INSERT INTO `providers_new` (`Provider_Tax_ID`, `Provider_Suffix`, `Provider_Network_ID`, `Provider_Region`, `Provider_Name`, `Provider_Doctor_First_Name`, `Provider_Doctor_Middle_Name`, `Provider_Doctor_Last_Name`, `Provider_Doctor_Degree`, `Provider_Specialty_1`, `Provider_Specialty_2`, `Provider_Specialty_3`, `Provider_Specialty_4`, `Provider_Address_Type`, `Provider_Address`, `Provider_City`, `Provider_County`, `Provider_State`, `Provider_Zip`, `Provider_Phone`, `Provider_Fax`, `Provider_Mailing_Address`, `Provider_Mailing_City`, `Provider_Mailing_County`, `Provider_Mailing_State`, `Provider_Mailing_Zip`, `Provider_Mailing_Phone`, `Provider_Mailing_Fax`, `Provider_Primary_Schedule`, `Provider_Secondary_Schedule`, `Provider_Rate_Sheet`, `Provider_Anes_Rate`, `Provider_Default_Rate`, `Provider_Max_DOS`, `Provider_Min_Match_Value`, `Provider_Effective_Date`, `Provider_Term_Date`, `Provider_Pend`, `Provider_Anes_Minutes`, `Provider_PPO`, `Provider_Hospital_1`, `Provider_Hospital_2`, `Provider_Hospital_3`, `Provider_Hospital_4`, `Provider_Type`, `Provider_NPI`, `Provider_Check_Override`, `Exclude_Dir`, `Audit_Status`, `Last_Change_Date`, `Medicare_ID`, `Provider_Lang`, `Provider_Latitude`, `Provider_Longitude`, `Provider_school`, `Provider_cert`) VALUES
('522229954', 'W11014386', 'W11014386', 'UT01', 'Wasatch Peak Physical Therapy', 'Christopher', 'Greg', 'Packard', 'PT', 'Physical Therapy', NULL, NULL, NULL, 'O', '1492 W Antelope Dr Ste 100', 'Layton', 'Davis', 'UT', '84041', '8018258091', NULL, '1492 W Antelope Dr', 'Layton', 'Davis', 'UT', '84041', NULL, NULL, 'WestRehab', 'WUSTDHCPC5', NULL, '0.00', '0.00', '68.00', 3, '2009-11-01', '2009-01-01', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '0000008025', 0, 'N', 0, '2008-10-03', NULL, NULL, 0, 0, NULL, NULL),
('522229954', 'W11014421', 'W11014421', 'UT01', 'Professional Physical Therapy & Sports Medicine', 'Steven', 'J', 'Orrock', 'PT', 'Physical Therapy', NULL, NULL, NULL, 'O', '680 E Main St', 'Lehi', 'Utah', 'UT', '84043', '8017682723', NULL, '680 E Main St', 'Lehi', 'Utah', 'UT', '84043', '8017682723', '          ', 'WestRehab', 'WUSTDHCPC5', '', '0.00', '0.00', '68.00', 3, '2009-11-01', '2009-12-31', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1629125174', 0, 'N', 0, '2013-06-26', NULL, NULL, 0, 0, NULL, NULL),
('522229954', 'W11014029', 'W11014029', 'UT01', 'Professional Physical Therapy & Sports Medicine', 'Steven', 'J', 'Orrock', 'PT', 'Physical Therapy', NULL, NULL, NULL, 'O', '680 E Main St', 'Lehi', 'Utah', 'UT', '84043', '8017682723', NULL, '680 E Main St', 'Lehi', 'Utah', 'UT', '84043', '8017682723', '          ', 'WestRehab', 'WUSTDHCPC5', '', '0.00', '0.00', '65.00', 3, '2008-10-01', '2009-10-31', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1629125174', 0, 'N', 0, '2013-06-26', NULL, NULL, 0, 0, NULL, NULL),
('522229954', 'W11014247', 'W11014247', 'UT01', NULL, 'Michael', 'R', 'Bond', 'PT', 'Physical Therapy', NULL, NULL, NULL, 'O', '1305 N Commerce Dr Ste 100', 'Saratoga Springs', 'Utah', 'UT', '84043', '8017683105', NULL, '1305 N Commerce Dr', 'Saratoga Springs', 'Utah', 'UT', '84043', NULL, NULL, 'WestRehab', 'WUSTDHCPC5', NULL, '0.00', '0.00', '68.00', 3, '2009-11-01', '2009-11-01', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1518990183', 0, 'N', 0, '2008-10-03', NULL, NULL, 0, 0, NULL, NULL),
