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
('870277578', 'W77001281', 'W77001281', 'UT01', 'Ear Nose And Throat Center', 'John', 'R', 'Bennett', 'MD', 'Ear, Nose and Throat', NULL, NULL, NULL, 'O', '22 S 900 E', 'Salt Lake City', 'Salt Lake', 'UT', '84102', '8013282522', NULL, NULL, NULL, '', NULL, NULL, '', '', 'USTDENT', NULL, NULL, '0.00', '35.00', NULL, 3, '2003-08-13', '2004-03-31', 0, 0, 0, 'Salt Lake Regional Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1699800227', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870218917', 'W77001282', 'W77001282', 'UT01', 'Tanner Memorial Clinic', 'Charles', 'C', 'Harpe', 'MD', 'Internal Medicine', NULL, NULL, NULL, 'O', '2121 Robins Dr', 'Layton', 'Davis', 'UT', '84041', '8017734840', '8015258151', NULL, NULL, '', NULL, NULL, '', '', 'UTANNER', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2001-01-01', '2006-06-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1063498004', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870218917', 'W77001283', 'W77001283', 'UT01', 'Tanner Memorial Clinic', 'Rachel', 'B', 'Hobbs', 'MD', 'Family Practice', NULL, NULL, NULL, 'O', '2121 Robins Dr', 'Layton', 'Davis', 'UT', '84041', '8017734840', '8015258151', NULL, NULL, '', NULL, NULL, '', '', 'UTANNER', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2004-04-30', '2006-06-30', 0, 0, 0, 'Davis Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1275519126', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870218917', 'W77001284', 'W77001284', 'UT01', 'Tanner Memorial Clinic', 'Rachel', 'B', 'Hobbs', 'MD', 'Family Practice', NULL, NULL, NULL, 'B', 'PO Box 337', 'Layton', 'Davis', 'UT', '84041', '8017734840', '8015258151', NULL, NULL, '', NULL, NULL, '', '', 'UTANNER', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2004-04-30', '2006-06-30', 0, 0, 0, 'Davis Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1275519126', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870218917', 'W77001285', 'W77001285', 'UT01', 'Tanner Memorial Clinic', 'Jennifer', NULL, 'Hogge', 'AUD', 'Audiology', NULL, NULL, NULL, 'O', '2121 Robins Dr', 'Layton', 'Davis', 'UT', '84041', '8017734840', '8015258151', NULL, NULL, '', NULL, NULL, '', '', 'UTANNER', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2004-04-30', '2006-06-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '833033', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870218917', 'W77001286', 'W77001286', 'UT01', 'Tanner Memorial Clinic', 'Jennifer', NULL, 'Hogge', 'AUD', 'Audiology', NULL, NULL, NULL, 'B', 'PO Box 337', 'Layton', 'Davis', 'UT', '84041', '8017734840', '8015258151', NULL, NULL, '', NULL, NULL, '', '', 'UTANNER', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2004-04-30', '2006-06-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '833033', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870218917', 'W77001287', 'W77001287', 'UT01', 'Tanner Memorial Clinic', 'Robert', 'A', 'Jacobsen', 'MD', 'General Surgery', NULL, NULL, NULL, 'O', '2121 Robins Dr', 'Layton', 'Davis', 'UT', '84041', '8017734840', '8015258151', NULL, NULL, '', NULL, NULL, '', '', 'USTDSURG', NULL, NULL, '0.00', '35.00', NULL, 3, '2001-01-01', '2005-03-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '833185', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870218917', 'W77001288', 'W77001288', 'UT01', 'Tanner Memorial Clinic', 'Wade', 'B', 'Larsen', 'MD', 'General Surgery', NULL, NULL, NULL, 'O', '2121 Robins Dr', 'Layton', 'Davis', 'UT', '84041', '8017734840', '8015258151', NULL, NULL, '', NULL, NULL, '', '', 'UTANNER', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2003-07-11', '2006-06-30', 0, 0, 0, 'Davis Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1326024191', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870218917', 'W77001289', 'W77001289', 'UT01', 'Tanner Memorial Clinic', 'Wade', 'B', 'Larsen', 'MD', 'General Surgery', NULL, NULL, NULL, 'B', 'PO Box 337', 'Layton', 'Davis', 'UT', '84041', '8017734840', '8015258151', NULL, NULL, '', NULL, NULL, '', '', 'UTANNER', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2003-07-11', '2006-06-30', 0, 0, 0, 'Davis Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1326024191', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870218917', 'W77001290', 'W77001290', 'UT01', 'Tanner Memorial Clinic', 'Robert', 'L', 'Mellor', 'MD', 'Ear, Nose and Throat', 'Plastic Surgery', NULL, NULL, 'O', '2121 Robins Dr', 'Layton', 'Davis', 'UT', '84041', '8017734840', '8015258151', NULL, NULL, '', NULL, NULL, '', '', 'UTANNER', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2001-01-01', '2006-06-30', 0, 0, 0, 'Davis Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1023094992', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870218917', 'W77001291', 'W77001291', 'UT01', 'Tanner Memorial Clinic', 'Stephen', 'L', 'Morrell', 'MD', 'Family Practice', NULL, NULL, NULL, 'O', '380 N 400 W', 'Kaysville', 'Davis', 'UT', '84037', '8017734840', NULL, NULL, NULL, '', NULL, NULL, '', '', 'UTANNER', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2001-05-25', '2006-06-30', 0, 0, 0, 'Davis Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1801872601', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870218917', 'W77001292', 'W77001292', 'UT01', 'Tanner Memorial Clinic', 'Noel', 'C', 'Nye', 'DO', 'Pediatrics', NULL, NULL, NULL, 'B', 'PO Box 337', 'Layton', 'Davis', 'UT', '84041', '8017734840', '8015258151', NULL, NULL, '', NULL, NULL, '', '', 'UTANNER', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2001-01-01', '2006-06-30', 0, 0, 0, 'Davis Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1437135399', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870218917', 'W77001293', 'W77001293', 'UT01', 'Tanner Memorial Clinic', 'Bryan', 'L', 'Richards', 'MD', 'Ear, Nose and Throat', NULL, NULL, NULL, 'O', '2121 Robins Dr', 'Layton', 'Davis', 'UT', '84041', '8017734840', '8015258151', NULL, NULL, '', NULL, NULL, '', '', 'UTANNER', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2001-01-01', '2006-06-30', 0, 0, 0, 'Davis Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1780660548', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870218917', 'W77001294', 'W77001294', 'UT01', 'Tanner Memorial Clinic', 'Craig', NULL, 'Sacco', 'AUD', 'Audiology', NULL, NULL, NULL, 'B', 'PO Box 337', 'Layton', 'Davis', 'UT', '84041', '8017734840', '8015258151', NULL, NULL, '', NULL, NULL, '', '', 'USTDMULT', NULL, NULL, '0.00', '35.00', NULL, 3, '2001-01-01', '2006-02-11', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '834748', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870218917', 'W77001295', 'W77001295', 'UT01', 'Tanner Memorial Clinic', 'Kevin', 'Spafford', 'Sumsion', 'MD', 'Obstetrics and Gynecology', NULL, NULL, NULL, 'O', '2121 Robins Dr', 'Layton', 'Davis', 'UT', '84041', '8017734840', '8015258151', NULL, NULL, '', NULL, NULL, '', '', 'UTANNER', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '1999-09-01', '2006-06-30', 0, 0, 0, 'Davis Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1255317053', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870218917', 'W77001296', 'W77001296', 'UT01', 'Tanner Memorial Clinic', 'Bohus', NULL, 'Svagr', 'MD', 'Orthopedic Surgery', NULL, NULL, NULL, 'O', '2121 Robins Dr', 'Layton', 'Davis', 'UT', '84041', '8017734840', '8015258151', NULL, NULL, '', NULL, NULL, '', '', 'UTANNER', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2004-09-24', '2006-06-30', 0, 0, 0, 'Davis Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1164408118', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('861037124', 'W77001298', 'W77001298', 'UT01', 'MediServ', 'tems', NULL, 'Personal Fitness Sys', 'GROUP', 'Physical Therapy', NULL, NULL, NULL, 'B', 'PO Box 307', 'Bountiful', 'Davis', 'UT', '84011', '8012946907', NULL, NULL, NULL, '', NULL, NULL, '', '', NULL, NULL, NULL, '0.00', '0.00', '57.75', 3, '2005-04-05', '2005-06-27', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '916420', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('861076116', 'W77001299', 'W77001299', 'UT01', 'Mountain West Surgical Service', 'Lisa', NULL, 'Zuraff-Perryman', 'MD', 'General Surgery', NULL, NULL, NULL, 'O', '196 E 2000 N Ste 106', 'Tooele', 'Tooele', 'UT', '84074', '4358434930', '4358439997', NULL, NULL, '', NULL, NULL, '', '', 'USTDSURG', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2003-11-07', '2006-12-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '832831', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870212456', 'W77001300', 'W77001300', 'UT01', 'Jackson Family Clinic', 'Christine', 'L', 'Jackson', 'MD', 'Family Practice', NULL, NULL, NULL, 'O', '95 E Ctr', 'Gunnison', 'Sanpete', 'UT', '84634', '4355287752', '4355287796', NULL, NULL, '', NULL, NULL, '', '', 'URURAL', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2005-09-30', '2006-11-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1114087996', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870212456', 'W77001301', 'W77001301', 'UT01', 'Jackson Family Clinic', 'John', 'W', 'Jackson', 'MD', 'Family Practice', NULL, NULL, NULL, 'O', '260 E Ctr St', 'Monroe', 'Sevier', 'UT', '84754', '4355278866', '4355274436', NULL, NULL, '', NULL, NULL, '', '', 'URURAL', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2005-10-28', '2006-11-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1548321862', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870212456', 'W77001302', 'W77001302', 'UT01', 'Jackson Family Clinic', 'John', 'W', 'Jackson', 'MD', 'Family Practice', NULL, NULL, NULL, 'O', '95 E Ctr', 'Gunnison', 'Sanpete', 'UT', '84634', '4355287752', '4355287796', NULL, NULL, '', NULL, NULL, '', '', 'URURAL', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2005-10-28', '2006-11-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1548321862', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870212456', 'W77001303', 'W77001303', 'UT01', 'Gunnison Family Practice', 'Cary', 'J', 'Judy', 'MD', 'Family Practice', NULL, NULL, NULL, 'O', '95 E Ctr St', 'Gunnison', 'Sanpete', 'UT', '84634', '4355287227', NULL, NULL, NULL, '', NULL, NULL, '', '', 'URURAL', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2005-11-18', '2006-11-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1013078344', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870217443', 'W77001304', 'W77001304', 'UT01', 'East Carbon Medical Service', 'Russell', NULL, 'Hunt', 'PA', 'Family Practice', NULL, NULL, NULL, 'B', 'PO Box 930', 'East Carbon City', 'Carbon', 'UT', '84520', '4358884441', '4358882270', NULL, NULL, '', NULL, NULL, '', '', 'URURAL', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2003-04-01', '2006-10-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1740242866', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870217443', 'W77001305', 'W77001305', 'UT01', 'East Carbon Medical Service', 'Virginia', NULL, 'Wheeler', 'NP', 'Family Practice', NULL, NULL, NULL, 'B', 'PO Box 930', 'East Carbon City', 'Carbon', 'UT', '84520', '4358884441', '4358882270', NULL, NULL, '', NULL, NULL, '', '', 'URURAL', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2002-09-01', '2006-10-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1699737510', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870218917', 'W77001306', 'W77001306', 'UT01', 'Tanner Memorial Clinic', 'Michael', 'G', 'Allred', 'MD', 'Family Practice', NULL, NULL, NULL, 'B', 'PO Box 337', 'Layton', 'Davis', 'UT', '84041', '8017734840', '8015258151', NULL, NULL, '', NULL, NULL, '', '', 'UTANNER', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2004-04-02', '2006-06-30', 0, 0, 0, 'Davis Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1811973829', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870218917', 'W77001307', 'W77001307', 'UT01', 'Tanner Memorial Clinic', 'Charles', 'P', 'Bean', 'MD', 'Orthopedic Surgery', NULL, NULL, NULL, 'O', '2121 Robins Dr', 'Layton', 'Davis', 'UT', '84041', '8017734840', '8015258151', NULL, NULL, '', NULL, NULL, '', '', 'UTANNER', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2002-11-01', '2006-06-30', 0, 0, 0, 'Davis Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1205812245', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870218917', 'W77001308', 'W77001308', 'UT01', 'Tanner Memorial Clinic', 'Charles', 'P', 'Bean', 'MD', 'Orthopedic Surgery', NULL, NULL, NULL, 'B', 'PO Box 337', 'Layton', 'Davis', 'UT', '84041', '8017734840', '8015258151', NULL, NULL, '', NULL, NULL, '', '', 'UTANNER', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2002-11-01', '2006-06-30', 0, 0, 0, 'Davis Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1205812245', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870218917', 'W77001309', 'W77001309', 'UT01', 'Tanner Memorial Clinic', 'Bruce', 'F', 'Burtenshaw', 'MD', 'Internal Medicine', NULL, NULL, NULL, 'O', '2121 Robins Dr', 'Layton', 'Davis', 'UT', '84041', '8017734840', '8015258151', NULL, NULL, '', NULL, NULL, '', '', 'UTANNER', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2001-01-01', '2006-06-30', 0, 0, 0, 'Davis Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1609852656', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870218917', 'W77001310', 'W77001310', 'UT01', 'Tanner Memorial Clinic', 'Warren', 'L', 'Butler', 'MD', 'Family Practice', NULL, NULL, NULL, 'O', '2038 W 1900 S', 'Syracuse', 'Davis', 'UT', '84075', '8017734840', NULL, NULL, NULL, '', NULL, NULL, '', '', 'UTANNER', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2001-01-01', '2006-06-30', 0, 0, 0, 'Davis Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1679559694', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870280366', 'W77001311', 'W77001311', 'UT01', 'Obstetrics And Gynecology Clinic', 'Jason', 'L', 'Johnson', 'MD', 'Obstetrics and Gynecology', NULL, NULL, NULL, 'O', '850 E 300 S Ste 1', 'Salt Lake City', 'Salt Lake', 'UT', '84102', '8013221214', NULL, NULL, NULL, '', NULL, NULL, '', '', 'USTDOBG', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2002-04-01', '2006-08-31', 0, 0, 0, 'Salt Lake Regional Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1376638718', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870280408', 'W77001312', 'W77001312', 'UT01', 'Pediatric Anesthesiologists', 'Christine', NULL, 'Chen', 'MD', 'Anesthesiology', NULL, NULL, NULL, 'O', '1954 E Fort Union Blvd Ste 111', 'Salt Lake City', 'Salt Lake', 'UT', '84121', '8019939551', '8017335872', '1954 E Ft Union Blvd', 'Salt Lake City', '', 'UT', '84121', '', '', '135', NULL, '1000', '54.60', NULL, NULL, 3, '2001-08-06', '2006-08-31', 1, 12, 0, 'Primary Childrens Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1295840247', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870280408', 'W77001313', 'W77001313', 'UT01', 'Pediatric Anesthesiologists', 'William', 'M', 'Clark', 'MD', 'Anesthesiology', NULL, NULL, NULL, 'O', '1954 E Fort Union Blvd Ste 111', 'Salt Lake City', 'Salt Lake', 'UT', '84121', '8019939551', '8017335872', '1954 E Ft Union Blvd', 'Salt Lake City', '', 'UT', '84121', '', '', '135', NULL, '1000', '54.06', NULL, NULL, 3, '2002-10-01', '2006-08-31', 1, 12, 0, 'Primary Childrens Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1386759041', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870280408', 'W77001314', 'W77001314', 'UT01', 'Pediatric Anesthesiologists', 'Marty', 'L', 'Ericksen', 'MD', 'Anesthesiology', NULL, NULL, NULL, 'O', '1954 E Fort Union Blvd Ste 111', 'Salt Lake City', 'Salt Lake', 'UT', '84121', '8019939551', '8017335872', '1954 E Ft Union Blvd', 'Salt Lake City', '', 'UT', '84121', '', '', '135', NULL, '1000', '54.60', NULL, NULL, 3, '2004-08-01', '2006-08-31', 1, 12, 0, 'Primary Childrens Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1952338808', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870280408', 'W77001315', 'W77001315', 'UT01', 'Pediatric Anesthesiologists', 'Daniel', 'A', 'Evans', 'MD', 'Anesthesiology', NULL, NULL, NULL, 'O', '1954 E Fort Union Blvd Ste 111', 'Salt Lake City', 'Salt Lake', 'UT', '84121', '8019939551', '8017335872', '1954 E Ft Union Blvd', 'Salt Lake City', '', 'UT', '84121', '', '', '135', NULL, '1000', '54.60', NULL, NULL, 3, '2002-09-01', '2006-08-31', 1, 12, 0, 'Primary Childrens Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1760599161', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870280408', 'W77001316', 'W77001316', 'UT01', 'Pediatric Anesthesiologists', 'Alan', NULL, 'Gartrell', 'MD', 'Anesthesiology', NULL, NULL, NULL, 'O', '1954 E Fort Union Blvd Ste 111', 'Salt Lake City', 'Salt Lake', 'UT', '84121', '8019939551', '8017335872', '1954 E Ft Union Blvd', 'Salt Lake City', '', 'UT', '84121', '', '', '135', NULL, '1000', '54.60', NULL, NULL, 3, '2001-06-01', '2006-08-31', 1, 12, 0, 'Primary Childrens Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1295842250', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870280408', 'W77001317', 'W77001317', 'UT01', 'Pediatric Anesthesiologists', 'G Duggan', NULL, 'Hannon', 'MD', 'Anesthesiology', NULL, NULL, NULL, 'O', '1954 E Fort Union Blvd Ste 111', 'Salt Lake City', 'Salt Lake', 'UT', '84121', '8019939551', '8017335872', '1954 E Ft Union Blvd', 'Salt Lake City', '', 'UT', '84121', '', '', '135', NULL, '1000', '54.60', NULL, NULL, 3, '2001-06-01', '2006-08-31', 1, 12, 0, 'Primary Childrens Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1093822983', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870280408', 'W77001318', 'W77001318', 'UT01', 'Pediatric Anesthesiologists', 'Charles', 'G', 'Pribble', 'MD', 'Pediatric Critical Care', 'Anesthesiology', NULL, NULL, 'B', '1954 E Fort Union Blvd Ste 111', 'Salt Lake City', 'Salt Lake', 'UT', '84121', NULL, NULL, '1954 E Ft Union Blvd', 'Salt Lake City', '', 'UT', '84121', '', '', '135', NULL, '1000', '54.60', NULL, NULL, 3, '2000-01-01', '2004-05-08', 1, 12, 0, 'Primary Childrens Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1245349042', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
