULL),
('810422536', 'W11002597', 'W11002597', 'WY01', 'Yellowstone Pathologists PC', 'Duane', 'A', 'Schultz', 'MD', 'Pathology', '', '', NULL, 'O', '2900 12th Ave N Ste 295W', 'Billings', 'Yellowstone', 'MT', '59101', '4062386363', NULL, '2900 12th Ave N Ste 295W', 'Billings', 'Yellowstone', 'MT', '59101', '4062386363', '          ', 'WYSTD', 'Wyhcpcs', '', '0.00', '35.00', '0.00', 3, '2007-12-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1770585903', 0, 'Y', 0, '2013-06-27', NULL, NULL, 45.793, -108.518, NULL, NULL),
('518627077', 'W11002598', 'W11002598', 'UT01', NULL, 'Lee Ann', 'A', 'Turpin', 'LCPC', 'Mental Health', NULL, NULL, NULL, 'O', '4460 Central Way Ste 2', 'Pocatello', 'Bannock', 'ID', '83202', '2082371711', NULL, NULL, NULL, '', NULL, NULL, '', '', 'MA', NULL, NULL, '0.00', '100.00', '0.00', 3, '2007-12-01', '2008-06-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1780780775', 0, 'n', 0, '2007-12-27', NULL, NULL, 0, 0, NULL, NULL),
('870642181', 'W11002599', 'W11002599', 'UT01', NULL, 'Linda', NULL, 'Tuttle', 'LCSW', 'Mental Health', NULL, NULL, NULL, 'O', '1466 N Hwy 89 Ste 230', 'Farmington', 'Davis', 'UT', '84025', '8015915852', NULL, NULL, NULL, '', NULL, NULL, '', '', 'MA', NULL, NULL, '0.00', '100.00', '0.00', 3, '2007-12-01', '2008-06-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1972536019', 0, 'n', 0, '2007-12-27', NULL, NULL, 0, 0, NULL, NULL),
('870642181', 'W11002600', 'W11002600', 'UT01', NULL, 'Linda', NULL, 'Tuttle', 'LCSW', 'Mental Health', NULL, NULL, NULL, 'O', '1525 Lincoln Ave', 'Ogden', 'Weber', 'UT', '84404', '8016216570', NULL, NULL, NULL, '', NULL, NULL, '', '', 'MA', NULL, NULL, '0.00', '100.00', '0.00', 3, '2007-12-01', '2008-06-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1972536019', 0, 'n', 0, '2007-12-27', NULL, NULL, 0, 0, NULL, NULL),
('810501715', 'W11002601', 'W11002601', 'UT01', NULL, 'Tab', 'L', 'Uno', 'LCSW', 'Mental Health', 'Social Worker', NULL, NULL, 'O', '1208 E 3300 S', 'Salt Lake City', 'Salt Lake', 'UT', '84106', '8019653759', NULL, '1208 E 3300 S', 'Salt Lake City', '', 'UT', '84106', '', '', 'MA', NULL, NULL, '0.00', '100.00', '0.00', 3, '2006-05-01', '2008-06-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1194920991', 0, 'N', 0, '2008-06-23', NULL, NULL, 0, 0, NULL, NULL),
('558821397', 'W11002602', 'W11002602', 'UT01', NULL, 'Patricia', 'A', 'Voorhes', 'LCSW', 'Mental Health', 'Social Worker', '', NULL, 'O', '1255 E 3900 S Ste 300', 'Salt Lake City', 'Salt Lake', 'UT', '84124', '8017506024', NULL, '1255 E 3900 S Ste 300', 'Salt Lake City', 'Salt Lake', 'UT', '84124', '8017506024', '', 'MA', NULL, NULL, '0.00', '100.00', '0.00', 3, '2007-12-01', '2008-06-30', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1932144565', 0, 'n', 0, '2014-04-17', NULL, NULL, 0, 0, NULL, NULL),
('810501715', 'W11002603', 'W11002603', 'UT01', NULL, 'Stacy', NULL, 'Waldron', 'PHD', 'Mental Health', NULL, NULL, NULL, 'O', '1250 E 3900 S Ste 30', 'Salt Lake City', 'Salt Lake', 'UT', '84124', '8012687725', NULL, '1208 E 3300 S', 'Salt Lake City', '', 'UT', '84106', '', '', 'MA', NULL, NULL, '0.00', '100.00', '0.00', 3, '2006-05-01', '2008-06-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1295765238', 0, 'N', 0, '2007-12-27', NULL, NULL, 0, 0, NULL, NULL),