('522229954', 'W11014030', 'W11014030', 'UT01', 'Professional Physical Therapy & Sports Medicine', 'Wendell', 'Buck', 'Mendenhall', 'PT', 'Physical Therapy', '', '', NULL, 'O', '680 E Main St', 'Lehi', 'Utah', 'UT', '84043', '8017682723', NULL, '680 E Main St', 'Lehi', 'Utah', 'UT', '84043', '8017682723', '          ', 'WestRehab', 'WUSTDHCPC5', '', '0.00', '0.00', '65.00', 3, '2008-10-01', '2009-10-31', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1275682262', 0, 'N', 0, '2011-12-19', NULL, NULL, 0, 0, NULL, NULL),
('522229954', 'W11013855', 'W11013855', 'UT01', NULL, 'Michael', 'R', 'Bond', 'PT', 'Physical Therapy', NULL, NULL, NULL, 'O', '1305 N Commerce Dr Ste 100', 'Saratoga Springs', 'Utah', 'UT', '84043', '8017683105', NULL, '1305 N Commerce Dr', 'Saratoga Springs', 'Utah', 'UT', '84043', NULL, NULL, 'WestRehab', 'WUSTDHCPC5', NULL, '0.00', '0.00', '65.00', 3, '2008-10-01', '2009-04-01', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1518990183', 0, 'N', 0, '2008-10-03', NULL, NULL, 0, 0, NULL, NULL),
('522229954', 'W11014422', 'W11014422', 'UT01', 'Professional Physical Therapy & Sports Medicine', 'Wendell', 'Buck', 'Mendenhall', 'PT', 'Physical Therapy', '', '', NULL, 'O', '680 E Main St', 'Lehi', 'Utah', 'UT', '84043', '8017682723', NULL, '680 E Main St', 'Lehi', 'Utah', 'UT', '84043', '8017682723', '          ', 'WestRehab', 'WUSTDHCPC5', '', '0.00', '0.00', '68.00', 3, '2009-11-01', '2009-12-31', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1275682262', 0, 'N', 0, '2011-12-19', NULL, NULL, 0, 0, NULL, NULL),
('522229954', 'W11013841', 'W11013841', 'UT01', '', 'Noall', 'H', 'Latimer', 'PT', 'Physical Therapy', NULL, NULL, NULL, 'O', '3441 S 8400 W', 'Magna', 'Salt Lake', 'UT', '84044', '8012509107', NULL, '3441 S 8400 W', 'Magna', 'Salt Lake', 'UT', '84044', '8012509107', '          ', 'WestRehab', 'WUSTDHCPC5', '', '0.00', '0.00', '65.00', 3, '2008-10-01', '2009-10-31', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1932167665', 0, 'N', 0, '2012-06-21', NULL, NULL, 0, 0, NULL, NULL),
('522229954', 'W11014152', 'W11014152', 'UT01', 'Advanced Motion Physical Therapy', 'Daniel', '', 'Mcatee', 'DPT', 'Physical Therapy', '', '', NULL, 'O', '8089 W 3500 S', 'Magna', 'Salt Lake', 'UT', '84044', '8012506733', '8012505038', '8089 W 3500 S', 'Magna', 'Salt Lake', 'UT', '84044', '8012506733', '8012505038', 'WestRehab', 'WUSTDHCPC5', '', '0.00', '0.00', '65.00', 3, '2008-10-01', '2009-10-31', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1215057617', 0, 'N', 0, '2013-09-30', NULL, NULL, 0, 0, NULL, NULL),
('522229954', 'W11014172', 'W11014172', 'UT01', 'Advanced Motion Physical Therapy', 'Robert', 'Lance', 'Dougher', 'PT', 'Physical Therapy', NULL, NULL, NULL, 'O', '8089 W 3500 S', 'Magna', 'Salt Lake', 'UT', '84044', '8016281924', NULL, '8089 W 3500 S', 'Magna', 'Salt Lake', 'UT', '84044', NULL, NULL, 'WestRehab', 'WUSTDHCPC5', NULL, '0.00', '0.00', '68.00', 3, '2009-11-01', '2009-12-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1669458220', 0, 'N', 0, '2010-03-12', NULL, NULL, 0, 0, NULL, NULL),
('522229954', 'W11013780', 'W11013780', 'UT01', 'Advanced Motion Physical Therapy', 'Robert', 'Lance', 'Dougher', 'PT', 'Physical Therapy', NULL, NULL, NULL, 'O', '8089 W 3500 S', 'Magna', 'Salt Lake', 'UT', '84044', '8016281924', NULL, '8089 W 3500 S', 'Magna', 'Salt Lake', 'UT', '84044', NULL, NULL, 'WestRehab', 'WUSTDHCPC5', NULL, '0.00', '0.00', '65.00', 3, '2008-10-01', '2009-10-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1669458220', 0, 'N', 0, '2010-03-12', NULL, NULL, 0, 0, NULL, NULL),