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('870280459', 'W77001320', 'W77001320', 'UT01', 'Western Gyn & Ob Clinic', 'Suphithaya', NULL, 'Anders', 'MD', 'Obstetrics and Gynecology', NULL, NULL, NULL, 'B', '5770 S 250 E Ste G-50', 'Murray', 'Salt Lake', 'UT', '84107', '8013144440', '8013144437', NULL, NULL, '', NULL, NULL, '', '', 'USTDOBG', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2002-04-01', '2006-10-31', 0, 0, 0, 'Riverton Childrens Unit Operated by Primary Childrens Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1558401919', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
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('870280366', 'W77001364', 'W77001364', 'UT01', 'Obstetrics And Gynecology Clinic', 'Joanne', 'S', 'Hinson', 'MD', 'Obstetrics and Gynecology', NULL, NULL, NULL, 'O', '850 E 300 S Ste 1', 'Salt Lake City', 'Salt Lake', 'UT', '84102', '8013221214', NULL, NULL, NULL, '', NULL, NULL, '', '', 'USTDOBG', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2002-04-01', '2006-08-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1881789212', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
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('870218917', 'W77001377', 'W77001377', 'UT01', 'Tanner Memorial Clinic', 'Robert', 'A', 'Jacobsen', 'MD', 'General Surgery', NULL, NULL, NULL, 'B', 'PO Box 337', 'Layton', 'Davis', 'UT', '84041', '8017734840', '8015258151', NULL, NULL, '', NULL, NULL, '', '', 'USTDSURG', NULL, NULL, '0.00', '35.00', NULL, 3, '2001-01-01', '2005-03-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '833185', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
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('870218917', 'W77001381', 'W77001381', 'UT01', 'Tanner Memorial Clinic', 'Robert', 'L', 'Mellor', 'MD', 'Ear, Nose and Throat', 'Plastic Surgery', NULL, NULL, 'B', 'PO Box 337', 'Layton', 'Davis', 'UT', '84041', '8017734840', '8015258151', NULL, NULL, '', NULL, NULL, '', '', 'UTANNER', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2001-01-01', '2006-06-30', 0, 0, 0, 'Davis Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1023094992', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
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('870218917', 'W77001383', 'W77001383', 'UT01', 'Tanner Memorial Clinic', 'Cynthia', 'S', 'Murray', 'MD', 'Family Practice', NULL, NULL, NULL, 'O', '2121 Robins Dr', 'Layton', 'Davis', 'UT', '84041', '8017734840', '8015258151', NULL, NULL, '', NULL, NULL, '', '', 'UTANNER', NULL, NULL, '0.00', '35.00', NULL, 3, '2002-09-20', '2005-08-01', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '831745', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870218917', 'W77001384', 'W77001384', 'UT01', 'Tanner Memorial Clinic', 'Noel', 'C', 'Nye', 'DO', 'Pediatrics', NULL, NULL, NULL, 'O', '2038 W 1900 S', 'Syracuse', 'Davis', 'UT', '84075', '8017734840', NULL, NULL, NULL, '', NULL, NULL, '', '', 'UTANNER', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2001-01-01', '2006-06-30', 0, 0, 0, 'Davis Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1437135399', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870218917', 'W77001385', 'W77001385', 'UT01', 'Tanner Memorial Clinic', 'Noel', 'C', 'Nye', 'DO', 'Pediatrics', NULL, NULL, NULL, 'O', '2121 Robins Dr', 'Layton', 'Davis', 'UT', '84041', '8017734840', '8015258151', NULL, NULL, '', NULL, NULL, '', '', 'UTANNER', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2001-01-01', '2006-06-30', 0, 0, 0, 'Davis Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1437135399', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL);
INSERT INTO `providers_new` (`Provider_Tax_ID`, `Provider_Suffix`, `Provider_Network_ID`, `Provider_Region`, `Provider_Name`, `Provider_Doctor_First_Name`, `Provider_Doctor_Middle_Name`, `Provider_Doctor_Last_Name`, `Provider_Doctor_Degree`, `Provider_Specialty_1`, `Provider_Specialty_2`, `Provider_Specialty_3`, `Provider_Specialty_4`, `Provider_Address_Type`, `Provider_Address`, `Provider_City`, `Provider_County`, `Provider_State`, `Provider_Zip`, `Provider_Phone`, `Provider_Fax`, `Provider_Mailing_Address`, `Provider_Mailing_City`, `Provider_Mailing_County`, `Provider_Mailing_State`, `Provider_Mailing_Zip`, `Provider_Mailing_Phone`, `Provider_Mailing_Fax`, `Provider_Primary_Schedule`, `Provider_Secondary_Schedule`, `Provider_Rate_Sheet`, `Provider_Anes_Rate`, `Provider_Default_Rate`, `Provider_Max_DOS`, `Provider_Min_Match_Value`, `Provider_Effective_Date`, `Provider_Term_Date`, `Provider_Pend`, `Provider_Anes_Minutes`, `Provider_PPO`, `Provider_Hospital_1`, `Provider_Hospital_2`, `Provider_Hospital_3`, `Provider_Hospital_4`, `Provider_Type`, `Provider_NPI`, `Provider_Check_Override`, `Exclude_Dir`, `Audit_Status`, `Last_Change_Date`, `Medicare_ID`, `Provider_Lang`, `Provider_Latitude`, `Provider_Longitude`, `Provider_school`, `Provider_cert`) VALUES
('870218917', 'W77001386', 'W77001386', 'UT01', 'Tanner Memorial Clinic', 'Bryan', 'L', 'Richards', 'MD', 'Ear, Nose and Throat', NULL, NULL, NULL, 'B', 'PO Box 337', 'Layton', 'Davis', 'UT', '84041', '8017734840', '8015258151', NULL, NULL, '', NULL, NULL, '', '', 'UTANNER', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2001-01-01', '2006-06-30', 0, 0, 0, 'Davis Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1780660548', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870218917', 'W77001387', 'W77001387', 'UT01', 'Tanner Memorial Clinic', 'Teela', 'S', 'Sorensen', 'MD', 'Obstetrics and Gynecology', NULL, NULL, NULL, 'B', 'PO Box 337', 'Layton', 'Davis', 'UT', '84041', '8017734840', '8015258151', NULL, NULL, '', NULL, NULL, '', '', 'UTANNER', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2001-01-01', '2006-06-30', 0, 0, 0, 'Davis Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1871579920', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870218917', 'W77001388', 'W77001388', 'UT01', 'Tanner Memorial Clinic', 'Kevin', 'Spafford', 'Sumsion', 'MD', 'Obstetrics and Gynecology', NULL, NULL, NULL, 'B', 'PO Box 337', 'Layton', 'Davis', 'UT', '84041', '8017734840', '8015258151', NULL, NULL, '', NULL, NULL, '', '', 'UTANNER', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '1999-09-01', '2006-06-30', 0, 0, 0, 'Davis Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1255317053', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870218917', 'W77001389', 'W77001389', 'UT01', 'Tanner Memorial Clinic', 'Bohus', NULL, 'Svagr', 'MD', 'Orthopedic Surgery', NULL, NULL, NULL, 'B', 'PO Box 337', 'Layton', 'Davis', 'UT', '84041', '8017734840', '8015258151', NULL, NULL, '', NULL, NULL, '', '', 'UTANNER', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2004-09-24', '2006-06-30', 0, 0, 0, 'Davis Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1164408118', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870218917', 'W77001390', 'W77001390', 'UT01', 'Tanner Memorial Clinic', 'Robert', 'R', 'Taylor', 'MD', 'Internal Medicine', NULL, NULL, NULL, 'O', '2121 Robins Dr', 'Layton', 'Davis', 'UT', '84041', '8017734840', '8015258151', NULL, NULL, '', NULL, NULL, '', '', 'UTANNER', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2001-01-01', '2006-06-30', 0, 0, 0, 'Davis Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1285610063', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870218917', 'W77001391', 'W77001391', 'UT01', 'Tanner Memorial Clinic', 'York', 'J', 'Yates', 'MD', 'Plastic Surgery', NULL, NULL, NULL, 'O', '2121 Robins Dr', 'Layton', 'Davis', 'UT', '84041', '8017734840', '8015258151', NULL, NULL, '', NULL, NULL, '', '', 'UTANNER', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2003-06-20', '2006-06-30', 0, 0, 0, 'Davis Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1851377725', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870281028', 'W77001392', 'W77001392', 'UT01', 'Central Utah Clinic', 'Robert', 'W', 'Day', 'MD', 'Internal Medicine', NULL, NULL, NULL, 'O', '1055 N 500 W', 'Provo', 'Utah', 'UT', '84604', '8013742362', '8014290629', NULL, NULL, '', NULL, NULL, '', '', 'UUVPN', NULL, NULL, '0.00', '35.00', NULL, 3, '1999-09-01', '2005-03-15', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1376557579', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870281028', 'W77001393', 'W77001393', 'UT01', 'Central Utah Clinic', 'Thomas', 'A', 'Dickinson', 'MD', 'Gastroenterology', NULL, NULL, NULL, 'O', '1055 N 500 W', 'Provo', 'Utah', 'UT', '84604', '8013741268', '8014290629', NULL, NULL, '', NULL, NULL, '', '', 'UUVPN', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '1999-09-01', '2005-12-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1376591354', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870281028', 'W77001394', 'W77001394', 'UT01', 'Central Utah Clinic', 'Jonathan', 'R', 'Faux', 'MD', 'Orthopedic Surgery', NULL, NULL, NULL, 'O', '700 W 800 N Ste 100', 'Orem', 'Utah', 'UT', '84057', '8012245373', NULL, NULL, NULL, '', NULL, NULL, '', '', 'UUVPN', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2003-07-16', '2006-05-31', 0, 0, 0, 'Mountain View Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1538250287', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870281028', 'W77001395', 'W77001395', 'UT01', 'Central Utah Clinic', 'Randal', 'B', 'Gibb', 'MD', 'Ear, Nose and Throat', NULL, NULL, NULL, 'B', '1055 N 500 W', 'Provo', 'Utah', 'UT', '84604', '8013742362', '8013742615', NULL, NULL, '', NULL, NULL, '', '', 'UUVPN', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '1999-09-01', '1999-09-01', 0, 0, 0, 'Mountain View Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1679675383', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870281028', 'W77001396', 'W77001396', 'UT01', 'Wasatch Otolaryngology Group', 'Randal', 'B', 'Gibb', 'MD', 'Ear, Nose and Throat', NULL, NULL, NULL, 'O', '39 Professional Way Ste 1', 'Payson', 'Utah', 'UT', '84651', '8014654805', NULL, NULL, NULL, '', NULL, NULL, '', '', 'UUVPN', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '1999-09-01', '2005-12-31', 0, 0, 0, 'Mountain View Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1679675383', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
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('870280366', 'W77001494', 'W77001494', 'UT01', 'Obstetrics And Gynecology Clinic', 'Richard', 'W', 'Chapa', 'MD', 'Obstetrics and Gynecology', NULL, NULL, NULL, 'O', '850 E 300 S Ste 1', 'Salt Lake City', 'Salt Lake', 'UT', '84102', '8013221214', NULL, NULL, NULL, '', NULL, NULL, '', '', 'USTDOBG', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2002-04-01', '2006-08-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1568556298', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870280408', 'W77001495', 'W77001495', 'UT01', 'Pediatric Anesthesiologists', 'Barry', 'J', 'Anderton', 'MD', 'Anesthesiology', NULL, NULL, NULL, 'O', '1954 E Fort Union Blvd Ste 111', 'Salt Lake City', 'Salt Lake', 'UT', '84121', '8019939551', '8017335872', '1954 E Ft Union Blvd', 'Salt Lake City', '', 'UT', '84121', '', '', '135', NULL, '1000', '54.60', NULL, NULL, 3, '2001-06-01', '2006-08-31', 1, 12, 0, 'Primary Childrens Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1962517961', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870281028', 'W77001496', 'W77001496', 'UT01', 'Central Utah Clinic', 'Devon', 'A', 'Nelson', 'MD', 'Orthopedic Surgery', NULL, NULL, NULL, 'B', '1055 N 500 W', 'Provo', 'Utah', 'UT', '84604', '8013742362', '8013742615', NULL, NULL, '', NULL, NULL, '', '', 'UUVPN', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2002-07-01', '2002-07-01', 0, 0, 0, 'Mountain View Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1235232307', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL);
INSERT INTO `providers_new` (`Provider_Tax_ID`, `Provider_Suffix`, `Provider_Network_ID`, `Provider_Region`, `Provider_Name`, `Provider_Doctor_First_Name`, `Provider_Doctor_Middle_Name`, `Provider_Doctor_Last_Name`, `Provider_Doctor_Degree`, `Provider_Specialty_1`, `Provider_Specialty_2`, `Provider_Specialty_3`, `Provider_Specialty_4`, `Provider_Address_Type`, `Provider_Address`, `Provider_City`, `Provider_County`, `Provider_State`, `Provider_Zip`, `Provider_Phone`, `Provider_Fax`, `Provider_Mailing_Address`, `Provider_Mailing_City`, `Provider_Mailing_County`, `Provider_Mailing_State`, `Provider_Mailing_Zip`, `Provider_Mailing_Phone`, `Provider_Mailing_Fax`, `Provider_Primary_Schedule`, `Provider_Secondary_Schedule`, `Provider_Rate_Sheet`, `Provider_Anes_Rate`, `Provider_Default_Rate`, `Provider_Max_DOS`, `Provider_Min_Match_Value`, `Provider_Effective_Date`, `Provider_Term_Date`, `Provider_Pend`, `Provider_Anes_Minutes`, `Provider_PPO`, `Provider_Hospital_1`, `Provider_Hospital_2`, `Provider_Hospital_3`, `Provider_Hospital_4`, `Provider_Type`, `Provider_NPI`, `Provider_Check_Override`, `Exclude_Dir`, `Audit_Status`, `Last_Change_Date`, `Medicare_ID`, `Provider_Lang`, `Provider_Latitude`, `Provider_Longitude`, `Provider_school`, `Provider_cert`) VALUES