('521431804', 'W11002604', 'W11002604', 'UT01', NULL, 'Jared', 'S', 'Warren', 'PHD', 'Mental Health', NULL, NULL, NULL, 'O', '1355 N University Ave Ste 200', 'Provo', 'Rich', 'UT', '84064', '8012210223', NULL, NULL, NULL, '', NULL, NULL, '', '', 'PHD', NULL, NULL, '0.00', '100.00', '0.00', 3, '2007-12-01', '2008-06-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1871640953', 0, 'n', 0, '2007-12-27', NULL, NULL, 0, 0, NULL, NULL),
('870625250', 'W11002605', 'W11002605', 'UT01', NULL, 'Rachel', 'A', 'Weir', 'MD', 'Mental Health', 'Psychiatry', 'Pediatric Psychiatry', NULL, 'O', '845 E 4800 S Ste 200', 'Salt Lake City', 'Salt Lake', 'UT', '84107', '8012649522', NULL, '845 E 4800 S Ste 200', 'Salt Lake City', 'Salt Lake', 'UT', '84107', '8012649522', '', 'MD', NULL, NULL, '0.00', '100.00', '0.00', 3, '2006-05-01', '2008-06-30', 0, 0, 0, 'University Health Care University Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1487779955', 0, 'N', 0, '2012-01-26', NULL, NULL, 0, 0, NULL, NULL),
('826001205', 'W11002606', 'W11002606', 'UT01', NULL, 'Donald', 'M', 'Whitley', 'PHD', 'Mental Health', NULL, NULL, NULL, 'O', '1598 Delphie Way Ste A1', 'Pocatello', 'Bannock', 'ID', '83201', '2082334900', NULL, NULL, NULL, '', NULL, NULL, '', '', 'PHD', NULL, NULL, '0.00', '100.00', '0.00', 3, '2007-12-01', '2008-06-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1275543738', 0, 'n', 0, '2007-12-27', NULL, NULL, 0, 0, NULL, NULL),
('826001205', 'W11002607', 'W11002607', 'UT01', NULL, 'Donald', 'M', 'Whitley', 'PHD', 'Mental Health', NULL, NULL, NULL, 'O', '98 Poplar', 'American Falls', 'Power', 'ID', '83211', '2087853800', NULL, NULL, NULL, '', NULL, NULL, '', '', 'PHD', NULL, NULL, '0.00', '100.00', '0.00', 3, '2007-12-01', '2008-06-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1275543738', 0, 'n', 0, '2007-12-27', NULL, NULL, 0, 0, NULL, NULL),
('200014396', 'W11002608', 'W11002608', 'UT01', NULL, 'Michael', 'J', 'Wolfe', 'LCSW', 'Mental Health', NULL, NULL, NULL, 'O', '276 River Vista Pl', 'TWIN FALLS', 'Twin Falls', 'ID', '83301', '2087331131', NULL, NULL, NULL, '', NULL, NULL, '', '', 'MA', NULL, NULL, '0.00', '100.00', '0.00', 3, '2007-12-01', '2008-06-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1134131048', 0, 'n', 0, '2007-12-27', NULL, NULL, 0, 0, NULL, NULL),
('870390017', 'W11002609', 'W11002609', 'UT01', NULL, 'Jessica', 'L', 'Wolfinger', 'LCSW', 'Mental Health', 'Social Worker', '', NULL, 'O', '1128 E 200 S', 'Salt Lake City', 'Salt Lake', 'UT', '84119', '8014246170', NULL, '1128 E 200 S', 'Salt Lake City', 'Salt Lake', 'UT', '84119', '8014246170', '', 'MA', NULL, NULL, '0.00', '100.00', '0.00', 3, '2006-05-01', '2008-06-30', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1134189277', 0, 'N', 0, '2012-01-18', NULL, NULL, 0, 0, NULL, NULL),