('522229954', 'W11014233', 'W11014233', 'UT01', '', 'Noall', 'H', 'Latimer', 'PT', 'Physical Therapy', NULL, NULL, NULL, 'O', '3441 S 8400 W', 'Magna', 'Salt Lake', 'UT', '84044', '8012509107', NULL, '3441 S 8400 W', 'Magna', 'Salt Lake', 'UT', '84044', '8012509107', '          ', 'WestRehab', 'WUSTDHCPC5', '', '0.00', '0.00', '68.00', 3, '2009-11-01', '2009-12-31', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1932167665', 0, 'N', 0, '2012-06-21', NULL, NULL, 0, 0, NULL, NULL),
('522229954', 'W11014544', 'W11014544', 'UT01', 'Advanced Motion Physical Therapy', 'Daniel', '', 'Mcatee', 'DPT', 'Physical Therapy', '', '', NULL, 'O', '8089 W 3500 S', 'Magna', 'Salt Lake', 'UT', '84044', '8012506733', '8012505038', '8089 W 3500 S', 'Magna', 'Salt Lake', 'UT', '84044', '8012506733', '8012505038', 'WestRehab', 'WUSTDHCPC5', '', '0.00', '0.00', '68.00', 3, '2009-11-01', '2009-12-31', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1215057617', 0, 'N', 0, '2013-09-30', NULL, NULL, 0, 0, NULL, NULL),
('522229954', 'W11013809', 'W11013809', 'UT01', 'Morgan Valley Physical Therapy', 'Alan', 'John', 'Kerbs', 'PT', 'Physical Therapy', '', '', NULL, 'O', '103 N Commercial St', 'Morgan', 'Morgan', 'UT', '84050', '4358451403', NULL, '103 N Commercial St', 'Morgan', 'Morgan', 'UT', '84050', '4358451403', '          ', 'WestRehab', 'WUSTDHCPC5', '', '0.00', '0.00', '65.00', 3, '2008-10-01', '2009-10-31', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1952485625', 0, 'N', 0, '2012-02-08', NULL, NULL, 0, 0, NULL, NULL),
('522229954', 'W11014201', 'W11014201', 'UT01', 'Morgan Valley Physical Therapy', 'Alan', 'John', 'Kerbs', 'PT', 'Physical Therapy', '', '', NULL, 'O', '103 N Commercial St', 'Morgan', 'Morgan', 'UT', '84050', '4358451403', NULL, '103 N Commercial St', 'Morgan', 'Morgan', 'UT', '84050', '4358451403', '          ', 'WestRehab', 'WUSTDHCPC5', '', '0.00', '0.00', '68.00', 3, '2009-11-01', '2009-12-31', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1952485625', 0, 'N', 0, '2012-02-08', NULL, NULL, 0, 0, NULL, NULL),
('522229954', 'W11013852', 'W11013852', 'UT01', 'Physical & Sports Therapy Services', 'Craig', 'Alan', 'Schultz', 'PT', 'Physical Therapy', '', '', NULL, 'O', '684 W 800 N', 'Orem', 'Utah', 'UT', '84057', '8012242250', NULL, '684 W 800 N', 'Orem', 'Utah', 'UT', '84057', '8012242250', '          ', 'WestRehab', 'WUSTDHCPC5', '', '0.00', '0.00', '65.00', 3, '2008-10-01', '2009-10-31', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1508852484', 0, 'N', 0, '2011-10-26', NULL, NULL, 0, 0, NULL, NULL),
('522229954', 'W11013853', 'W11013853', 'UT01', 'Physical & Sports Therapy Services', 'William', '', 'Sumsion', 'PT', 'Physical Therapy', '', '', NULL, 'O', '684 W 800 N', 'Orem', 'Utah', 'UT', '84057', '8012242250', NULL, '684 W 800 N', 'Orem', 'Utah', 'UT', '84057', '8012242250', '          ', 'WestRehab', 'WUSTDHCPC5', '', '0.00', '0.00', '65.00', 3, '2008-10-01', '2009-10-31', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1659367845', 0, 'N', 0, '2011-10-26', NULL, NULL, 0, 0, NULL, NULL),
('522229954', 'W11014245', 'W11014245', 'UT01', 'Physical & Sports Therapy Services', 'William', '', 'Sumsion', 'PT', 'Physical Therapy', '', '', NULL, 'O', '684 W 800 N', 'Orem', 'Utah', 'UT', '84057', '8012242250', NULL, '684 W 800 N', 'Orem', 'Utah', 'UT', '84057', '8012242250', '          ', 'WestRehab', 'WUSTDHCPC5', '', '0.00', '0.00', '68.00', 3, '2009-11-01', '2009-12-31', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1659367845', 0, 'N', 0, '2011-10-26', NULL, NULL, 0, 0, NULL, NULL),