('870281028', 'W77001497', 'W77001497', 'UT01', 'Central Utah Clinic', 'Richard', 'K', 'Olsen', 'MD', 'Internal Medicine', NULL, NULL, NULL, 'O', '1055 N 500 W', 'Provo', 'Utah', 'UT', '84604', '8013742362', '8014298191', NULL, NULL, '', NULL, NULL, '', '', 'UUVPN', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '1999-09-01', '2005-12-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1932157138', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870281028', 'W77001498', 'W77001498', 'UT01', 'Central Utah Clinic', 'Mark', 'William', 'Pulsipher', 'MD', 'Cardiovascular Disease', 'Cardiovascular Disease', NULL, NULL, 'O', '1055 N 500 W', 'Provo', 'Utah', 'UT', '84604', '8013734366', '8014290629', NULL, NULL, '', NULL, NULL, '', '', 'UUVPN', NULL, NULL, '0.00', '35.00', NULL, 3, '2003-07-28', '2004-07-13', 0, 0, 0, 'Dixie Regional Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1689631913', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870281028', 'W77001499', 'W77001499', 'UT01', 'Central Utah Clinic', 'Mark', 'William', 'Pulsipher', 'MD', 'Cardiovascular Disease', 'Cardiovascular Disease', NULL, NULL, 'O', '700 W 800 N Ste 220', 'Orem', 'Utah', 'UT', '84057', '8013734366', NULL, NULL, NULL, '', NULL, NULL, '', '', 'UUVPN', NULL, NULL, '0.00', '35.00', NULL, 3, '2003-07-28', '2004-07-13', 0, 0, 0, 'Dixie Regional Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1689631913', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870281028', 'W77001500', 'W77001500', 'UT01', 'Central Utah Clinic', 'Paul', 'K', 'Ritchie', 'MD', 'Orthopedic Surgery', NULL, NULL, NULL, 'B', '1055 N 500 W', 'Provo', 'Utah', 'UT', '84604', '8013742362', '8013742615', NULL, NULL, '', NULL, NULL, '', '', 'UUVPN', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2004-09-24', '2004-09-24', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1720021678', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870281028', 'W77001501', 'W77001501', 'UT01', 'Central Utah Clinic', 'A Mouaz', NULL, 'Sbei', 'MD', 'Neurology', NULL, NULL, NULL, 'O', '1055 N 500 W', 'Provo', 'Utah', 'UT', '84604', '8014298000', '8014298191', NULL, NULL, '', NULL, NULL, '', '', 'UUVPN', NULL, NULL, '0.00', '35.00', NULL, 3, '2003-06-20', '2006-04-01', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '832582', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870281028', 'W77001502', 'W77001502', 'UT01', 'Central Utah Clinic', 'Brian', 'P', 'Tudor', 'MD', 'Hematology and Oncology', NULL, NULL, NULL, 'O', '64 E 100 N', 'Gunnison', 'Sanpete', 'UT', '84634', '8013734366', NULL, NULL, NULL, '', NULL, NULL, '', '', 'UUVPN', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '1999-09-01', '2006-05-31', 0, 0, 0, 'Dixie Regional Medical Center', 'Valley View Medical Center', NULL, NULL, 'HCFA|UB|', '1699877308', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870281028', 'W77001503', 'W77001503', 'UT01', 'Central Utah Clinic PC-Radiology', 'David', 'H', 'Watters', 'MD', 'Radiologist', NULL, NULL, NULL, 'O', '852 N 500 W', 'Provo', 'Utah', 'UT', '84604', '8018124624', '8018124699', NULL, NULL, '', NULL, NULL, '', '', 'UUVPN', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '1999-09-01', '2006-05-31', 0, 0, 0, 'Mountain View Hospital', 'Timpanogos Regional Hospital', NULL, NULL, 'HCFA|UB|', '1558397570', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870281028', 'W77001504', 'W77001504', 'UT01', 'Central Utah Clinic', 'John', 'T', 'Wells', 'MD', 'Orthopedic Surgery', NULL, NULL, NULL, 'B', '1055 N 500 W', 'Provo', 'Utah', 'UT', '84604', '8013742362', '8013742615', NULL, NULL, '', NULL, NULL, '', '', 'UUVPN', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2002-12-01', '2002-12-01', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1740371376', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870281028', 'W77001505', 'W77001505', 'UT01', 'Central Utah Clinic', 'Dalton', 'H', 'Wright', 'MD', 'Radiologist', NULL, NULL, NULL, 'B', '1055 N 500 W', 'Provo', 'Utah', 'UT', '84604', '8013742362', '8013742615', NULL, NULL, '', NULL, NULL, '', '', 'UUVPN', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '1999-09-01', '2005-12-31', 0, 0, 0, 'Mountain View Hospital', 'Timpanogos Regional Hospital', NULL, NULL, 'HCFA|UB|', '1174569131', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870281028', 'W77001506', 'W77001506', 'UT01', 'Central Utah Clinic PC-Radiology', 'Dalton', 'H', 'Wright', 'MD', 'Radiologist', NULL, NULL, NULL, 'O', '852 N 500 W', 'Provo', 'Utah', 'UT', '84604', '8018124624', '8018124699', NULL, NULL, '', NULL, NULL, '', '', 'UUVPN', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '1999-09-01', '2006-05-31', 0, 0, 0, 'Mountain View Hospital', 'Timpanogos Regional Hospital', NULL, NULL, 'HCFA|UB|', '1174569131', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870281299', 'W77001507', 'W77001507', 'UT01', 'American Fork Clinic', 'David', 'K', 'Hafen', 'MD', 'Family Practice', NULL, NULL, NULL, 'O', '226 N 1100 E Ste A', 'American Fork', 'Utah', 'UT', '84003', '8018553841', '8018553847', NULL, NULL, '', NULL, NULL, '', '', 'UUVPN', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '1999-09-01', '2005-12-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1134238207', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870281299', 'W77001508', 'W77001508', 'UT01', 'American Fork Clinic', 'Cheryl', 'A', 'Johnson', 'MD', 'Family Practice', NULL, NULL, NULL, 'O', '226 N 1100 E Ste A', 'American Fork', 'Utah', 'UT', '84003', '8018553841', '8018553847', NULL, NULL, '', NULL, NULL, '', '', 'UUVPN', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '1999-09-01', '2005-12-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1417066671', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870281299', 'W77001509', 'W77001509', 'UT01', 'American Fork Clinic', 'G Brent', NULL, 'Johnson', 'MD', 'Family Practice', NULL, NULL, NULL, 'O', '226 N 1100 E Ste A', 'American Fork', 'Utah', 'UT', '84003', '8018553841', '8018553847', NULL, NULL, '', NULL, NULL, '', '', 'UUVPN', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '1999-09-01', '2006-05-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1902914427', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870281028', 'W77001510', 'W77001510', 'UT01', 'Central Utah Clinic', 'Kevin', 'J', 'Colver', 'MD', 'Internal Medicine', 'Hospitalist', NULL, NULL, 'O', '1120 E 100 N', 'Payson', 'Utah', 'UT', '84651', '8014654813', NULL, NULL, NULL, '', NULL, NULL, '', '', 'UUVPN', NULL, NULL, '0.00', '35.00', NULL, 3, '1999-09-01', '2004-10-01', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1013922533', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870281028', 'W77001511', 'W77001511', 'UT01', 'Central Utah Clinic', 'Robert', 'E', 'Corniea', 'MD', 'Internal Medicine', NULL, NULL, NULL, 'O', '1055 N 500 W', 'Provo', 'Utah', 'UT', '84604', '8013742362', '8014298191', NULL, NULL, '', NULL, NULL, '', '', 'UUVPN', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '1999-09-01', '2005-12-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1447218664', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870281028', 'W77001512', 'W77001512', 'UT01', 'Central Utah Clinic', 'Sean', 'R', 'Curzon', 'DO', 'Internal Medicine', NULL, NULL, NULL, 'O', '700 W 800 N Ste 220', 'Orem', 'Utah', 'UT', '84057', '8012218811', NULL, NULL, NULL, '', NULL, NULL, '', '', 'UUVPN', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2003-04-04', '2005-12-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1780600247', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870281028', 'W77001513', 'W77001513', 'UT01', 'Central Utah Clinic', 'Jonathan', 'R', 'Faux', 'MD', 'Orthopedic Surgery', NULL, NULL, NULL, 'O', '1055 N 500 W Ste 121', 'Provo', 'Utah', 'UT', '84604', '8013577350', NULL, NULL, NULL, '', NULL, NULL, '', '', 'UUVPN', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2003-07-16', '2006-05-31', 0, 0, 0, 'Mountain View Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1538250287', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870281028', 'W77001514', 'W77001514', 'UT01', 'Central Utah Clinic', 'Jonathan', 'R', 'Faux', 'MD', 'Orthopedic Surgery', NULL, NULL, NULL, 'B', '1055 N 500 W', 'Provo', 'Utah', 'UT', '84604', '8013742362', '8013742615', NULL, NULL, '', NULL, NULL, '', '', 'UUVPN', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2003-07-16', '2003-07-16', 0, 0, 0, 'Mountain View Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1538250287', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870281028', 'W77001515', 'W77001515', 'UT01', 'Central Utah Clinic', 'Walstir', NULL, 'Fonseca', 'MD', 'Internal Medicine', NULL, NULL, NULL, 'B', '1055 N 500 W', 'Provo', 'Utah', 'UT', '84604', '8013742362', '8013742615', NULL, NULL, '', NULL, NULL, '', '', 'UUVPN', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '1999-09-01', '2005-12-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1013933506', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870281028', 'W77001516', 'W77001516', 'UT01', 'Central Utah Clinic', 'John', 'Kay', 'Frischknecht', 'MD', 'Cardiovascular Disease', NULL, NULL, NULL, 'O', '1055 N 500 W', 'Provo', 'Utah', 'UT', '84604', '8013734366', '8014290629', NULL, NULL, '', NULL, NULL, '', '', 'UUVPN', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '1999-09-01', '2005-12-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1235197674', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870281028', 'W77001517', 'W77001517', 'UT01', 'Wasatch Otolaryngology Group', 'Randal', 'B', 'Gibb', 'MD', 'Ear, Nose and Throat', NULL, NULL, NULL, 'O', '700 W 800 N Ste 230', 'Orem', 'Utah', 'UT', '84057', '8014290620', NULL, NULL, NULL, '', NULL, NULL, '', '', 'UUVPN', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '1999-09-01', '2006-05-31', 0, 0, 0, 'Mountain View Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1679675383', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870281028', 'W77001518', 'W77001518', 'UT01', 'Central Utah Clinic PC-Radiology', 'Kent', 'M', 'Gledhill', 'MD', 'Radiologist', NULL, NULL, NULL, 'O', '852 N 500 W', 'Provo', 'Utah', 'UT', '84604', '8018124624', '8018124699', NULL, NULL, '', NULL, NULL, '', '', 'UUVPN', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '1999-09-01', '2006-05-31', 0, 0, 0, 'Mountain View Hospital', 'Timpanogos Regional Hospital', NULL, NULL, 'HCFA|UB|', '1871539833', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870281028', 'W77001519', 'W77001519', 'UT01', 'Central Utah Clinic', 'Heidi', 'Ann', 'Heras', 'MD', 'Ear, Nose and Throat', NULL, NULL, NULL, 'B', '1055 N 500 W', 'Provo', 'Utah', 'UT', '84604', '8013742362', '8013742615', NULL, NULL, '', NULL, NULL, '', '', 'UUVPN', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '1999-12-01', '2005-12-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1619910684', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
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('870281028', 'W77001535', 'W77001535', 'UT01', 'Central Utah Clinic', 'Igor', NULL, 'Abolnik', 'MD', 'Infectious Disease', NULL, NULL, NULL, 'O', '1055 N 500 W', 'Provo', 'Utah', 'UT', '84604', '8014298166', '8014290629', NULL, NULL, '', NULL, NULL, '', '', 'UUVPN', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '1999-12-17', '2005-12-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1194783829', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
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('870281707', 'W77001542', 'W77001542', 'UT01', 'Cache Valley Eye Associates', 'David', 'G', 'Waterman', 'MD', 'Ophthalmology', NULL, NULL, NULL, 'O', '1300 N 500 E Ste 350', 'Logan', 'Cache', 'UT', '84341', '4357527445', '4357533059', NULL, NULL, '', NULL, NULL, '', '', 'USTDOPHT', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '1999-09-01', '2006-09-30', 0, 0, 0, 'Logan Regional Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1689603284', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
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('870281028', 'W77001553', 'W77001553', 'UT01', 'Central Utah Clinic', 'Curtis', NULL, 'Johnson', 'MD', 'Hand Surgery', 'Orthopedic Surgery', NULL, NULL, 'O', '700 W 800 N Ste 100', 'Orem', 'Utah', 'UT', '84057', '8012245373', NULL, NULL, NULL, '', NULL, NULL, '', '', 'UUVPN', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2002-07-01', '2006-05-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1205939089', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870281028', 'W77001554', 'W77001554', 'UT01', 'Central Utah Clinic', 'Kirt', 'M', 'Kimball', 'MD', 'Orthopedic Surgery', NULL, NULL, NULL, 'O', '700 W 800 N Ste 100', 'Orem', 'Utah', 'UT', '84057', '8012245373', NULL, NULL, NULL, '', NULL, NULL, '', '', 'UUVPN', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2002-07-01', '2006-05-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1548363419', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870281028', 'W77001555', 'W77001555', 'UT01', 'Central Utah Clinic', 'Mitchell', 'W', 'Larsen', 'MD', 'Orthopedic Surgery', NULL, NULL, NULL, 'O', '1055 N 500 W Ste 121', 'Provo', 'Utah', 'UT', '84604', '8013577350', NULL, NULL, NULL, '', NULL, NULL, '', '', 'UUVPN', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2005-08-01', '2006-05-31', 0, 0, 0, 'Mountain View Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1205928546', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870281028', 'W77001556', 'W77001556', 'UT01', 'Central Utah Clinic', 'Mitchell', 'W', 'Larsen', 'MD', 'Orthopedic Surgery', NULL, NULL, NULL, 'O', '50 S Medical Dr', 'Payson', 'Utah', 'UT', '84651', '8014652527', NULL, NULL, NULL, '', NULL, NULL, '', '', 'UUVPN', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2005-08-01', '2006-05-31', 0, 0, 0, 'Mountain View Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1205928546', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870281028', 'W77001557', 'W77001557', 'UT01', 'Central Utah Clinic PC-Radiology', 'Brent', 'T', 'Layton', 'MD', 'Radiologist', NULL, NULL, NULL, 'O', '852 N 500 W', 'Provo', 'Utah', 'UT', '84604', '8018124624', '8018124699', NULL, NULL, '', NULL, NULL, '', '', 'UUVPN', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2000-01-10', '2006-05-31', 0, 0, 0, 'Mountain View Hospital', 'Timpanogos Regional Hospital', NULL, NULL, 'HCFA|UB|', '1346286317', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870281028', 'W77001558', 'W77001558', 'UT01', 'Central Utah Clinic', 'Devon', 'A', 'Nelson', 'MD', 'Orthopedic Surgery', NULL, NULL, NULL, 'O', '1055 N 500 W Ste 121', 'Provo', 'Utah', 'UT', '84604', '8013577350', NULL, NULL, NULL, '', NULL, NULL, '', '', 'UUVPN', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2002-07-01', '2005-12-31', 0, 0, 0, 'Mountain View Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1235232307', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870281028', 'W77001559', 'W77001559', 'UT01', 'Central Utah Clinic', 'Devon', 'A', 'Nelson', 'MD', 'Orthopedic Surgery', NULL, NULL, NULL, 'B', '1055 N 500 W', 'Provo', 'Utah', 'UT', '84604', '8013742362', '8013742615', NULL, NULL, '', NULL, NULL, '', '', 'UUVPN', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2002-07-01', '2005-12-31', 0, 0, 0, 'Mountain View Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1235232307', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870281028', 'W77001561', 'W77001561', 'UT01', 'Central Utah Clinic', 'Devon', 'A', 'Nelson', 'MD', 'Orthopedic Surgery', NULL, NULL, NULL, 'O', '50 S Medical Dr', 'Payson', 'Utah', 'UT', '84651', '8014652527', NULL, NULL, NULL, '', NULL, NULL, '', '', 'UUVPN', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2002-07-01', '2006-05-31', 0, 0, 0, 'Mountain View Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1235232307', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870281028', 'W77001562', 'W77001562', 'UT01', 'Central Utah Clinic', 'Samuel', 'R', 'Peterson', 'MD', 'Dermatology', NULL, NULL, NULL, 'O', '1055 N 500 W', 'Provo', 'Utah', 'UT', '84604', '8013748999', '8014290629', NULL, NULL, '', NULL, NULL, '', '', 'UUVPN', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2003-06-20', '2003-06-20', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1073571295', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870281028', 'W77001563', 'W77001563', 'UT01', 'Central Utah Clinic', 'McKay', 'L', 'Platt', 'MD', 'Urology', NULL, NULL, NULL, 'B', '1055 N 500 W', 'Provo', 'Utah', 'UT', '84604', '8013742362', '8013742615', NULL, NULL, '', NULL, NULL, '', '', 'UUVPN', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2000-01-01', '2005-12-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1336230085', 0, 'Y', 0, NULL, 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