('530520545', 'W11002610', 'W11002610', 'UT01', NULL, 'Kent', 'T', 'Worthen', 'DO', 'Mental Health', '', '', NULL, 'O', '1140 W 500 S', 'Vernal', 'Uintah', 'UT', '84078', '4357896300', NULL, '1140 W 500 S', 'Vernal', 'Uintah', 'UT', '84078', '4357896300', '', 'MD', NULL, NULL, '0.00', '100.00', '0.00', 3, '2007-12-01', '2008-06-30', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1295748804', 0, 'n', 0, '2013-02-27', NULL, NULL, 0, 0, NULL, NULL),
('530520545', 'W11002611', 'W11002611', 'UT01', NULL, 'Kent', 'T', 'Worthen', 'DO', 'Mental Health', '', '', NULL, 'B', 'PO Box 1908', 'Vernal', 'Uintah', 'UT', '84078', '4357896300', NULL, 'PO Box 1908', 'Vernal', 'Uintah', 'UT', '84078', '4357896300', '', 'MD', NULL, NULL, '0.00', '100.00', '0.00', 3, '2007-12-01', '2008-06-30', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1295748804', 0, 'Y', 0, '2013-02-27', NULL, NULL, 0, 0, NULL, NULL),
('830234097', 'W11002612', 'W11002612', 'WYWSBAIT', 'Campbell County Memorial Hospital', '', '', 'Campbell County Memorial Hospital', 'GROUP', 'Hospital', '', '', NULL, 'O', '501 S Burma Ave', 'Gillette', 'Campbell', 'WY', '82716', '3076881000', NULL, '501 S Burma Ave', 'Gillette', 'Campbell', 'WY', '82716', '3076881000', '          ', '', '', '5001A', '0.00', '0.00', '0.00', 3, '2007-11-15', '2011-06-30', 0, 0, 1, '', '', '', '', 'HCFA|UB|', '0000005551', 0, 'N', 0, '2013-10-23', NULL, NULL, 0, 0, NULL, NULL),
('820588653', 'W11002613', 'W11002613', 'UTIASIS1', 'Pioneer Valley Hospital', NULL, NULL, 'Pioneer Valley Hospital', 'GROUP', 'Hospital', NULL, NULL, NULL, 'B', 'PO Box 27448', 'Salt Lake City', 'Salt Lake', 'UT', '84127', '8019643100', NULL, 'PO Box 27448', 'Salt Lake City', '', 'UT', '84127', '', '', NULL, NULL, NULL, '0.00', '40.00', NULL, 3, '2007-06-01', '2007-06-30', 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '3022', 0, 'y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('820588653', 'W11002614', 'W11002614', 'UTIASIS1', 'Pioneer Valley Hospital', NULL, NULL, 'Pioneer Valley Hospital', 'GROUP', 'Hospital', NULL, NULL, NULL, 'O', '3460 Pioneer Pkwy', 'Salt Lake City', 'Salt Lake', 'UT', '84120', '8019643100', NULL, 'PO Box 27448', 'Salt Lake City', '', 'UT', '84127', '', '', NULL, NULL, NULL, '0.00', '40.00', NULL, 3, '2007-06-01', '2007-06-30', 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '3022', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('820588653', 'W11002615', 'W11002615', 'UTIASIS2', 'Pioneer Valley Hospital', NULL, NULL, 'Pioneer Valley Hospital', 'GROUP', 'Hospital', NULL, NULL, NULL, 'O', '3460 Pioneer Pkwy', 'Salt Lake City', 'Salt Lake', 'UT', '84120', '8019643100', NULL, 'PO Box 27448', 'Salt Lake City', '', 'UT', '84127', '', '', NULL, NULL, NULL, '0.00', '49.00', NULL, 3, '2007-06-01', '2007-06-30', 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '3022', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('820588653', 'W11002616', 'W11002616', 'UTIASIS2', 'Pioneer Valley Hospital', NULL, NULL, 'Pioneer Valley Hospital', 'GROUP', 'Hospital', NULL, NULL, NULL, 'B', 'PO Box 27448', 'Salt Lake City', 'Salt Lake', 'UT', '84127', '8019643100', NULL, 'PO Box 27448', 'Salt Lake City', '', 'UT', '84127', '', '', NULL, NULL, NULL, '0.00', '49.00', NULL, 3, '2007-06-01', '2007-06-30', 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '3022', 