('522229954', 'W11014235', 'W11014235', 'UT01', 'Orem Sports Medicine', 'Ned', 'B', 'Bushnell', 'PT', 'Physical Therapy', '', '', NULL, 'O', '252 N State St', 'Orem', 'Utah', 'UT', '84057', '8012260599', NULL, '252 N State St', 'Orem', 'Utah', 'UT', '84057', '8012260599', '          ', 'WestRehab', 'WUSTDHCPC5', '', '0.00', '0.00', '68.00', 3, '2009-11-01', '2009-12-31', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1528050861', 0, 'N', 0, '2012-06-21', NULL, NULL, 0, 0, NULL, NULL),
('522229954', 'W11013843', 'W11013843', 'UT01', 'Orem Sports Medicine', 'Ned', 'B', 'Bushnell', 'PT', 'Physical Therapy', '', '', NULL, 'O', '252 N State St', 'Orem', 'Utah', 'UT', '84057', '8012260599', NULL, '252 N State St', 'Orem', 'Utah', 'UT', '84057', '8012260599', '          ', 'WestRehab', 'WUSTDHCPC5', '', '0.00', '0.00', '65.00', 3, '2008-10-01', '2009-10-31', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1528050861', 0, 'N', 0, '2012-06-21', NULL, NULL, 0, 0, NULL, NULL),
('522229954', 'W11014244', 'W11014244', 'UT01', 'Physical & Sports Therapy Services', 'Craig', 'Alan', 'Schultz', 'PT', 'Physical Therapy', '', '', NULL, 'O', '684 W 800 N', 'Orem', 'Utah', 'UT', '84057', '8012242250', NULL, '684 W 800 N', 'Orem', 'Utah', 'UT', '84057', '8012242250', '          ', 'WestRehab', 'WUSTDHCPC5', '', '0.00', '0.00', '68.00', 3, '2009-11-01', '2009-12-31', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1508852484', 0, 'N', 0, '2011-10-26', NULL, NULL, 0, 0, NULL, NULL),
('522229954', 'W11014505', 'W11014505', 'UT01', 'Orem Sports Medicine Center', 'Jeffrey', '', 'Kingsolver', 'PT', 'Physical Therapy', NULL, NULL, NULL, 'O', '252 N State St', 'Orem', 'Utah', 'UT', '84057', '8012260599', NULL, 'PO Box 74125', 'Salt Lake City', 'Utah', 'UT', '84171', NULL, NULL, 'WestRehab', 'WUSTDHCPC5', NULL, '0.00', '0.00', '68.00', 3, '2009-11-01', '2009-03-20', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1972687606', 0, 'N', 0, '2008-10-03', NULL, NULL, 0, 0, NULL, NULL),
('522229954', 'W11014113', 'W11014113', 'UT01', 'Orem Sports Medicine Center', 'Jeffrey', '', 'Kingsolver', 'PT', 'Physical Therapy', NULL, NULL, NULL, 'O', '252 N State St', 'Orem', 'Utah', 'UT', '84057', '8012260599', NULL, 'PO Box 74125', 'Salt Lake City', 'Utah', 'UT', '84171', NULL, NULL, 'WestRehab', 'WUSTDHCPC5', NULL, '0.00', '0.00', '65.00', 3, '2008-10-01', '2009-03-20', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1972687606', 0, 'N', 0, '2008-10-03', NULL, NULL, 0, 0, NULL, NULL),
('522229954', 'W11014504', 'W11014504', 'UT01', 'Blue Sky Therapeutics', 'Jessica', NULL, 'Kahn', 'MS OTR', 'Physical Therapy', NULL, NULL, NULL, 'O', '1901 Prospector Ave Ste 201', 'Park City', 'Summit', 'UT', '84060', '4356591746', NULL, 'PO Box 74125', 'Salt Lake City', 'Summit', 'UT', '84171', NULL, NULL, 'WestRehab', 'WUSTDHCPC5', NULL, '0.00', '0.00', '68.00', 3, '2009-11-01', '2009-12-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1992905350', 0, 'N', 0, '2009-11-30', NULL, NULL, 0, 0, NULL, NULL),
('522229954', 'W11014112', 'W11014112', 'UT01', 'Blue Sky Therapeutics', 'Jessica', NULL, 'Kahn', 'MS OTR', 'Physical Therapy', NULL, NULL, NULL, 'O', '1901 Prospector Ave Ste 201', 'Park City', 'Summit', 'UT', '84060', '4356591746', NULL, 'PO Box 74125', 'Salt Lake City', 'Summit', 'UT', '84171', NULL, NULL, 'WestRehab', 'WUSTDHCPC5', NULL, '0.00', '0.00', '65.00', 3, '2008-10-01', '2009-10-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1992905350', 0, 'N', 0, '2009-11-30', NULL, NULL, 0, 0, NULL, NULL),