('870281299', 'W77001609', 'W77001609', 'UT01', 'American Fork Clinic', 'Daniel', 'W', 'Egan', 'MD', 'Family Practice', NULL, NULL, NULL, 'O', '226 N 1100 E Ste A', 'American Fork', 'Utah', 'UT', '84003', '8018553850', '8018553847', NULL, NULL, '', NULL, NULL, '', '', 'UUVPN', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2003-07-21', '2005-12-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1417066564', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870281028', 'W77001610', 'W77001610', 'UT01', 'Central Utah Clinic', 'Izabella', NULL, 'Gurau', 'MD', 'Nephrology', NULL, NULL, NULL, 'B', '1055 N 500 W', 'Provo', 'Utah', 'UT', '84604', '8013742362', '8013742615', NULL, NULL, '', NULL, NULL, '', '', 'UUVPN', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2004-08-27', '2006-05-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1821034885', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870281028', 'W77001611', 'W77001611', 'UT01', 'Central Utah Clinic', 'Heidi', 'Ann', 'Heras', 'MD', 'Ear, Nose and Throat', NULL, NULL, NULL, 'O', '482 W 50 N Ste 14', 'American Fork', 'Utah', 'UT', '84003', '8014927662', NULL, NULL, NULL, '', NULL, NULL, '', '', 'UUVPN', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '1999-12-01', '2005-12-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1619910684', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870281028', 'W77001612', 'W77001612', 'UT01', 'Central Utah Clinic', 'Richard', 'T', 'Jackson', 'MD', 'Orthopedic Surgery', NULL, NULL, NULL, 'O', '1055 N 500 W Ste 121', 'Provo', 'Utah', 'UT', '84604', '8013577350', NULL, NULL, NULL, '', NULL, NULL, '', '', 'UUVPN', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2002-07-01', '2005-12-31', 0, 0, 0, 'Mountain View Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1144323163', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870281028', 'W77001613', 'W77001613', 'UT01', 'Central Utah Clinic', 'Richard', 'T', 'Jackson', 'MD', 'Orthopedic Surgery', NULL, NULL, NULL, 'O', '50 S Medical Dr', 'Payson', 'Utah', 'UT', '84651', '8014652527', NULL, NULL, NULL, '', NULL, NULL, '', '', 'UUVPN', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2002-07-01', '2006-05-31', 0, 0, 0, 'Mountain View Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1144323163', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870281028', 'W77001614', 'W77001614', 'UT01', 'Central Utah Clinic', 'Robert', 'T', 'Jackson', 'MD', 'Orthopedic Surgery', NULL, NULL, NULL, 'O', '1055 N 500 W Ste 121', 'Provo', 'Utah', 'UT', '84604', '8013577350', NULL, NULL, NULL, '', NULL, NULL, '', '', 'UUVPN', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2002-07-01', '2005-12-31', 0, 0, 0, 'Mountain View Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1407959695', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870281028', 'W77001615', 'W77001615', 'UT01', 'Central Utah Clinic', 'Robert', 'T', 'Jackson', 'MD', 'Orthopedic Surgery', NULL, NULL, NULL, 'B', '1055 N 500 W', 'Provo', 'Utah', 'UT', '84604', '8013742362', '8013742615', NULL, NULL, '', NULL, NULL, '', '', 'UUVPN', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2002-07-01', '2002-07-01', 0, 0, 0, 'Mountain View Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1407959695', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870281028', 'W77001617', 'W77001617', 'UT01', 'Central Utah Clinic', 'Scott', 'T', 'Jackson', 'MD', 'Orthopedic Surgery', NULL, NULL, NULL, 'O', '700 W 800 N Ste 100', 'Orem', 'Utah', 'UT', '84057', '8012245373', NULL, NULL, NULL, '', NULL, NULL, '', '', 'UUVPN', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2002-07-01', '2006-05-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1578666533', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870281028', 'W77001618', 'W77001618', 'UT01', 'Central Utah Clinic', 'Curtis', NULL, 'Johnson', 'MD', 'Hand Surgery', 'Orthopedic Surgery', NULL, NULL, 'O', '1055 N 500 W Ste 121', 'Provo', 'Utah', 'UT', '84604', '8013577350', NULL, NULL, NULL, '', NULL, NULL, '', '', 'UUVPN', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2002-07-01', '2005-12-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1205939089', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870281028', 'W77001619', 'W77001619', 'UT01', 'Central Utah Clinic', 'Kirt', 'M', 'Kimball', 'MD', 'Orthopedic Surgery', NULL, NULL, NULL, 'O', '50 S Medical Dr', 'Payson', 'Utah', 'UT', '84651', '8014652527', NULL, NULL, NULL, '', NULL, NULL, '', '', 'UUVPN', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2002-07-01', '2006-05-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1548363419', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870281028', 'W77001620', 'W77001620', 'UT01', 'Central Utah Clinic', 'Mitchell', 'W', 'Larsen', 'MD', 'Orthopedic Surgery', NULL, NULL, NULL, 'B', '1055 N 500 W', 'Provo', 'Utah', 'UT', '84604', '8013742362', '8013742615', NULL, NULL, '', NULL, NULL, '', '', 'UUVPN', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2005-08-01', '2005-08-01', 0, 0, 0, 'Mountain View Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1205928546', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870281028', 'W77001621', 'W77001621', 'UT01', 'Central Utah Clinic', 'Brent', 'T', 'Layton', 'MD', 'Radiologist', NULL, NULL, NULL, 'B', '1055 N 500 W', 'Provo', 'Utah', 'UT', '84604', '8013742362', '8013742615', NULL, NULL, '', NULL, NULL, '', '', 'UUVPN', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2000-01-10', '2006-05-31', 0, 0, 0, 'Mountain View Hospital', 'Timpanogos Regional Hospital', NULL, NULL, 'HCFA|UB|', '1346286317', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870281028', 'W77001622', 'W77001622', 'UT01', 'Central Utah Clinic', 'E William', NULL, 'LeRoy', 'MD', 'Internal Medicine', NULL, NULL, NULL, 'B', '1055 N 500 W', 'Provo', 'Utah', 'UT', '84604', '8013742362', '8013742615', NULL, NULL, '', NULL, NULL, '', '', 'UUVPN', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '1999-09-01', '2006-05-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1356432009', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870281028', 'W77001623', 'W77001623', 'UT01', 'Central Utah Clinic', 'E William', NULL, 'LeRoy', 'MD', 'Internal Medicine', NULL, NULL, NULL, 'O', '1120 E 100 N', 'Payson', 'Utah', 'UT', '84651', '8014654813', NULL, NULL, NULL, '', NULL, NULL, '', '', 'UUVPN', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '1999-09-01', '2006-05-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1356432009', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870284475', 'W77001624', 'W77001624', 'UT01', 'Granger Medical Clinic', 'Cheryle', NULL, 'Cutlip', 'MD', 'Family Practice', NULL, NULL, NULL, 'B', 'PO Box 70658', 'West Valley', 'Salt Lake', 'UT', '84170', NULL, NULL, NULL, NULL, '', NULL, NULL, '', '', 'UGRANGER', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2003-01-01', '2006-07-31', 0, 0, 0, 'Pioneer Valley Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1336171586', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870284475', 'W77001625', 'W77001625', 'UT01', 'Granger Medical Clinic', 'Steven', 'C', 'Dinger', 'MD', 'Obstetrics and Gynecology', NULL, NULL, NULL, 'B', 'PO Box 70658', 'West Valley', 'Salt Lake', 'UT', '84170', NULL, NULL, NULL, NULL, '', NULL, NULL, '', '', 'UGRANGER', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2003-01-01', '2006-07-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1770514168', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870284475', 'W77001626', 'W77001626', 'UT01', 'Granger Medical Clinic', 'Roy', 'J', 'Gandolfi', 'MD', 'Internal Medicine', NULL, NULL, NULL, 'O', '3725 W 4100 S', 'West Valley', 'Salt Lake', 'UT', '84120', '8019653419', '8019683605', NULL, NULL, '', NULL, NULL, '', '', 'UGRANGER', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2003-01-01', '2006-07-31', 0, 0, 0, 'Pioneer Valley Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1740211101', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870284475', 'W77001627', 'W77001627', 'UT01', 'Granger Medical Clinic', 'Roy', 'J', 'Gandolfi', 'MD', 'Internal Medicine', NULL, NULL, NULL, 'B', 'PO Box 70658', 'West Valley', 'Salt Lake', 'UT', '84170', NULL, NULL, NULL, NULL, '', NULL, NULL, '', '', 'UGRANGER', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2003-01-01', '2006-07-31', 0, 0, 0, 'Pioneer Valley Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1740211101', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870284475', 'W77001628', 'W77001628', 'UT01', 'Granger Medical Clinic', 'David', 'A', 'Harris', 'MD', 'Pediatrics', NULL, NULL, NULL, 'O', '3725 W 4100 S', 'West Valley', 'Salt Lake', 'UT', '84120', '8019653448', '8019683605', NULL, NULL, '', NULL, NULL, '', '', 'UGRANGER', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2003-01-01', '2006-07-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1922023324', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870284475', 'W77001629', 'W77001629', 'UT01', 'Granger Medical Clinic', 'Timothy', 'C', 'Hollingsed', 'MD', 'General Surgery', NULL, NULL, NULL, 'O', '3725 W 4100 S', 'West Valley', 'Salt Lake', 'UT', '84120', '8019653425', '8019683605', NULL, NULL, '', NULL, NULL, '', '', 'UGRANGER', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2003-01-01', '2006-07-31', 0, 0, 0, 'Pioneer Valley Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1790716181', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870284475', 'W77001630', 'W77001630', 'UT01', 'Granger Medical Clinic', 'Pinky', NULL, 'Kotwal', 'MD', 'Internal Medicine', NULL, NULL, NULL, 'B', 'PO Box 70658', 'West Valley', 'Salt Lake', 'UT', '84170', NULL, NULL, NULL, NULL, '', NULL, NULL, '', '', 'UGRANGER', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2003-01-01', '2006-07-31', 0, 0, 0, 'Pioneer Valley Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1083645444', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870284475', 'W77001631', 'W77001631', 'UT01', 'Granger Medical Clinic', 'Kristin', 'A', 'Lynch', 'MD', 'Pediatrics', NULL, NULL, NULL, 'O', '3725 W 4100 S', 'West Valley', 'Salt Lake', 'UT', '84120', '8019653600', '8019683605', NULL, NULL, '', NULL, NULL, '', '', 'UGRANGER', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2003-01-01', '2006-07-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1588602320', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870284475', 'W77001632', 'W77001632', 'UT01', 'Granger Medical Clinic', 'Kristin', 'A', 'Lynch', 'MD', 'Pediatrics', NULL, NULL, NULL, 'B', 'PO Box 70658', 'West Valley', 'Salt Lake', 'UT', '84170', NULL, NULL, NULL, NULL, '', NULL, NULL, '', '', 'UGRANGER', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2003-01-01', '2006-07-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1588602320', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870284475', 'W77001633', 'W77001633', 'UT01', 'Granger Medical Clinic', 'Karen', 'A', 'Nash', 'NP', NULL, NULL, NULL, NULL, 'O', '3725 W 4100 S', 'West Valley', 'Salt Lake', 'UT', '84120', '8019653600', '8019683605', NULL, NULL, '', NULL, NULL, '', '', 'UGRANGER', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2002-01-01', '2006-07-31', 0, 0, 0, 'Pioneer Valley Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1770514127', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870284475', 'W77001634', 'W77001634', 'UT01', 'Granger Medical Clinic', 'Karen', 'A', 'Nash', 'NP', NULL, NULL, NULL, NULL, 'B', 'PO Box 70658', 'West Valley', 'Salt Lake', 'UT', '84170', '8019653720', '8019653740', NULL, NULL, '', NULL, NULL, '', '', 'UGRANGER', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2002-01-01', '2006-07-31', 0, 0, 0, 'Pioneer Valley Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1770514127', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870284475', 'W77001635', 'W77001635', 'UT01', 'Granger Medical Clinic', 'Deborah', NULL, 'Plasman-Coles', 'PA', 'Gastroenterology', NULL, NULL, NULL, 'O', '3725 W 4100 S', 'West Valley', 'Salt Lake', 'UT', '84120', '8019653600', '8019683605', NULL, NULL, '', NULL, NULL, '', '', 'UGRANGER', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2003-04-02', '2006-07-31', 0, 0, 0, 'Pioneer Valley Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1083645469', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870284475', 'W77001636', 'W77001636', 'UT01', 'Granger Medical Clinic', 'Mindy', NULL, 'Ruhlman', 'CNM', 'Obstetrics and Gynecology', NULL, NULL, NULL, 'B', 'PO Box 70658', 'West Valley', 'Salt Lake', 'UT', '84170', NULL, NULL, NULL, NULL, '', NULL, NULL, '', '', 'UGRANGER', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2003-01-01', '2006-07-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '831238', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870284475', 'W77001637', 'W77001637', 'UT01', 'Granger Medical Clinic', 'Kenneth', 'L', 'Schaecher', 'MD', 'Internal Medicine', NULL, NULL, NULL, 'O', '3725 W 4100 S', 'West Valley', 'Salt Lake', 'UT', '84120', '8019653419', '8019683605', NULL, NULL, '', NULL, NULL, '', '', 'UGRANGER', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2003-01-01', '2006-07-31', 0, 0, 0, 'Pioneer Valley Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1245262492', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870281299', 'W77001638', 'W77001638', 'UT01', 'American Fork Clinic', 'Daniel', 'W', 'Egan', 'MD', 'Family Practice', NULL, NULL, NULL, 'O', '680 E Main St Ste 100', 'Lehi', 'Utah', 'UT', '84043', '8017681699', '8017684526', NULL, NULL, '', NULL, NULL, '', '', 'UUVPN', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2003-07-21', '2006-05-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1417066564', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870281299', 'W77001639', 'W77001639', 'UT01', 'American Fork Clinic', 'Douglas', 'R', 'Jones', 'MD', 'Family Practice', NULL, NULL, NULL, 'B', '226 N 1100 E Ste A', 'American Fork', 'Utah', 'UT', '84003', '8018553843', '8018553854', NULL, NULL, '', NULL, NULL, '', '', 'UUVPN', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2002-04-01', '2002-04-01', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '831575', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870281299', 'W77001640', 'W77001640', 'UT01', 'American Fork Clinic', 'Toran', 'J', 'MacArthur', 'MD', 'Family Practice', NULL, NULL, NULL, 'B', '226 N 1100 E Ste A', 'American Fork', 'Utah', 'UT', '84003', '8018553843', '8018553854', NULL, NULL, '', NULL, NULL, '', '', 'UUVPN', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2002-12-20', '2002-12-20', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1063521177', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870281299', 'W77001641', 'W77001641', 'UT01', 'American Fork Clinic', 'K Joe', NULL, 'Murdock', 'MD', 'Family Practice', NULL, NULL, NULL, 'O', '226 N 1100 E Ste A', 'American Fork', 'Utah', 'UT', '84003', '8018553841', '8018553847', NULL, NULL, '', NULL, NULL, '', '', 'UUVPN', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '1999-09-01', '2006-05-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1053429563', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870281299', 'W77001642', 'W77001642', 'UT01', 'American Fork Clinic', 'Peter', 'V', 'Sundwall', 'MD', 'Family Practice', NULL, NULL, NULL, 'B', '226 N 1100 E Ste A', 'American Fork', 'Utah', 'UT', '84003', '8018553843', '8018553854', NULL, NULL, '', NULL, NULL, '', '', 'USTDMULT', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2002-04-02', '2002-04-02', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1558470641', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870281942', 'W77001643', 'W77001643', 'UT01', 'Brigham Medical Clinic', 'Thomas', 'M', 'Matthews', 'MD', 'Family Practice', NULL, NULL, NULL, 'O', '600 W Hospital Rd', 'Brigham City', 'Box Elder', 'UT', '84302', '4357342041', '4357238028', NULL, NULL, '', NULL, NULL, '', '', 'USTDMULT', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '1999-09-01', '2006-11-30', 0, 0, 0, 'Brigham City Community Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1144331711', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870281942', 'W77001644', 'W77001644', 'UT01', 'Brigham Medical Clinic', 'James', 'R', 'Taylor', 'MD', 'Family Practice', NULL, NULL, NULL, 'O', '600 W Hospital Rd', 'Brigham City', 'Box Elder', 'UT', '84302', '4357342041', '4357238028', NULL, NULL, '', NULL, NULL, '', '', 'USTDMULT', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '1999-09-01', '2006-11-30', 0, 0, 0, 'Brigham City Community Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1215048335', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870281942', 'W77001645', 'W77001645', 'UT01', 'Brigham Medical Clinic', 'David', 'G', 'Wilding', 'MD', 'Internal Medicine', NULL, NULL, NULL, 'B', 'PO Box 719', 'Brigham City', 'Box Elder', 'UT', '84302', '4357342041', '4357238028', NULL, NULL, '', NULL, NULL, '', '', 'USTDMULT', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '1999-09-01', '2006-11-30', 0, 0, 0, 'Brigham City Community Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1740391226', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