0, 'y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('820588653', 'W11002617', 'W11002617', 'UTIASIS1', 'Jordan Valley Medical Center', '', '', 'Jordan Valley Medical Center', 'GROUP', 'Hospital', NULL, NULL, NULL, 'B', 'PO Box 26893', 'Salt Lake City', 'Salt Lake', 'UT', '84126', '8015623112', NULL, 'PO Box 26893', 'Salt Lake City', 'Salt Lake', 'UT', '84126', '8015623112', '', '', NULL, NULL, '0.00', '42.00', '0.00', 3, '2007-07-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1033159603', 0, 'Y', 0, '2011-06-30', NULL, NULL, 0, 0, NULL, NULL),
('820588653', 'W11002618', 'W11002618', 'UTIASIS1', 'Jordan Valley Medical Center', '', '', 'Jordan Valley Medical Center', 'GROUP', 'Hospital', NULL, NULL, NULL, 'O', '3580 W 9000 S', 'West Jordan', 'Salt Lake', 'UT', '84088', '8015618888', NULL, '3580 W 9000 S', 'West Jordan', 'Salt Lake', 'UT', '84088', '8015618888', '', '', NULL, NULL, '0.00', '42.00', '0.00', 3, '2007-07-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1033159603', 0, 'N', 0, '2011-06-30', NULL, NULL, 0, 0, NULL, NULL),
('820588653', 'W11002619', 'W11002619', 'UTIASIS2', 'Jordan Valley Medical Center', '', '', 'Jordan Valley Medical Center', 'GROUP', 'Hospital', NULL, NULL, NULL, 'O', '3580 W 9000 S', 'West Jordan', 'Salt Lake', 'UT', '84088', '8015618888', NULL, '3580 W 9000 S', 'West Jordan', 'Salt Lake', 'UT', '84088', '8015618888', '', '', NULL, NULL, '0.00', '50.00', '0.00', 3, '2007-07-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1033159603', 0, 'N', 0, '2011-06-30', NULL, NULL, 0, 0, NULL, NULL),
('820588653', 'W11002620', 'W11002620', 'UTIASIS2', 'Jordan Valley Medical Center', '', '', 'Jordan Valley Medical Center', 'GROUP', 'Hospital', NULL, NULL, NULL, 'B', 'PO Box 26893', 'Salt Lake City', 'Salt Lake', 'UT', '84126', '8015623112', NULL, 'PO Box 26893', 'Salt Lake City', 'Salt Lake', 'UT', '84126', '8015623112', '', '', NULL, NULL, '0.00', '50.00', '0.00', 3, '2007-07-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1033159603', 0, 'Y', 0, '2011-06-30', NULL, NULL, 0, 0, NULL, NULL),
('621795216', 'W11002621', 'W11002621', 'UTIASIS1', 'Pioneer Valley Hospital', NULL, NULL, 'Pioneer Valley Hospital', 'GROUP', 'Hospital', NULL, NULL, NULL, 'B', 'PO Box 27448', 'Salt Lake City', 'Salt Lake', 'UT', '84127', '8019643100', NULL, 'PO Box 27448', 'Salt Lake City', '', 'UT', '84127', '', '', NULL, NULL, NULL, '0.00', '40.00', NULL, 3, '2007-02-01', '2007-06-30', 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1366440620', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('621795216', 'W11002622', 'W11002622', 'UTIASIS1', 'Pioneer Valley Hospital', NULL, NULL, 'Pioneer Valley Hospital', 'GROUP', 'Hospital', NULL, NULL, NULL, 'O', '3460 Pioneer Pkwy', 'Salt Lake City', 'Salt Lake', 'UT', '84120', '8019643100', NULL, 'PO Box 27448', 'Salt Lake City', '', 'UT', '84127', '', '', NULL, NULL, NULL, '0.00', '40.00', NULL, 3, '2007-02-01', '2007-06-30', 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1366440620', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
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