('522229954', 'W11014501', 'W11014501', 'UT01', 'Bear Lake Physical Therapy', 'Kam', 'E', 'Jarman', 'PT', 'Physical Therapy', '', '', NULL, 'O', '350 N Main', 'Randolph', 'Rich', 'UT', '84064', '4359462777', NULL, '350 N Main', 'Randolph', 'Rich', 'UT', '84064', '4359462777', '          ', 'WestRehab', 'WUSTDHCPC5', '', '0.00', '0.00', '68.00', 3, '2009-11-01', '2009-12-31', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1710073523', 0, 'N', 0, '2012-06-29', NULL, NULL, 0, 0, NULL, NULL),
('522229954', 'W11014171', 'W11014171', 'UT01', 'Bear Lake Physical Therapy', 'Bryce', 'S', 'Woodfield', 'PT', 'Physical Therapy', '', '', NULL, 'O', '350 N Main', 'Randolph', 'Rich', 'UT', '84064', '4359462777', NULL, '350 N Main', 'Randolph', 'Rich', 'UT', '84064', '4359462777', '          ', 'WestRehab', 'WUSTDHCPC5', '', '0.00', '0.00', '68.00', 3, '2009-11-01', '2009-12-31', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1063508885', 0, 'N', 0, '2012-08-16', NULL, NULL, 0, 0, NULL, NULL),
('522229954', 'W11014109', 'W11014109', 'UT01', 'Bear Lake Physical Therapy', 'Kam', 'E', 'Jarman', 'PT', 'Physical Therapy', '', '', NULL, 'O', '350 N Main', 'Randolph', 'Rich', 'UT', '84064', '4359462777', NULL, '350 N Main', 'Randolph', 'Rich', 'UT', '84064', '4359462777', '          ', 'WestRehab', 'WUSTDHCPC5', '', '0.00', '0.00', '65.00', 3, '2008-10-01', '2009-10-31', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1710073523', 0, 'N', 0, '2012-06-29', NULL, NULL, 0, 0, NULL, NULL),
('522229954', 'W11013779', 'W11013779', 'UT01', 'Bear Lake Physical Therapy', 'Bryce', 'S', 'Woodfield', 'PT', 'Physical Therapy', '', '', NULL, 'O', '350 N Main', 'Randolph', 'Rich', 'UT', '84064', '4359462777', NULL, '350 N Main', 'Randolph', 'Rich', 'UT', '84064', '4359462777', '          ', 'WestRehab', 'WUSTDHCPC5', '', '0.00', '0.00', '65.00', 3, '2008-10-01', '2009-10-31', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1063508885', 0, 'N', 0, '2012-08-16', NULL, NULL, 0, 0, NULL, NULL),
('522229954', 'W11014194', 'W11014194', 'UT01', 'Herriman Physical Therapy', 'Shaun', 'S', 'Schultz', 'PT', 'Physical Therapy', '', '', NULL, 'O', '5734 W 13400 S', 'Herriman', 'Salt Lake', 'UT', '84065', '8013027232', NULL, '5734 W 13400 S', 'Herriman', 'Salt Lake', 'UT', '84065', '8013027232', '          ', 'WestRehab', 'WUSTDHCPC5', '', '0.00', '0.00', '68.00', 3, '2009-11-01', '2009-12-31', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1295783702', 0, 'N', 0, '2011-04-19', NULL, NULL, 0, 0, NULL, NULL),
('522229954', 'W11014155', 'W11014155', 'UT01', 'Herriman Physical Therapy', 'Paul', NULL, 'Smith', 'DPT', 'Physical Therapy', NULL, NULL, NULL, 'O', '5734 W 13400 S', 'Herriman', 'Salt Lake', 'UT', '84065', '8013027232', '8013027237', NULL, NULL, 'Salt Lake', NULL, NULL, NULL, NULL, 'WestRehab', 'WUSTDHCPC5', NULL, '0.00', '0.00', '65.00', 3, '2008-10-01', '2008-12-08', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1023276375', 0, 'N', 0, '2008-10-03', NULL, NULL, 0, 0, NULL, NULL),
('522229954', 'W11014240', 'W11014240', 'UT01', 'Physical & Sports Therapy Services', 'Darren', '', 'Averett', 'PT', 'Physical Therapy', '', '', NULL, 'O', '15 S 1000 W Ste 25', 'Payson', 'Utah', 'UT', '84651', '8014655610', '8014655615', '15 S 1000 W Ste 25', 'Payson', 'Utah', 'UT', '84651', '8014655610', '8014655615', 'WestRehab', 'WUSTDHCPC5', '', '0.00', '0.00', '68.00', 3, '2009-11-01', '2009-12-31', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1548232549', 0, 'N', 0, '2011-04-21', NULL, NULL, 0, 0, NULL, NULL),