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('870284475', 'W77001693', 'W77001693', 'UT01', 'Granger Medical Clinic', 'Dale', 'L', 'Chapman', 'MD', 'Pediatrics', NULL, NULL, NULL, 'B', 'PO Box 70658', 'West Valley', 'Salt Lake', 'UT', '84170', NULL, NULL, NULL, NULL, '', NULL, NULL, '', '', 'UGRANGER', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2003-01-01', '2006-07-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1114959368', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870281028', 'W77001694', 'W77001694', 'UT01', 'Central Utah Clinic', 'Brian', 'P', 'Tudor', 'MD', 'Hematology and Oncology', NULL, NULL, NULL, 'B', '1055 N 500 W', 'Provo', 'Utah', 'UT', '84604', '8013742362', '8013742615', NULL, NULL, '', NULL, NULL, '', '', 'UUVPN', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '1999-09-01', '1999-09-01', 0, 0, 0, 'Dixie Regional Medical Center', 'Valley View Medical Center', NULL, NULL, 'HCFA|UB|', '1699877308', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870281028', 'W77001695', 'W77001695', 'UT01', 'Central Utah Clinic', 'Jerry', 'Dale', 'Walker, Jr', 'MD', 'Cardiovascular Disease', NULL, NULL, NULL, 'O', '700 W 800 N Ste 220', 'Orem', 'Utah', 'UT', '84057', '8013734366', NULL, NULL, NULL, '', NULL, NULL, '', '', 'UUVPN', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2003-07-01', '2006-05-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1649238866', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870281028', 'W77001696', 'W77001696', 'UT01', 'Central Utah Clinic', 'Jeffrey', 'M', 'Wallentine', 'MD', 'Orthopedic Surgery', NULL, NULL, NULL, 'B', '1055 N 500 W', 'Provo', 'Utah', 'UT', '84604', '8013742362', '8013742615', NULL, NULL, '', NULL, NULL, '', '', 'UUVPN', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2002-07-01', '2002-07-01', 0, 0, 0, 'Mountain View Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1124121934', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870281028', 'W77001697', 'W77001697', 'UT01', 'Central Utah Clinic', 'Jeffrey', 'M', 'Wallentine', 'MD', 'Orthopedic Surgery', NULL, NULL, NULL, 'O', '50 S Medical Dr', 'Payson', 'Utah', 'UT', '84651', '8014652527', NULL, NULL, NULL, '', NULL, NULL, '', '', 'UUVPN', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2002-07-01', '2006-05-31', 0, 0, 0, 'Mountain View Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1124121934', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870281028', 'W77001698', 'W77001698', 'UT01', 'Central Utah Clinic', 'John', 'T', 'Wells', 'MD', 'Orthopedic Surgery', NULL, NULL, NULL, 'O', '680 E Main St', 'Lehi', 'Utah', 'UT', '84043', '8017633885', NULL, NULL, NULL, '', NULL, NULL, '', '', 'UUVPN', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2002-12-01', '2006-05-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1740371376', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870281299', 'W77001699', 'W77001699', 'UT01', 'American Fork Clinic', 'Michael', 'L', 'Cosgrave', 'MD', 'Family Practice', NULL, NULL, NULL, 'O', '226 N 1100 E Ste A', 'American Fork', 'Utah', 'UT', '84003', '8018553841', '8018553847', NULL, NULL, '', NULL, NULL, '', '', 'UUVPN', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '1999-09-01', '2005-12-31', 0, 0, 0, 'Salt Lake Regional Medical Center', 'St Marks Hospital', NULL, NULL, 'HCFA|UB|', '1023127214', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870281299', 'W77001701', 'W77001701', 'UT01', 'American Fork Clinic', 'Douglas', 'R', 'Jones', 'MD', 'Family Practice', NULL, NULL, NULL, 'O', '226 N 1100 E Ste A', 'American Fork', 'Utah', 'UT', '84003', '8018553841', '8018553847', NULL, NULL, '', NULL, NULL, '', '', 'UUVPN', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2002-04-01', '2006-05-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '831575', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870281299', 'W77001702', 'W77001702', 'UT01', 'American Fork Clinic', 'Toran', 'J', 'MacArthur', 'MD', 'Family Practice', NULL, NULL, NULL, 'O', '680 E Main St Ste 100', 'Lehi', 'Utah', 'UT', '84043', '8017681699', '8017684526', NULL, NULL, '', NULL, NULL, '', '', 'UUVPN', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2002-12-20', '2006-05-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1063521177', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870281299', 'W77001703', 'W77001703', 'UT01', 'American Fork Clinic', 'Peter', 'V', 'Sundwall', 'MD', 'Family Practice', NULL, NULL, NULL, 'O', '226 N 1100 E Ste A', 'American Fork', 'Utah', 'UT', '84003', '8018553841', '8018553847', NULL, NULL, '', NULL, NULL, '', '', 'USTDMULT', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2002-04-02', '2006-05-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1558470641', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870281299', 'W77001704', 'W77001704', 'UT01', 'American Fork Clinic', 'Dorothea', NULL, 'Verbrugge', 'MD', 'Family Practice', NULL, NULL, NULL, 'B', '226 N 1100 E Ste A', 'American Fork', 'Utah', 'UT', '84003', '8018553843', '8018553854', NULL, NULL, '', NULL, NULL, '', '', 'UUVPN', NULL, NULL, '0.00', '35.00', NULL, 3, '1999-09-01', '2004-08-01', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1669562252', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870281942', 'W77001705', 'W77001705', 'UT01', 'Brigham Medical Clinic', 'Bruce', 'W', 'Keller', 'MD', 'Family Practice', NULL, NULL, NULL, 'O', '600 W Hospital Rd', 'Brigham City', 'Box Elder', 'UT', '84302', '4357342041', '4357238028', NULL, NULL, '', NULL, NULL, '', '', 'USTDMULT', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '1999-09-01', '2006-11-30', 0, 0, 0, 'Brigham City Community Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1427169036', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870281942', 'W77001706', 'W77001706', 'UT01', 'Brigham Medical Clinic', 'John', 'R', 'Markeson', 'MD', 'Internal Medicine', NULL, NULL, NULL, 'O', '600 W Hospital Rd', 'Brigham City', 'Box Elder', 'UT', '84302', '4357342041', '4357238028', NULL, NULL, '', NULL, NULL, '', '', 'USTDMULT', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '1999-09-01', '2006-11-30', 0, 0, 0, 'Brigham City Community Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1861503419', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870281942', 'W77001707', 'W77001707', 'UT01', 'Brigham Medical Clinic', 'John', 'R', 'Markeson', 'MD', 'Internal Medicine', NULL, NULL, NULL, 'B', 'PO Box 719', 'Brigham City', 'Box Elder', 'UT', '84302', '4357342041', '4357238028', NULL, NULL, '', NULL, NULL, '', '', 'USTDMULT', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '1999-09-01', '2006-11-30', 0, 0, 0, 'Brigham City Community Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1861503419', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870286381', 'W77001708', 'W77001708', 'UT01', 'Ogden Clinic', 'Kelly', 'R', 'Amann', 'DO', 'Family Practice', NULL, NULL, NULL, 'O', '4650 Harrison Blvd', 'Ogden', 'Weber', 'UT', '84403', '8014794621', '8014762670', NULL, NULL, '', NULL, NULL, '', '', 'UOGDCLIN', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2003-04-01', '2006-07-31', 0, 0, 0, 'Ogden Regional Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1134116783', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870286381', 'W77001709', 'W77001709', 'UT01', 'Ogden Clinic', 'Carolyn', NULL, 'Belfry', 'MD', 'Family Practice', NULL, NULL, NULL, 'B', '4650 Harrison Blvd', 'Ogden', 'Weber', 'UT', '84403', '8014799870', NULL, NULL, NULL, '', NULL, NULL, '', '', 'UOGDCLIN', NULL, NULL, '0.00', '35.00', NULL, 3, '2003-04-01', '2003-04-01', 0, 0, 0, 'Ogden Regional Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1417944083', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870286381', 'W77001711', 'W77001711', 'UT01', 'Ogden Clinic', 'Joseph', 'W', 'Bell', 'DO', 'Obstetrics and Gynecology', NULL, NULL, NULL, 'O', '5430 S 1900 W Ste G1', 'Roy', 'Weber', 'UT', '84067', '8017799975', NULL, NULL, NULL, '', NULL, NULL, '', '', 'USTDOBG', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2003-04-01', '2005-01-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1851471767', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870286381', 'W77001712', 'W77001712', 'UT01', 'Ogden Clinic', 'Nadim', 'B', 'Bikhazi', 'MD', 'Ear, Nose and Throat', NULL, NULL, NULL, 'O', '4650 Harrison Blvd', 'Ogden', 'Weber', 'UT', '84403', '8014794621', '8014762670', NULL, NULL, '', NULL, NULL, '', '', 'UOGDCLIN', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2003-04-01', '2006-07-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1588651152', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870286381', 'W77001713', 'W77001713', 'UT01', 'Ogden Clinic', 'Mindy', 'M', 'Boehm', 'MD', 'Pediatrics', NULL, NULL, NULL, 'O', '4650 Harrison Blvd', 'Ogden', 'Weber', 'UT', '84403', '8014794621', '8014762670', NULL, NULL, '', NULL, NULL, '', '', 'UOGDCLIN', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2003-04-01', '2006-07-31', 0, 0, 0, 'Ogden Regional Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1710974381', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870286381', 'W77001714', 'W77001714', 'UT01', 'Ogden Clinic', 'Kimberly', 'A', 'Boyer', 'PA', 'Family Practice', NULL, NULL, NULL, 'O', '4650 Harrison Blvd', 'Ogden', 'Weber', 'UT', '84403', '8014794621', '8014762670', NULL, NULL, '', NULL, NULL, '', '', 'UOGDCLIN', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2003-04-01', '2006-07-31', 0, 0, 0, 'Ogden Regional Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1982692000', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870286381', 'W77001715', 'W77001715', 'UT01', 'Ogden Clinic', 'Laurel', 'C', 'Brewer', 'AUD', 'Audiology', NULL, NULL, NULL, 'O', '4650 Harrison Blvd', 'Ogden', 'Weber', 'UT', '84403', '8014794621', '8014762670', NULL, NULL, '', NULL, NULL, '', '', 'UOGDCLIN', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2005-09-30', '2006-07-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1578551693', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870286381', 'W77001716', 'W77001716', 'UT01', 'Ogden Clinic', 'Tanya', NULL, 'Chesley', 'PA', NULL, NULL, NULL, NULL, 'O', '4650 Harrison Blvd', 'Ogden', 'Weber', 'UT', '84403', '8014794621', '8014762670', NULL, NULL, '', NULL, NULL, '', '', 'UOGDCLIN', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2003-04-01', '2006-07-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1477541506', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870286381', 'W77001717', 'W77001717', 'UT01', 'Ogden Clinic', 'Laura', 'A', 'Colvin', 'PA', 'Family Practice', NULL, NULL, NULL, 'O', '1159 12th St', 'Ogden', 'Weber', 'UT', '84404', '8013343000', '8014762670', NULL, NULL, '', NULL, NULL, '', '', 'UOGDCLIN', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2003-04-01', '2006-07-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1447248596', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870286381', 'W77001718', 'W77001718', 'UT01', 'Ogden Clinic', 'Laura', 'A', 'Colvin', 'PA', 'Family Practice', NULL, NULL, NULL, 'O', '4650 Harrison Blvd', 'Ogden', 'Weber', 'UT', '84403', '8014794621', '8014762670', NULL, NULL, '', NULL, NULL, '', '', 'UOGDCLIN', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2003-04-01', '2006-07-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1447248596', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870286381', 'W77001720', 'W77001720', 'UT01', 'Ogden Clinic', 'Katherine', 'L', 'Dreyer', 'CNM', 'Obstetrics and Gynecology', NULL, NULL, NULL, 'O', '5430 S 1900 W Ste G1', 'Roy', 'Weber', 'UT', '84067', '8017799975', NULL, NULL, NULL, '', NULL, NULL, '', '', 'UOGDCLIN', NULL, NULL, '0.00', '35.00', NULL, 3, '2003-04-01', '2004-02-29', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '831474', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870286381', 'W77001721', 'W77001721', 'UT01', 'Ogden Clinic', 'Roxina', NULL, 'Fischer', 'NP', 'Family Practice', NULL, NULL, NULL, 'O', '4350 Washington Blvd', 'Ogden', 'Weber', 'UT', '84403', '8014765100', NULL, NULL, NULL, '', NULL, NULL, '', '', 'UOGDCLIN', NULL, NULL, '0.00', '35.00', NULL, 3, '2003-06-16', '2006-01-31', 0, 0, 0, 'Ogden Regional Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1932197084', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870286381', 'W77001722', 'W77001722', 'UT01', 'Ogden Clinic Physical Therapy', 'Nathan', 'S', 'Goff', 'PT', 'Physical Therapy', NULL, NULL, NULL, 'O', '4700 Harrison Blvd', 'Ogden', 'Weber', 'UT', '84403', '8014757010', '8014762670', NULL, NULL, '', NULL, NULL, '', '', 'UOGDCLIN', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2004-08-02', '2006-07-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1629066675', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL);
INSERT INTO `providers_new` (`Provider_Tax_ID`, `Provider_Suffix`, `Provider_Network_ID`, `Provider_Region`, `Provider_Name`, `Provider_Doctor_First_Name`, `Provider_Doctor_Middle_Name`, `Provider_Doctor_Last_Name`, `Provider_Doctor_Degree`, `Provider_Specialty_1`, `Provider_Specialty_2`, `Provider_Specialty_3`, `Provider_Specialty_4`, `Provider_Address_Type`, `Provider_Address`, `Provider_City`, `Provider_County`, `Provider_State`, `Provider_Zip`, `Provider_Phone`, `Provider_Fax`, `Provider_Mailing_Address`, `Provider_Mailing_City`, `Provider_Mailing_County`, `Provider_Mailing_State`, `Provider_Mailing_Zip`, `Provider_Mailing_Phone`, `Provider_Mailing_Fax`, `Provider_Primary_Schedule`, `Provider_Secondary_Schedule`, `Provider_Rate_Sheet`, `Provider_Anes_Rate`, `Provider_Default_Rate`, `Provider_Max_DOS`, `Provider_Min_Match_Value`, `Provider_Effective_Date`, `Provider_Term_Date`, `Provider_Pend`, `Provider_Anes_Minutes`, `Provider_PPO`, `Provider_Hospital_1`, `Provider_Hospital_2`, `Provider_Hospital_3`, `Provider_Hospital_4`, `Provider_Type`, `Provider_NPI`, `Provider_Check_Override`, `Exclude_Dir`, `Audit_Status`, `Last_Change_Date`, `Medicare_ID`, `Provider_Lang`, `Provider_Latitude`, `Provider_Longitude`, `Provider_school`, `Provider_cert`) VALUES
('870284475', 'W77001723', 'W77001723', 'UT01', 'Granger Medical Clinic', 'Peter', 'L', 'Christensen', 'MD', 'Family Practice', NULL, NULL, NULL, 'O', '2751 W 9000 S', 'West Jordan', 'Salt Lake', 'UT', '84088', '8013525900', NULL, NULL, NULL, '', NULL, NULL, '', '', 'UGRANGER', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2003-01-01', '2006-07-31', 0, 0, 0, 'Jordan Valley Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1992737159', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870284475', 'W77001724', 'W77001724', 'UT01', 'Granger Medical Clinic', 'James', 'S', 'Coy', 'MD', 'Family Practice', 'Urgent Care', NULL, NULL, 'O', '3725 W 4100 S', 'West Valley', 'Salt Lake', 'UT', '84120', '8019653600', '8019683605', NULL, NULL, '', NULL, NULL, '', '', 'UGRANGER', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2003-07-17', '2006-07-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1174555320', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870284475', 'W77001725', 'W77001725', 'UT01', 'Granger Medical Clinic', 'James', 'S', 'Coy', 'MD', 'Family Practice', 'Urgent Care', NULL, NULL, 'B', 'PO Box 70658', 'West Valley', 'Salt Lake', 'UT', '84170', '8019653720', '8019653740', NULL, NULL, '', NULL, NULL, '', '', 'UGRANGER', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2003-07-17', '2006-07-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1174555320', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870284475', 'W77001726', 'W77001726', 'UT01', 'Granger Medical Clinic', 'Michael', 'D', 'Darnell', 'DO', 'Orthopedic Surgery', NULL, NULL, NULL, 'B', 'PO Box 70658', 'West Valley', 'Salt Lake', 'UT', '84170', NULL, NULL, NULL, NULL, '', NULL, NULL, '', '', 'UGRANGER', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2003-01-01', '2006-07-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1265464416', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870284475', 'W77001727', 'W77001727', 'UT01', 'Granger Medical Clinic', 'Jennifer', 'E', 'DenBleyker', 'MD', 'Family Practice', NULL, NULL, NULL, 'B', 'PO Box 70658', 'West Valley', 'Salt Lake', 'UT', '84170', NULL, NULL, NULL, NULL, '', NULL, NULL, '', '', 'UGRANGER', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2002-04-01', '2006-07-31', 0, 0, 0, 'Pioneer Valley Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1033141270', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870284475', 'W77001728', 'W77001728', 'UT01', 'Granger Medical Clinic', 'Steven', 'C', 'Dinger', 'MD', 'Obstetrics and Gynecology', NULL, NULL, NULL, 'O', '3725 W 4100 S', 'West Valley', 'Salt Lake', 'UT', '84120', '8019653444', '8019683605', NULL, NULL, '', NULL, NULL, '', '', 'UGRANGER', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2003-01-01', '2006-07-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1770514168', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870284475', 'W77001729', 'W77001729', 'UT01', 'Granger Medical Clinic', 'Douglas', 'R', 'Douville', 'MD', 'Family Practice', NULL, NULL, NULL, 'O', '3725 W 4100 S', 'West Valley', 'Salt Lake', 'UT', '84120', '8019653470', '8019683605', NULL, NULL, '', NULL, NULL, '', '', 'UGRANGER', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2003-01-01', '2006-07-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1497786677', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870284475', 'W77001730', 'W77001730', 'UT01', 'Granger Medical Clinic', 'Douglas', 'R', 'Douville', 'MD', 'Family Practice', NULL, NULL, NULL, 'B', 'PO Box 70658', 'West Valley', 'Salt Lake', 'UT', '84170', NULL, NULL, NULL, NULL, '', NULL, NULL, '', '', 'UGRANGER', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2003-01-01', '2006-07-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1497786677', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
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('870286381', 'W77001821', 'W77001821', 'UT01', 'Ogden Clinic', 'Joseph', 'W', 'Bell', 'DO', 'Obstetrics and Gynecology', NULL, NULL, NULL, 'B', '4650 Harrison Blvd', 'Ogden', 'Weber', 'UT', '84403', '8014794621', '8014762670', NULL, NULL, '', NULL, NULL, '', '', 'USTDOBG', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2003-04-01', '2005-01-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1851471767', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870284475', 'W77001823', 'W77001823', 'UT01', 'Granger Medical Clinic', 'Michael', 'D', 'Darnell', 'DO', 'Orthopedic Surgery', NULL, NULL, NULL, 'O', '3725 W 4100 S', 'West Valley', 'Salt Lake', 'UT', '84120', '8019653600', '8019683605', NULL, NULL, '', NULL, NULL, '', '', 'UGRANGER', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2003-01-01', '2006-07-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1265464416', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870284475', 'W77001824', 'W77001824', 'UT01', 'Granger Medical Clinic', 'Deborah', NULL, 'Ellis', 'CNM', 'Obstetrics and Gynecology', NULL, NULL, NULL, 'B', 'PO Box 70658', 'West Valley', 'Salt Lake', 'UT', '84170', '8019653720', '8019653740', NULL, NULL, '', NULL, NULL, '', '', 'UGRANGER', NULL, NULL, '0.00', '35.00', NULL, 3, '2003-01-01', '2004-04-29', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '831460', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870284475', 'W77001825', 'W77001825', 'UT01', 'Granger Medical Clinic', 'G Raychel', NULL, 'Gonzales', 'MD', 'Internal Medicine', NULL, NULL, NULL, 'O', '3725 W 4100 S', 'West Valley', 'Salt Lake', 'UT', '84120', '8019653600', '8019683605', NULL, NULL, '', NULL, NULL, '', '', 'UGRANGER', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2003-01-01', '2006-07-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '831710', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870284475', 'W77001826', 'W77001826', 'UT01', 'Granger Medical Clinic', 'G Raychel', NULL, 'Gonzales', 'MD', 'Internal Medicine', NULL, NULL, NULL, 'B', 'PO Box 70658', 'West Valley', 'Salt Lake', 'UT', '84170', NULL, NULL, NULL, NULL, '', NULL, NULL, '', '', 'UGRANGER', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2003-01-01', '2006-07-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '831710', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870284475', 'W77001827', 'W77001827', 'UT01', 'Granger Medical Clinic', 'Katherine', NULL, 'Griffin', 'NP', 'Pediatrics', NULL, NULL, NULL, 'O', '3725 W 4100 S', 'West Valley', 'Salt Lake', 'UT', '84120', '8019653600', '8019683605', NULL, NULL, '', NULL, NULL, '', '', 'UGRANGER', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2003-01-01', '2006-07-31', 0, 0, 0, 'Pioneer Valley Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1710912738', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870284475', 'W77001828', 'W77001828', 'UT01', 'Granger Medical Clinic', 'Katherine', NULL, 'Griffin', 'NP', 'Pediatrics', NULL, NULL, NULL, 'B', 'PO Box 70658', 'West Valley', 'Salt Lake', 'UT', '84170', '8019653720', '8019653740', NULL, NULL, '', NULL, NULL, '', '', 'UGRANGER', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2003-01-01', '2006-07-31', 0, 0, 0, 'Pioneer Valley Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1710912738', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870284475', 'W77001829', 'W77001829', 'UT01', 'Granger Medical Clinic', 'Reid', 'C', 'Harrison', 'MD', 'Internal Medicine', NULL, NULL, NULL, 'O', '3725 W 4100 S', 'West Valley', 'Salt Lake', 'UT', '84120', '8019653600', '8019683605', NULL, NULL, '', NULL, NULL, '', '', 'UGRANGER', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2003-01-01', '2006-07-31', 0, 0, 0, 'Riverton Childrens Unit Operated by Primary Childrens Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1356373500', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870284475', 'W77001830', 'W77001830', 'UT01', 'Granger Medical Clinic', 'Timothy', 'C', 'Hollingsed', 'MD', 'General Surgery', NULL, NULL, NULL, 'B', 'PO Box 70658', 'West Valley', 'Salt Lake', 'UT', '84170', NULL, NULL, NULL, NULL, '', NULL, NULL, '', '', 'UGRANGER', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2003-01-01', '2006-07-31', 0, 0, 0, 'Pioneer Valley Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1790716181', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870284475', 'W77001831', 'W77001831', 'UT01', 'Granger Medical Clinic', 'Christopher', NULL, 'Hutchison', 'MD', 'Obstetrics and Gynecology', NULL, NULL, NULL, 'O', '3725 W 4100 S', 'West Valley', 'Salt Lake', 'UT', '84120', '8019653417', '8019683605', NULL, NULL, '', NULL, NULL, '', '', 'UGRANGER', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2003-01-01', '2006-07-31', 0, 0, 0, 'Pioneer Valley Hospital', 'Riverton Childrens Unit Operated by Primary Childrens Medical Center', NULL, NULL, 'HCFA|UB|', '1134151384', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870284475', 'W77001832', 'W77001832', 'UT01', 'Granger Medical Clinic', 'Bruce', 'C', 'Irvine', 'MD', 'General Surgery', NULL, NULL, NULL, 'O', '3725 W 4100 S', 'West Valley', 'Salt Lake', 'UT', '84120', '8019653425', '8019683605', NULL, NULL, '', NULL, NULL, '', '', 'UGRANGER', NULL, NULL, '0.00', '35.00', NULL, 3, '2003-01-01', '2006-07-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1336170760', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870284475', 'W77001833', 'W77001833', 'UT01', 'Granger Medical Clinic', 'Bruce', 'C', 'Irvine', 'MD', 'General Surgery', NULL, NULL, NULL, 'B', 'PO Box 70658', 'West Valley', 'Salt Lake', 'UT', '84170', NULL, NULL, NULL, NULL, '', NULL, NULL, '', '', 'UGRANGER', NULL, NULL, '0.00', '35.00', NULL, 3, '2003-01-01', '2006-07-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1336170760', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870284475', 'W77001834', 'W77001834', 'UT01', 'Granger Medical Clinic', 'David', 'B', 'Isaac', 'MD', 'Obstetrics and Gynecology', NULL, NULL, NULL, 'O', '3725 W 4100 S', 'West Valley', 'Salt Lake', 'UT', '84120', '8019653444', '8019683605', NULL, NULL, '', NULL, NULL, '', '', 'UGRANGER', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2003-01-01', '2006-07-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '831220', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870284475', 'W77001835', 'W77001835', 'UT01', 'Granger Medical Clinic', 'David', 'B', 'Isaac', 'MD', 'Obstetrics and Gynecology', NULL, NULL, NULL, 'B', 'PO Box 70658', 'West Valley', 'Salt Lake', 'UT', '84170', NULL, NULL, NULL, NULL, '', NULL, NULL, '', '', 'UGRANGER', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2003-01-01', '2006-07-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '831220', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870284475', 'W77001836', 'W77001836', 'UT01', 'Granger Medical Clinic', 'Diane', 'M', 'Mattocks', 'PA', 'Family Practice', NULL, NULL, NULL, 'B', 'PO Box 70658', 'West Valley', 'Salt Lake', 'UT', '84170', NULL, NULL, NULL, NULL, '', NULL, NULL, '', '', 'UGRANGER', NULL, NULL, '0.00', '35.00', NULL, 3, '2003-11-01', '2004-01-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '834745', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL);
INSERT INTO `providers_new` (`Provider_Tax_ID`, `Provider_Suffix`, `Provider_Network_ID`, `Provider_Region`, `Provider_Name`, `Provider_Doctor_First_Name`, `Provider_Doctor_Middle_Name`, `Provider_Doctor_Last_Name`, `Provider_Doctor_Degree`, `Provider_Specialty_1`, `Provider_Specialty_2`, `Provider_Specialty_3`, `Provider_Specialty_4`, `Provider_Address_Type`, `Provider_Address`, `Provider_City`, `Provider_County`, `Provider_State`, `Provider_Zip`, `Provider_Phone`, `Provider_Fax`, `Provider_Mailing_Address`, `Provider_Mailing_City`, `Provider_Mailing_County`, `Provider_Mailing_State`, `Provider_Mailing_Zip`, `Provider_Mailing_Phone`, `Provider_Mailing_Fax`, `Provider_Primary_Schedule`, `Provider_Secondary_Schedule`, `Provider_Rate_Sheet`, `Provider_Anes_Rate`, `Provider_Default_Rate`, `Provider_Max_DOS`, `Provider_Min_Match_Value`, `Provider_Effective_Date`, `Provider_Term_Date`, `Provider_Pend`, `Provider_Anes_Minutes`, `Provider_PPO`, `Provider_Hospital_1`, `Provider_Hospital_2`, `Provider_Hospital_3`, `Provider_Hospital_4`, `Provider_Type`, `Provider_NPI`, `Provider_Check_Override`, `Exclude_Dir`, `Audit_Status`, `Last_Change_Date`, `Medicare_ID`, `Provider_Lang`, `Provider_Latitude`, `Provider_Longitude`, `Provider_school`, `Provider_cert`) VALUES
('870288620', 'W77001837', 'W77001837', 'UT01', 'Utah Orthopaedic Associates', 'Charles', 'M', 'Bova', 'MD', 'Pain Management', 'Sports Medicine', NULL, NULL, 'O', '1250 E 3900 S Ste 440', 'Salt Lake City', 'Salt Lake', 'UT', '84124', '8012612232', '8012641138', NULL, NULL, '', NULL, NULL, '', '', 'USTDORTH', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2002-04-01', '2006-12-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1013071885', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870288620', 'W77001838', 'W77001838', 'UT01', 'Utah Orthopaedic Associates', 'Robert', 'P', 'Hansen', 'MD', 'Orthopedic Surgery', NULL, NULL, NULL, 'O', '1250 E 3900 S Ste 440', 'Salt Lake City', 'Salt Lake', 'UT', '84124', '8012612232', '8012641138', NULL, NULL, '', NULL, NULL, '', '', 'USTDORTH', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2002-04-01', '2006-12-31', 0, 0, 0, 'St Marks Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1598808503', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870288620', 'W77001839', 'W77001839', 'UT01', 'Utah Orthopaedic Associates', 'James', 'C', 'Pingree', 'MD', 'Neurosurgery', NULL, NULL, NULL, 'O', '1250 E 3900 S Ste 440', 'Salt Lake City', 'Salt Lake', 'UT', '84124', '8012612232', '8012641138', NULL, NULL, '', NULL, NULL, '', '', 'USTDNEUR', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2002-08-23', '2006-12-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '832283', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870290203', 'W77001840', 'W77001840', 'UT01', 'Podiatry Center', 'Douglas', 'G', 'Stoker', 'DPM', 'Podiatry', NULL, NULL, NULL, 'O', '144 S 700 E', 'Salt Lake City', 'Salt Lake', 'UT', '84102', '8015321822', '8015327544', NULL, NULL, '', NULL, NULL, '', '', 'USTDPOD', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2003-08-26', '2006-08-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1548336696', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870293594', 'W77001841', 'W77001841', 'UT01', 'Fit Quest Physical Therapy', 'Therapy', NULL, 'Fit Quest', 'GROUP', 'Physical Therapy', 'Occupational Therapy', 'Speech Therapy', NULL, 'B', 'PO Box 150173', 'Ogden', 'Weber', 'UT', '84415', '8017823500', '8017861926', NULL, NULL, '', NULL, NULL, '', '', 'UDME', 'USTDHCPC', '2298', '0.00', '35.00', NULL, 3, '2004-05-01', '2006-12-31', 1, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '834838', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870293594', 'W77001842', 'W77001842', 'UT01', 'Fit Quest Therapy', 'Therapy', NULL, 'Fit Quest', 'GROUP', 'Physical Therapy', 'Occupational Therapy', 'Speech Therapy', NULL, 'B', 'PO Box 150173', 'Ogden', 'Weber', 'UT', '84415', '8017823500', '8017861926', NULL, NULL, '', NULL, NULL, '', '', 'UDME', 'USTDHCPC', '2298', '0.00', '35.00', NULL, 3, '2004-05-01', '2004-05-01', 1, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '834838', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870293594', 'W77001843', 'W77001843', 'UT01', 'Fit Quest Therapy', 'Cleo', NULL, 'Adams', 'SPT', 'Speech Therapy', NULL, NULL, NULL, 'O', '2120 N 400 E', 'North Ogden', 'Weber', 'UT', '84414', '8017823500', '8017861926', NULL, NULL, '', NULL, NULL, '', '', 'UDME', 'USTDHCPC', '2298', '0.00', '35.00', NULL, 3, '2001-11-08', '2005-10-14', 1, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '832006', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870293594', 'W77001844', 'W77001844', 'UT01', 'Fit Quest Therapy', 'Sydney', 'D', 'Hicks', 'SPT', 'Speech Therapy', NULL, NULL, NULL, 'O', '2120 N 400 E', 'North Ogden', 'Weber', 'UT', '84414', '8017823500', '8017861926', NULL, NULL, '', NULL, NULL, '', '', 