('522229954', 'W11014547', 'W11014547', 'UT01', 'Herriman Physical Therapy', 'Paul', NULL, 'Smith', 'DPT', 'Physical Therapy', NULL, NULL, NULL, 'O', '5734 W 13400 S', 'Herriman', 'Salt Lake', 'UT', '84065', '8013027232', '8013027237', NULL, NULL, 'Salt Lake', NULL, NULL, NULL, NULL, 'WestRehab', 'WUSTDHCPC5', NULL, '0.00', '0.00', '68.00', 3, '2009-11-01', '2009-11-01', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1023276375', 0, 'N', 0, '2008-10-03', NULL, NULL, 0, 0, NULL, NULL),
('522229954', 'W11013848', 'W11013848', 'UT01', 'Physical & Sports Therapy Services', 'Darren', '', 'Averett', 'PT', 'Physical Therapy', '', '', NULL, 'O', '15 S 1000 W Ste 25', 'Payson', 'Utah', 'UT', '84651', '8014655610', '8014655615', '15 S 1000 W Ste 25', 'Payson', 'Utah', 'UT', '84651', '8014655610', '8014655615', 'WestRehab', 'WUSTDHCPC5', '', '0.00', '0.00', '65.00', 3, '2008-10-01', '2009-10-31', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1548232549', 0, 'N', 0, '2011-04-21', NULL, NULL, 0, 0, NULL, NULL),
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('522229954', 'W11014209', 'W11014209', 'UT01', 'Mountain Land Rehabilitation', 'Craig', 'A', 'Packham', 'PA-C', 'Orthopedic Surgery', 'Physical Therapy', NULL, NULL, 'O', '29 S Main St', 'Tooele', 'Tooele', 'UT', '84074', '4358437466', NULL, '29 S Main St', 'Tooele', 'Tooele', 'UT', '84074', NULL, NULL, 'WestRehab', 'WUSTDHCPC5', NULL, '0.00', '0.00', '68.00', 3, '2009-11-01', '2009-12-31', 0, 0, 0, 'Mountain West Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1104920354', 0, 'N', 0, '2009-09-15', NULL, NULL, 0, 0, NULL, NULL),
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('522229954', 'W11013808', 'W11013808', 'UT01', 'Meier & Marsh Professional Therapies', 'Charles', 'Wade', 'Meier', 'PT', 'Physical Therapy', '', '', NULL, 'O', '1929 N Aaron Dr Ste K', 'Tooele', 'Tooele', 'UT', '84074', '4358431311', NULL, '1929 N Aaron Dr Ste K', 'Tooele', 'Tooele', 'UT', '84074', '4358431311', '          ', 'WestRehab', 'WUSTDHCPC5', '', '0.00', '0.00', '65.00', 3, '2008-10-01', '2009-10-31', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1699767954', 0, 'N', 0, '2011-04-22', NULL, NULL, 0, 0, NULL, NULL),
('522229954', 'W11013820', 'W11013820', 'UT01', 'Mountain Land Rehabilitation', 'Jill', '', 'Thurber', 'PT', 'Physical Therapy', '', '', NULL, 'O', '2055 N Main St', 'Tooele', 'Tooele', 'UT', '84074', '4358433737', NULL, '2055 N Main St', 'Tooele', 'Tooele', 'UT', '84074', '4358433737', '          ', 'WestRehab', 'WUSTDHCPC5', '', '0.00', '0.00', '65.00', 3, '2008-10-01', '2009-10-31', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1336242924', 0, 'N', 0, '2011-10-26', NULL, NULL, 0, 0, NULL, NULL),
('522229954', 'W11013817', 'W11013817', 'UT01', 'Mountain Land Rehabilitation', 'Craig', 'A', 'Packham', 'PA-C', 'Orthopedic Surgery', 'Physical Therapy', NULL, NULL, 'O', '29 S Main St', 'Tooele', 'Tooele', 'UT', '84074', '4358437466', NULL, '29 S Main St', 'Tooele', 'Tooele', 'UT', '84074', NULL, NULL, 'WestRehab', 'WUSTDHCPC5', NULL, '0.00', '0.00', '65.00', 3, '2008-10-01', '2009-10-31', 0, 0, 0, 'Mountain West Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1104920354', 0, 'N', 0, '2009-09-15', NULL, NULL, 0, 0, NULL, NULL),
('522229954', 'W11014125', 'W11014125', 'UT01', 'Mountain Land Rehab/ Pinnacle Tooele', 'Robert', 'Oliver', 'Pagani', 'PT', 'Physical Therapy', NULL, NULL, NULL, 'O', '29 S Main St', 'Tooele', 'Tooele', 'UT', '84074', '4358437466', NULL, '29 S Main St', 'Tooele', 'Tooele', 'UT', '84074', '4358437466', '          ', 'WestRehab', 'WUSTDHCPC5', '', '0.00', '0.00', '65.00', 3, '2008-10-01', '2009-10-31', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1790977692', 0, 'N', 0, '2011-04-20', NULL, NULL, 0, 0, NULL, NULL),
('522229954', 'W11013985', 'W11013985', 'UT01', 'Ashley Creek Physical Therapy', 'Jerry', 'D', 'Kulland', 'PT', 'Physical Therapy', '', '', NULL, 'O', '1180 N Vernal Ave', 'Vernal', 'Uintah', 'UT', '84078', '4357890022', NULL, '1180 N Vernal Ave', 'Vernal', 'Uintah', 'UT', '84078', '4357890022', '          ', 'WestRehab', 'WUSTDHCPC5', '', '0.00', '0.00', '65.00', 3, '2008-10-01', '2009-10-31', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1194721704', 0, 'N', 0, '2012-06-21', NULL, NULL, 0, 0, NULL, NULL),
('522229954', 'W11014377', 'W11014377', 'UT01', 'Ashley Creek Physical Therapy', 'Jerry', 'D', 'Kulland', 'PT', 'Physical Therapy', '', '', NULL, 'O', '1180 N Vernal Ave', 'Vernal', 'Uintah', 'UT', '84078', '4357890022', NULL, '1180 N Vernal Ave', 'Vernal', 'Uintah', 'UT', '84078', '4357890022', '          ', 'WestRehab', 'WUSTDHCPC5', '', '0.00', '0.00', '68.00', 3, '2009-11-01', '2009-12-31', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1194721704', 0, 'N', 0, '2012-06-21', NULL, NULL, 0, 0, NULL, NULL),
('522229954', 'W11014127', 'W11014127', 'UT01', 'Utah Physical Therapy Specialists', 'Brian', NULL, 'Rodriguez', 'PT', 'Physical Therapy', NULL, NULL, NULL, 'O', '2700 W 8969 S', 'West Jordan', 'Salt Lake', 'UT', '84088', '8015611061', NULL, 'PO Box 74125', 'Salt Lake City', 'Salt Lake', 'UT', '84171', NULL, NULL, 'WestRehab', 'WUSTDHCPC5', NULL, '0.00', '0.00', '65.00', 3, '2008-10-01', '2009-10-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1336223007', 0, 'N', 0, '2009-11-30', NULL, NULL, 0, 0, NULL, NULL),
('522229954', 'W11014250', 'W11014250', 'UT01', 'Registered Physical Therapists', 'Josh', 'Douglas', 'Boulton', 'PT', 'Physical Therapy', NULL, NULL, NULL, 'O', '1577 W 7000 S Ste 100', 'West Jordan', 'Salt Lake', 'UT', '84088', '8015666301', NULL, '1577 W 7000 S', 'West Jordan', 'Salt Lake', 'UT', '84088', NULL, NULL, 'WestRehab', 'WUSTDHCPC5', NULL, '0.00', '0.00', '68.00', 3, '2009-11-01', '2009-11-01', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1457338550', 0, 'N', 0, '2008-10-03', NULL, NULL, 0, 0, NULL, NULL),
('522229954', 'W11014488', 'W11014488', 'UT01', 'Mountain Land Rehabilitation', 'Joshua', NULL, 'Fuhriman', 'PT', 'Physical Therapy', NULL, NULL, NULL, 'O', '4624 S Holladay Blvd', 'Salt Lake City', 'Salt Lake', 'UT', '84117', '8012771028', NULL, 'PO Box 74125', 'Salt Lake City', 'Salt Lake', 'UT', '84171', NULL, NULL, 'WestRehab', 'WUSTDHCPC5', NULL, '0.00', '0.00', '68.00', 3, '2009-11-01', '2009-12-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1023105491', 0, 'N', 0, '2008-10-03', NULL, NULL, 0, 0, NULL, NULL),
('522229954', 'W11013773', 'W11013773', 'UT01', 'Registered Physical Therapists', 'Russell', 'L', 'Clarke', 'PT', 'Physical Therapy', NULL, NULL, NULL, 'O', '1577 W 7000 S Ste 100', 'West Jordan', 'Salt Lake', 'UT', '84088', '8015666301', NULL, 'PO Box 74125', 'Salt Lake City', 'Salt Lake', 'UT', '84171', NULL, NULL, 'WestRehab', 'WUSTDHCPC5', NULL, '0.00', '0.00', '65.00', 3, '2008-10-01', '2008-10-01', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1396894267', 0, 'N', 0, '2008-10-03', NULL, NULL, 0, 0, NULL, NULL),
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('522229954', 'W11014205', 'W11014205', 'UT01', 'Mountain Land Rehabilitation', 'Christopher', 'W', 'Harper', 'PT', 'Physical Therapy', '', '', NULL, 'O', '9301 S Wights Fort Rd', 'West Jordan', 'Salt Lake', 'UT', '84088', '8012822200', NULL, '9301 S Wights Fort Rd', 'West Jordan', 'Salt Lake', 'UT', '84088', '8012822200', '          ', 'WestRehab', 'WUSTDHCPC5', '', '0.00', '0.00', '68.00', 3, '2009-11-01', '2009-12-31', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1902900426', 0, 'N', 0, '2013-05-06', NULL, NULL, 0, 0, NULL, NULL),