'UDME', 'USTDHCPC', '2298', '0.00', '35.00', NULL, 3, '2005-09-30', '2006-12-31', 1, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '937295', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870293594', 'W77001845', 'W77001845', 'UT01', 'Fit Quest Therapy', 'Robert', 'D', 'Knighton', 'SPT', 'Speech Therapy', NULL, NULL, NULL, 'B', 'PO Box 150173', 'Ogden', 'Weber', 'UT', '84415', '8017823500', '8017861926', NULL, NULL, '', NULL, NULL, '', '', 'UDME', 'USTDHCPC', '2298', '0.00', '35.00', NULL, 3, '2001-01-02', '2005-10-01', 1, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '834911', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870293594', 'W77001846', 'W77001846', 'UT01', 'Fit Quest Therapy', 'David', 'Daines', 'Miller', 'SPT', 'Speech Therapy', NULL, NULL, NULL, 'B', 'PO Box 150173', 'Ogden', 'Weber', 'UT', '84415', '8017823500', '8017861926', NULL, NULL, '', NULL, NULL, '', '', 'UDME', 'USTDHCPC', '2298', '0.00', '35.00', NULL, 3, '2001-11-08', '2005-10-01', 1, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '832005', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870293594', 'W77001847', 'W77001847', 'UT01', 'Fit Quest Therapy', 'Ken', NULL, 'Newman', 'SPT', 'Speech Therapy', NULL, NULL, NULL, 'B', 'PO Box 150173', 'Ogden', 'Weber', 'UT', '84415', '8017823500', '8017861926', NULL, NULL, '', NULL, NULL, '', '', 'UDME', 'USTDHCPC', '2298', '0.00', '35.00', NULL, 3, '2002-05-15', '2005-10-01', 1, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '832164', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870293594', 'W77001848', 'W77001848', 'UT01', 'Fit Quest Therapy', 'Stephanie', 'Brooke', 'O''Reilly', 'OT', 'Occupational Therapy', NULL, NULL, NULL, 'B', 'PO Box 150173', 'Ogden', 'Weber', 'UT', '84415', '8017823500', '8017861926', NULL, NULL, '', NULL, NULL, '', '', 'UDME', 'USTDHCPC', '2298', '0.00', '35.00', NULL, 3, '2004-03-17', '2006-12-31', 1, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '832929', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870286381', 'W77001849', 'W77001849', 'UT01', 'Ogden Clinic', 'Edward', 'D', 'Brown', 'MD', 'Pediatrics', NULL, NULL, NULL, 'O', '4650 Harrison Blvd', 'Ogden', 'Weber', 'UT', '84403', '8014794621', '8014762670', NULL, NULL, '', NULL, NULL, '', '', 'UOGDCLIN', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2003-04-01', '2006-07-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1861489445', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870286381', 'W77001851', 'W77001851', 'UT01', 'Ogden Clinic', 'Julie', 'C', 'Child', 'NP', 'Obstetrics and Gynecology', NULL, NULL, NULL, 'O', '4650 Harrison Blvd', 'Ogden', 'Weber', 'UT', '84403', '8014762277', '8014762670', NULL, NULL, '', NULL, NULL, '', '', 'UOGDCLIN', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2003-04-01', '2006-07-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '831467', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870286381', 'W77001852', 'W77001852', 'UT01', 'Ogden Clinic', 'Van', 'G', 'Christiansen', 'MD', 'Family Practice', NULL, NULL, NULL, 'O', '5430 S 1900 W Ste G1', 'Roy', 'Weber', 'UT', '84067', '8017799975', NULL, NULL, NULL, '', NULL, NULL, '', '', 'UOGDCLIN', NULL, NULL, '0.00', '35.00', NULL, 3, '2003-04-01', '2006-02-14', 0, 0, 0, 'Ogden Regional Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1093702672', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870286381', 'W77001853', 'W77001853', 'UT01', 'Ogden Clinic', 'Laura', 'A', 'Colvin', 'PA', 'Family Practice', NULL, NULL, NULL, 'O', '5430 S 1900 W Ste G1', 'Roy', 'Weber', 'UT', '84067', '8017799975', NULL, NULL, NULL, '', NULL, NULL, '', '', 'UOGDCLIN', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2003-04-01', '2006-07-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1447248596', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870286381', 'W77001854', 'W77001854', 'UT01', 'Ogden Clinic', 'Catherine', NULL, 'Cook', 'MD', 'Pediatrics', NULL, NULL, NULL, 'O', '4650 Harrison Blvd', 'Ogden', 'Weber', 'UT', '84403', '8014794621', '8014762670', NULL, NULL, '', NULL, NULL, '', '', 'UOGDCLIN', NULL, NULL, '0.00', '35.00', NULL, 3, '2003-04-01', '2006-07-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1538156120', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870286381', 'W77001855', 'W77001855', 'UT01', 'Ogden Clinic', 'Katherine', 'L', 'Dreyer', 'CNM', 'Obstetrics and Gynecology', NULL, NULL, NULL, 'B', '4650 Harrison Blvd', 'Ogden', 'Weber', 'UT', '84403', '8014799870', NULL, NULL, NULL, '', NULL, NULL, '', '', 'UOGDCLIN', NULL, NULL, '0.00', '35.00', NULL, 3, '2003-04-01', '2004-02-29', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '831474', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870286381', 'W77001856', 'W77001856', 'UT01', 'Ogden Clinic', 'Katherine', 'L', 'Dreyer', 'CNM', 'Obstetrics and Gynecology', NULL, NULL, NULL, 'O', '5495 S 500 E Ste 350', 'Ogden', 'Weber', 'UT', '84405', '8014755397', NULL, NULL, NULL, '', NULL, NULL, '', '', 'UOGDCLIN', NULL, NULL, '0.00', '35.00', NULL, 3, '2003-04-01', '2004-02-29', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '831474', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870286381', 'W77001857', 'W77001857', 'UT01', 'Ogden Clinic', 'Sheila', 'G', 'Garvey', 'MD', 'General Surgery', NULL, NULL, NULL, 'O', '4650 Harrison Blvd', 'Ogden', 'Weber', 'UT', '84403', '8014762353', '8014762670', NULL, NULL, '', NULL, NULL, '', '', 'UOGDCLIN', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2003-04-01', '2006-07-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1245227792', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870286381', 'W77001858', 'W77001858', 'UT01', 'Ogden Clinic', 'Nathan', 'S', 'Goff', 'PT', 'Physical Therapy', NULL, NULL, NULL, 'B', '4650 Harrison Blvd', 'Ogden', 'Weber', 'UT', '84403', '8014799870', NULL, NULL, NULL, '', NULL, NULL, '', '', 'UOGDCLIN', NULL, NULL, '0.00', '35.00', NULL, 3, '2004-08-02', '2004-08-02', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1629066675', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
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('870286381', 'W77001952', 'W77001952', 'UT01', 'Ogden Clinic', 'Michael', 'J', 'Hall', 'MD', 'Orthopedic Surgery', NULL, NULL, NULL, 'O', '4350 Washington Blvd', 'Ogden', 'Weber', 'UT', '84403', '8014765100', NULL, NULL, NULL, '', NULL, NULL, '', '', 'UOGDCLIN', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2004-04-30', '2006-07-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1720075047', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870286381', 'W77001953', 'W77001953', 'UT01', 'Ogden Clinic', 'Philip', 'H', 'Hassrick', 'MD', 'Family Practice', NULL, NULL, NULL, 'O', '4350 Washington Blvd', 'Ogden', 'Weber', 'UT', '84403', '8014765100', NULL, NULL, NULL, '', NULL, NULL, '', '', 'UOGDCLIN', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2003-04-01', '2006-07-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1043207509', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870286381', 'W77001954', 'W77001954', 'UT01', 'Ogden Clinic', 'Philip', 'H', 'Hassrick', 'MD', 'Family Practice', NULL, NULL, NULL, 'B', '4650 Harrison Blvd', 'Ogden', 'Weber', 'UT', '84403', '8014799870', NULL, NULL, NULL, '', NULL, NULL, '', '', 'UOGDCLIN', NULL, NULL, '0.00', '35.00', NULL, 3, '2003-04-01', '2003-04-01', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1043207509', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL);
INSERT INTO `providers_new` (`Provider_Tax_ID`, `Provider_Suffix`, `Provider_Network_ID`, `Provider_Region`, `Provider_Name`, `Provider_Doctor_First_Name`, `Provider_Doctor_Middle_Name`, `Provider_Doctor_Last_Name`, `Provider_Doctor_Degree`, `Provider_Specialty_1`, `Provider_Specialty_2`, `Provider_Specialty_3`, `Provider_Specialty_4`, `Provider_Address_Type`, `Provider_Address`, `Provider_City`, `Provider_County`, `Provider_State`, `Provider_Zip`, `Provider_Phone`, `Provider_Fax`, `Provider_Mailing_Address`, `Provider_Mailing_City`, `Provider_Mailing_County`, `Provider_Mailing_State`, `Provider_Mailing_Zip`, `Provider_Mailing_Phone`, `Provider_Mailing_Fax`, `Provider_Primary_Schedule`, `Provider_Secondary_Schedule`, `Provider_Rate_Sheet`, `Provider_Anes_Rate`, `Provider_Default_Rate`, `Provider_Max_DOS`, `Provider_Min_Match_Value`, `Provider_Effective_Date`, `Provider_Term_Date`, `Provider_Pend`, `Provider_Anes_Minutes`, `Provider_PPO`, `Provider_Hospital_1`, `Provider_Hospital_2`, `Provider_Hospital_3`, `Provider_Hospital_4`, `Provider_Type`, `Provider_NPI`, `Provider_Check_Override`, `Exclude_Dir`, `Audit_Status`, `Last_Change_Date`, `Medicare_ID`, `Provider_Lang`, `Provider_Latitude`, `Provider_Longitude`, `Provider_school`, `Provider_cert`) VALUES
('870286381', 'W77001956', 'W77001956', 'UT01', 'Ogden Clinic', 'Eric', NULL, 'Johnson', 'PA', 'Family Practice', NULL, NULL, NULL, 'O', '5430 S 1900 W Ste G1', 'Roy', 'Weber', 'UT', '84067', '8017799975', NULL, NULL, NULL, '', NULL, NULL, '', '', 'UOGDCLIN', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2003-04-01', '2006-07-31', 0, 0, 0, 'Ogden Regional Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1841289600', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870286381', 'W77001957', 'W77001957', 'UT01', 'Ogden Clinic', 'Edward', 'A', 'Jordan', 'MD', 'General Surgery', NULL, NULL, NULL, 'O', '4650 Harrison Blvd', 'Ogden', 'Weber', 'UT', '84403', '8014794621', '8014762670', NULL, NULL, '', NULL, NULL, '', '', 'UOGDCLIN', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2003-04-01', '2006-07-31', 0, 0, 0, 'Ogden Regional Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1740277599', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870286381', 'W77001958', 'W77001958', 'UT01', 'Ogden Clinic', 'Dallen', NULL, 'Larson', 'PA', 'Family Practice', NULL, NULL, NULL, 'O', '4650 Harrison Blvd', 'Ogden', 'Weber', 'UT', '84403', '8014794621', '8014762670', NULL, NULL, '', NULL, NULL, '', '', 'UOGDCLIN', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2003-04-01', '2006-07-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1609865203', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870286381', 'W77001959', 'W77001959', 'UT01', 'Ogden Clinic', 'Blake', 'A', 'McMillan', 'PA', NULL, NULL, NULL, NULL, 'B', '4650 Harrison Blvd', 'Ogden', 'Weber', 'UT', '84403', '8014799870', NULL, NULL, NULL, '', NULL, NULL, '', '', 'UOGDCLIN', NULL, NULL, '0.00', '35.00', NULL, 3, '2003-04-01', '2003-04-01', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1356330153', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870332915', 'W77001960', 'W77001960', 'UT01', 'Associates In Radiology', 'Cole', NULL, 'Panushka', 'MD', 'Radiologist', NULL, NULL, NULL, 'B', 'PO Box 470', 'Ogden', 'Weber', 'UT', '84402', NULL, NULL, NULL, NULL, '', NULL, NULL, '', '', 'UUTIMAGE', NULL, NULL, '0.00', '35.00', NULL, 3, '2002-10-01', '2005-05-31', 0, 0, 0, 'Ogden Regional Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1053392050', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870333759', 'W77001961', 'W77001961', 'UT01', 'ODell, Richard H', 'Richard', 'H', 'Odell', 'MD', 'Dermatology', NULL, NULL, NULL, 'O', '1345 E 3900 S Ste 110', 'Salt Lake City', 'Salt Lake', 'UT', '84124', '8012724219', NULL, NULL, NULL, '', NULL, NULL, '', '', 'USTDMULT', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2002-04-01', '2006-10-31', 0, 0, 0, 'St Marks Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1215999875', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870337363', 'W77001962', 'W77001962', 'UT01', 'Gastroenterology Associates', 'Lynn', 'L', 'Wilcox', 'MD', 'Gastroenterology', NULL, NULL, NULL, 'O', '1250 E 3900 S Ste 360', 'Salt Lake City', 'Salt Lake', 'UT', '84124', '8012633041', '8012638485', NULL, NULL, '', NULL, NULL, '', '', 'USTDGAST', NULL, '7220', '0.00', NULL, NULL, 3, '2002-04-01', '2006-02-22', 1, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '832435', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870342259', 'W77001963', 'W77001963', 'UT01', 'Wayne Community Health Centers', 'Jeffrey', 'J', 'Brown', 'DO', 'Family Practice', NULL, NULL, NULL, 'O', '128 S 300 W', 'Bicknell', 'Wayne', 'UT', '84715', '4354253744', '4354253785', NULL, NULL, '', NULL, NULL, '', '', 'URURAL', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2005-07-29', '2006-09-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1205840642', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870342259', 'W77001964', 'W77001964', 'UT01', 'Wayne Community Health Centers', 'Leland', 'J', 'Chappell', 'MD', 'Family Practice', NULL, NULL, NULL, 'O', '128 S 300 W', 'Bicknell', 'Wayne', 'UT', '84715', '4354253744', '4354253785', NULL, NULL, '', NULL, NULL, '', '', 'URURAL', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2005-04-29', '2006-09-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '923429', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870342259', 'W77001965', 'W77001965', 'UT01', 'Wayne Community Health Centers', 'Joanna', NULL, 'Masi-Lynch', 'PA', NULL, NULL, NULL, NULL, 'B', 'PO Box 303', 'Bicknell', 'Wayne', 'UT', '84715', '4354253744', '4354253785', NULL, NULL, '', NULL, NULL, '', '', 'URURAL', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2005-06-24', '2006-09-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '925126', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870342259', 'W77001966', 'W77001966', 'UT01', 'Wayne Community Health Centers', 'Anthony', 'F', 'Millward', 'PA', NULL, NULL, NULL, NULL, 'B', 'PO Box 303', 'Bicknell', 'Wayne', 'UT', '84715', '4354253744', '4354253785', NULL, NULL, '', NULL, NULL, '', '', 'URURAL', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2005-06-24', '2006-09-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '924549', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870344424', 'W77001967', 'W77001967', 'UT01', 'Neslon, I William', 'Ivan', 'W', 'Nelson', 'MD', 'Ear, Nose and Throat', NULL, NULL, NULL, 'O', '750 W 800 N', 'Orem', 'Utah', 'UT', '84057', '8017146000', NULL, NULL, NULL, '', NULL, NULL, '', '', 'UUVPN', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2002-12-01', '2006-05-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '833396', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870344927', 'W77001968', 'W77001968', 'UT01', 'Arbon, Robert A', 'Robert', 'A', 'Arbon', 'MD', 'Ear, Nose and Throat', NULL, NULL, NULL, 'O', '777 N 500 W Ste 105', 'Provo', 'Utah', 'UT', '84601', '8013754433', NULL, NULL, NULL, '', NULL, NULL, '', '', 'UUVPN', NULL, NULL, '0.00', '35.00', NULL, 3, '1999-09-01', '2005-12-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '833397', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870346198', 'W77001969', 'W77001969', 'UT01', 'Rocky Mountain Associated Physicians', 'R', 'Chad', 'Halversen', 'MD', 'General Surgery', NULL, NULL, NULL, 'O', '1160 E 3900 S Ste 4100', 'Salt Lake City', 'Salt Lake', 'UT', '84124', '8012683800', '8012683997', NULL, NULL, '', NULL, NULL, '', '', 'WCSTRMAP5', 'USTDSURG', NULL, '0.00', '0.01', NULL, 3, '2004-08-27', '2006-10-31', 0, 0, 0, 'St Marks Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1275540585', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870347187', 'W77001970', 'W77001970', 'UT01', 'Utah Valley Eye Center', 'L Todd', NULL, 'Cook', 'MD', 'Ophthalmology', NULL, NULL, NULL, 'O', '1055 N 300 W Ste 204', 'Provo', 'Utah', 'UT', '84604', '8013577373', '8013577217', NULL, NULL, '', NULL, NULL, '', '', 'UUVPN', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2003-06-21', '2006-05-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1801893375', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870348655', 'W77001971', 'W77001971', 'UT01', 'Landeen, Jon L', 'Jon', 'L', 'Landeen', 'MD', 'Obstetrics and Gynecology', NULL, NULL, NULL, 'B', 'PO Box 998', 'Moab', 'Grand', 'UT', '84532', '4352597191', NULL, NULL, NULL, '', NULL, NULL, '', '', '110', NULL, NULL, '0.00', '10.00', NULL, 3, '1999-09-01', '2006-01-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1205890928', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870351714', 'W77001972', 'W77001972', 'UT01', 'Nielsen, J Barry', 'J Barry', NULL, 'Nielsen', 'MD', 'Ear, Nose and Throat', NULL, NULL, NULL, 'O', '5770 S 250 E Ste 285', 'Murray', 'Salt Lake', 'UT', '84107', '8012682822', '8012682832', NULL, NULL, '', NULL, NULL, '', '', 'USTDENT', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2003-04-01', '2006-10-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '833393', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870354382', 'W77001973', 'W77001973', 'UT01', 'Bermen, John F', 'John', 'F', 'Bermen', 'MD', 'Orthopedic Surgery', NULL, NULL, NULL, 'B', '3465 Pioneer Pkwy Ste 5', 'West Valley', 'Salt Lake', 'UT', '84120', '8019670282', NULL, NULL, NULL, '', NULL, NULL, '', '', 'USTDORTH', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2002-04-01', '2006-12-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1548351364', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870293594', 'W77001974', 'W77001974', 'UT01', 'Fit Quest Therapy', 'Cleo', NULL, 'Adams', 'SPT', 'Speech Therapy', NULL, NULL, NULL, 'B', 'PO Box 150173', 'Ogden', 'Weber', 'UT', '84415', '8017823500', '8017861926', NULL, NULL, '', NULL, NULL, '', '', 'UDME', 'USTDHCPC', '2298', '0.00', '35.00', NULL, 3, '2001-11-08', '2005-10-14', 1, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '832006', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870293594', 'W77001975', 'W77001975', 'UT01', 'Fit Quest Therapy', 'Rebecca', 'S', 'Christoffersen', 'SPT', 'Speech Therapy', NULL, NULL, NULL, 'O', '2120 N 400 E', 'North Ogden', 'Weber', 'UT', '84414', '8017823500', '8017861926', NULL, NULL, '', NULL, NULL, '', '', 'UDME', 'USTDHCPC', '2298', '0.00', '35.00', NULL, 3, '2002-09-20', '2005-07-01', 1, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '832316', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870293594', 'W77001976', 'W77001976', 'UT01', 'Fit Quest Therapy', 'Rebecca', 'S', 'Christoffersen', 'SPT', 'Speech Therapy', NULL, NULL, NULL, 'B', 'PO Box 150173', 'Ogden', 'Weber', 'UT', '84415', '8017823500', '8017861926', NULL, NULL, '', NULL, NULL, '', '', 'UDME', 'USTDHCPC', '2298', '0.00', '35.00', NULL, 3, '2002-09-20', '2005-07-01', 1, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '832316', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870293594', 'W77001977', 'W77001977', 'UT01', 'Fit Quest Therapy', 'Sydney', 'D', 'Hicks', 'SPT', 'Speech Therapy', NULL, NULL, NULL, 'B', 'PO Box 150173', 'Ogden', 'Weber', 'UT', '84415', '8017823500', '8017861926', NULL, NULL, '', NULL, NULL, '', '', 'UDME', 'USTDHCPC', '2298', '0.00', '35.00', NULL, 3, '2005-09-30', '2006-12-31', 1, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '937295', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870293594', 'W77001978', 'W77001978', 'UT01', 'Fit Quest Therapy', 'Todd', 'K', 'Larson', 'PT', 'Physical Therapy', NULL, NULL, NULL, 'B', 'PO Box 150173', 'Ogden', 'Weber', 'UT', '84415', '8017823500', '8017861926', NULL, NULL, '', NULL, NULL, '', '', 'SELECT', NULL, NULL, '0.00', NULL, NULL, 3, '2001-11-16', '2004-08-01', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '834009', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870293594', 'W77001979', 'W77001979', 'UT01', 'Fit Quest Therapy', 'David', NULL, 'Osteyee', 'PT', 'Physical Therapy', NULL, NULL, NULL, 'O', '275 N 300 W Ste 403', 'Kaysville', 'Davis', 'UT', '84037', '8015466868', '8015468225', NULL, NULL, '', NULL, NULL, '', '', 'UDME', 'USTDHCPC', '2298', '0.00', '35.00', NULL, 3, '2003-04-01', '2006-12-31', 1, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '834586', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870293594', 'W77001980', 'W77001980', 'UT01', 'Fit Quest Therapy', 'David', NULL, 'Osteyee', 'PT', 'Physical Therapy', NULL, NULL, NULL, 'B', 'PO Box 150173', 'Ogden', 'Weber', 'UT', '84415', '8017823500', '8017861926', NULL, NULL, '', NULL, NULL, '', '', 'UDME', 'USTDHCPC', '2298', '0.00', '35.00', NULL, 3, '2003-04-01', '2006-12-31', 1, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '834586', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870293873', 'W77001981', 'W77001981', 'UT01', 'Tri City Medical Clinic', 'E', 'J', 'Corry', 'MD', 'Family Practice', NULL, NULL, NULL, 'O', '830 N 2000 W', 'Pleasant Grove', 'Utah', 'UT', '84062', '8017563511', NULL, NULL, NULL, '', NULL, NULL, '', '', 'UUVPN', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '1999-09-01', '2006-05-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '831076', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870302621', 'W77001982', 'W77001982', 'UT01', 'Rocky Mountain Retina Consultants', 'Derek', 'B', 'Lauritzen', 'MD', 'Ophthalmology', 'Ophthalmology', NULL, NULL, 'O', '4400 S 700 E Ste 200', 'Salt Lake City', 'Salt Lake', 'UT', '84107', '8012644444', '8012812383', NULL, NULL, '', NULL, NULL, '', '', 'USTDMULT', NULL, NULL, '0.00', '35.00', NULL, 3, '2002-08-01', '2004-08-23', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '832288', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870302621', 'W77001983', 'W77001983', 'UT01', 'Rocky Mountain Retina Consultants', 'Douglas', 'S', 'Mehr', 'MD', 'Ophthalmology', NULL, NULL, NULL, 'O', '4400 S 700 E Ste 200', 'Salt Lake City', 'Salt Lake', 'UT', '84107', '8012644444', '8012812383', NULL, NULL, '', NULL, NULL, '', '', 'USTDMULT', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2005-08-26', '2006-12-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1720070899', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870305037', 'W77001984', 'W77001984', 'UT01', 'Nelson, John C', 'John', 'C', 'Nelson', 'MD', 'Ophthalmology', NULL, NULL, NULL, 'B', '3465 Pioneer Pkwy Ste 4', 'West Valley', 'Salt Lake', 'UT', '84120', '8019660081', '8019660218', NULL, NULL, '', NULL, NULL, '', '', 'USTDOPHT', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2002-04-01', '2005-10-13', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '832778', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870305037', 'W77001985', 'W77001985', 'UT01', 'Nelson, John C', 'John', 'C', 'Nelson', 'MD', 'Ophthalmology', NULL, NULL, NULL, 'O', '3465 Pioneer Pkwy Ste 4', 'West Valley', 'Salt Lake', 'UT', '84120', '8019660081', '8019660218', NULL, NULL, '', NULL, NULL, '', '', 'USTDOPHT', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2002-04-01', '2005-10-13', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '832778', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870306625', 'W77001986', 'W77001986', 'UT01', 'Brown DPM, H Ronald', 'H Ronald', NULL, 'Brown', 'DPM', 'Podiatry', NULL, NULL, NULL, 'B', '4370 S Redwood Rd', 'Salt Lake City', 'Salt Lake', 'UT', '84123', '8019673338', '8019670722', NULL, NULL, '', NULL, NULL, '', '', 'USTDPOD', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2005-09-30', '2006-08-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1619965225', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870286381', 'W77001987', 'W77001987', 'UT01', 'Ogden Clinic', 'David', 'W', 'Nemetz', 'MD', 'Family Practice', NULL, NULL, NULL, 'O', '5430 S 1900 W Ste G1', 'Roy', 'Weber', 'UT', '84067', '8017799975', NULL, NULL, NULL, '', NULL, NULL, '', '', 'UOGDCLIN', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2003-04-01', '2006-07-31', 0, 0, 0, 'Ogden Regional Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1811984800', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870286381', 'W77001988', 'W77001988', 'UT01', 'Ogden Clinic', 'Catherine', NULL, 'Ortega', 'PA', NULL, NULL, NULL, NULL, 'O', '1159 12th St', 'Ogden', 'Weber', 'UT', '84404', '8013343000', '8014762670', NULL, NULL, '', NULL, NULL, '', '', 'UOGDCLIN', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2002-04-03', '2006-07-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1396734919', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
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('870286381', 'W77001990', 'W77001990', 'UT01', 'Ogden Clinic', 'Jonathon', 'P', 'Rhodes', 'PT', 'Physical Therapy', NULL, NULL, NULL, 'B', '4650 Harrison Blvd', 'Ogden', 'Weber', 'UT', '84403', '8014794621', '8014762670', NULL, NULL, '', NULL, NULL, '', '', 'UOGDCLIN', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2003-04-01', '2006-07-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1437148053', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
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('870308023', 'W77002052', 'W77002052', 'UT01', 'Middleton Urological Associates', 'Anthony', 'W', 'Middleton', 'MD', 'Urology', NULL, NULL, NULL, 'O', '1060 E 100 S Ste 110', 'Salt Lake City', 'Salt Lake', 'UT', '84102', '8015319453', '8015319467', NULL, NULL, '', NULL, NULL, '', '', 'USTDURO', NULL, NULL, '0.00', '35.00', NULL, 3, '2002-04-01', '2005-06-16', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '833223', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
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('870322019', 'W77002056', 'W77002056', 'UT01', 'Lakeview Hospital Pro Fees', 'o Fees', NULL, 'Lakeview Hospital Pr', 'GROUP', 'Multi Specialty (Clinic)', NULL, NULL, NULL, 'O', '630 Medical Dr', 'Bountiful', 'Davis', 'UT', '84010', NULL, NULL, NULL, NULL, '', NULL, NULL, '', '', NULL, NULL, '2358', '0.00', '40.00', NULL, 3, '1999-01-01', '2005-06-30', 1, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '835317', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870322019', 'W77002057', 'W77002057', 'UT01', 'Lakeview Geriatric & Adult Medicine', 'Robert', NULL, 'Braun', 'PT', 'Physical Therapy', NULL, NULL, NULL, 'B', '1580 W Antelope Dr Ste 280', 'Layton', 'Davis', 'UT', '84041', '8012997801', NULL, NULL, NULL, '', NULL, NULL, '', '', '140', NULL, NULL, '0.00', '40.00', NULL, 3, '1998-01-01', '2004-05-10', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '834746', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
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('870323929', 'W77002062', 'W77002062', 'UT01', 'Jessen, G Shane', 'G', 'Shane', 'Jessen', 'MD', 'Oral/Maxillofacial Surgery', 'Oral Surgeon', NULL, NULL, 'O', '102 E Forest St', 'Brigham City', 'Box Elder', 'UT', '84302', '8008606260', NULL, NULL, NULL, '', NULL, NULL, '', '', 'USTDOSRG', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 6, '2003-10-03', '2006-10-31', 0, 0, 0, 'Ogden Regional Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1548349251', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
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('870293534', 'W77002064', 'W77002064', 'UT01', 'Neurosurgical Clinic Of Utah', 'Jodie', 'K', 'Levitt', 'MD', 'Neurosurgery', NULL, NULL, NULL, 'O', '24 S 1100 E Ste 302', 'Salt Lake City', 'Salt Lake', 'UT', '84102', '8015317806', NULL, NULL, NULL, '', NULL, NULL, '', '', 'USTDNRLG', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2002-11-15', '2006-09-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1053325365', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870293594', 'W77002065', 'W77002065', 'UT01', 'Fit Quest Therapy', 'Therapy', NULL, 'Fit Quest', 'GROUP', 'Physical Therapy', 'Occupational Therapy', 'Speech Therapy', NULL, 'O', '1885 Skyline Dr', 'South Ogden', 'Weber', 'UT', '84403', '8014764141', NULL, NULL, NULL, '', NULL, NULL, '', '', 'UDME', 'USTDHCPC', '2298', '0.00', '35.00', NULL, 3, '2004-05-01', '2006-12-31', 1, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '834838', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870293594', 'W77002066', 'W77002066', 'UT01', 'Fit Quest Therapy', 'Therapy', NULL, 'Fit Quest', 'GROUP', 'Physical Therapy', 'Occupational Therapy', 'Speech Therapy', NULL, 'O', '275 N 300 W Ste 403', 'Kaysville', 'Davis', 'UT', '84037', '8015466868', NULL, NULL, NULL, '', NULL, NULL, '', '', 'UDME', 'USTDHCPC', '2298', '0.00', '35.00', NULL, 3, '2004-05-01', '2006-12-31', 1, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '834838', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL);
INSERT INTO `providers_new` (`Provider_Tax_ID`, `Provider_Suffix`, `Provider_Network_ID`, `Provider_Region`, `Provider_Name`, `Provider_Doctor_First_Name`, `Provider_Doctor_Middle_Name`, `Provider_Doctor_Last_Name`, `Provider_Doctor_Degree`, `Provider_Specialty_1`, `Provider_Specialty_2`, `Provider_Specialty_3`, `Provider_Specialty_4`, `Provider_Address_Type`, `Provider_Address`, `Provider_City`, `Provider_County`, `Provider_State`, `Provider_Zip`, `Provider_Phone`, `Provider_Fax`, `Provider_Mailing_Address`, `Provider_Mailing_City`, `Provider_Mailing_County`, `Provider_Mailing_State`, `Provider_Mailing_Zip`, `Provider_Mailing_Phone`, `Provider_Mailing_Fax`, `Provider_Primary_Schedule`, `Provider_Secondary_Schedule`, `Provider_Rate_Sheet`, `Provider_Anes_Rate`, `Provider_Default_Rate`, `Provider_Max_DOS`, `Provider_Min_Match_Value`, `Provider_Effective_Date`, `Provider_Term_Date`, `Provider_Pend`, `Provider_Anes_Minutes`, `Provider_PPO`, `Provider_Hospital_1`, `Provider_Hospital_2`, `Provider_Hospital_3`, `Provider_Hospital_4`, `Provider_Type`, `Provider_NPI`, `Provider_Check_Override`, `Exclude_Dir`, `Audit_Status`, `Last_Change_Date`, `Medicare_ID`, `Provider_Lang`, `Provider_Latitude`, `Provider_Longitude`, `Provider_school`, `Provider_cert`) VALUES
('870293594', 'W77002068', 'W77002068', 'UT01', 'Fit Quest Therapy', 'Ken', NULL, 'Colledge', 'PT', 'Physical Therapy', NULL, NULL, NULL, 'O', '2120 N 400 E', 'North Ogden', 'Weber', 'UT', '84414', '8017823500', '8017861926', NULL, NULL, '', NULL, NULL, '', '', 'UDME', 'USTDHCPC', '2298', '0.00', '35.00', NULL, 3, '2001-01-02', '2006-12-31', 1, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '833745', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870293594', 'W77002069', 'W77002069', 'UT01', 'Fit Quest Therapy', 'Ken', NULL, 'Colledge', 'PT', 'Physical Therapy', NULL, NULL, NULL, 'B', 'PO Box 150173', 'Ogden', 'Weber', 'UT', '84415', '8017823500', '8017861926', NULL, NULL, '', NULL, NULL, '', '', 'UDME', 'USTDHCPC', '2298', '0.00', '35.00', NULL, 3, '2001-01-02', '2006-12-31', 1, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '833745', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870293594', 'W77002070', 'W77002070', 'UT01', '*Fit Quest Physical Therapy', 'Todd', 'K', 'Larson', 'PT', 'Physical Therapy', NULL, NULL, NULL, 'O', '4607 S 3500 W', 'Ogden', 'Weber', 'UT', '84401', '8017328700', NULL, NULL, NULL, '', NULL, NULL, '', '', 'SELECT', NULL, NULL, '0.00', NULL, NULL, 3, '2001-11-16', '2004-08-01', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '834009', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870293594', 'W77002071', 'W77002071', 'UT01', 'Fit Quest Therapy', 'David', 'Daines', 'Miller', 'SPT', 'Speech Therapy', NULL, NULL, NULL, 'O', '2120 N 400 E', 'North Ogden', 'Weber', 'UT', '84414', '8017823500', '8017861926', NULL, NULL, '', NULL, NULL, '', '', 'UDME', 'USTDHCPC', '2298', '0.00', '35.00', NULL, 3, '2001-11-08', '2005-10-01', 1, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '832005', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870293594', 'W77002072', 'W77002072', 'UT01', 'Fit Quest Therapy', 'Monte', 'R', 'Zundel', 'PT', 'Physical Therapy', NULL, NULL, NULL, 'O', '2120 N 400 E', 'North Ogden', 'Weber', 'UT', '84414', '8017823500', '8017861926', NULL, NULL, '', NULL, NULL, '', '', 'UDME', 'USTDHCPC', '2298', '0.00', '35.00', NULL, 3, '1999-09-01', '2006-12-31', 1, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '832129', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
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