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('522229954', 'W11014165', 'W11014165', 'UT01', 'Registered Physical Therapists', 'Russell', 'L', 'Clarke', 'PT', 'Physical Therapy', NULL, NULL, NULL, 'O', '1577 W 7000 S Ste 100', 'West Jordan', 'Salt Lake', 'UT', '84088', '8015666301', NULL, 'PO Box 74125', 'Salt Lake City', 'Salt Lake', 'UT', '84171', NULL, NULL, 'WestRehab', 'WUSTDHCPC5', NULL, '0.00', '0.00', '68.00', 3, '2009-11-01', '2009-12-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1396894267', 0, 'N', 0, '2008-10-03', NULL, NULL, 0, 0, NULL, NULL),
('522229954', 'W11014248', 'W11014248', 'UT01', 'Registered Physical Therapists', 'Scott', 'C', 'Benson', 'PT', 'Physical Therapy', '', '', NULL, 'O', '1577 W 7000 S Ste 100', 'West Jordan', 'Salt Lake', 'UT', '84088', '8015666301', NULL, '1577 W 7000 S Ste 100', 'West Jordan', 'Salt Lake', 'UT', '84088', '8015666301', '          ', 'WestRehab', '', '', '0.00', '0.00', '68.00', 3, '2009-11-01', '2009-12-31', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1447237490', 0, 'N', 0, '2011-10-20', 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
('522229954', 'W11014091', 'W11014091', 'UT01', 'Registered Physical Therapists', 'Jeffrey', '', 'Eckert', 'PT', 'Physical Therapy', '', '', NULL, 'O', '1578 W 7000 S Ste 100', 'West Jordan', 'Salt Lake', 'UT', '84088', '8015666301', NULL, '1578 W 7000 S Ste 100', 'West Jordan', 'Salt Lake', 'UT', '84088', '8015666301', '          ', 'WestRehab', 'WUSTDHCPC5', '', '0.00', '0.00', '65.00', 3, '2008-10-01', '2009-10-31', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1144404831', 0, 'N', 0, '2011-10-20', NULL, NULL, 0, 0, NULL, NULL),
('522229954', 'W11014230', 'W11014230', 'UT01', 'Mountain Land Sports & Orthopedic Physical Therapy', 'Josh', 'David', 'Fuhriman', 'PT', 'Physical Therapy', '', '', NULL, 'O', '9301 S Wights Fort Rd', 'West Jordan', 'Salt Lake', 'UT', '84088', '8012822200', NULL, '9301 S Wights Fort Rd', 'West Jordan', 'Salt Lake', 'UT', '84088', '8012822200', '          ', 'WestRehab', 'WUSTDHCPC5', '', '0.00', '0.00', '68.00', 3, '2009-11-01', '2009-12-31', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1376649400', 0, 'N', 0, '2011-06-13', NULL, NULL, 0, 0, NULL, NULL),
('522229954', 'W11013813', 'W11013813', 'UT01', 'Mountain Land Rehabilitation', 'Christopher', 'W', 'Harper', 'PT', 'Physical Therapy', '', '', NULL, 'O', '9301 S Wights Fort Rd', 'West Jordan', 'Salt Lake', 'UT', '84088', '8012822200', NULL, '9301 S Wights Fort Rd', 'West Jordan', 'Salt Lake', 'UT', '84088', '8012822200', '          ', 'WestRehab', 'WUSTDHCPC5', '', '0.00', '0.00', '65.00', 3, '2008-10-01', '2009-10-31', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1902900426', 0, 'N', 0, '2013-05-06', NULL, NULL, 0, 0, NULL, NULL),
('522229954', 'W11014116', 'W11014116', 'UT01', 'Mountain Land Rehabilitation', 'Deanna', NULL, 'Mackay-Clark', 'OT', 'Physical Therapy', NULL, NULL, NULL, 'O', '9301 S Wights Fort Rd', 'West Jordan', 'Salt Lake', 'UT', '84088', '8012822200', NULL, 'PO Box 74125', 'Salt Lake City', 'Salt Lake', 'UT', '84171', NULL, NULL, 'WestRehab', 'WUSTDHCPC5', NULL, '0.00', '0.00', '65.00', 3, '2008-10-01', '2009-10-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1134217904', 0, 'N', 0, '2008-10-03', NULL, NULL, 0, 0, NULL, NULL),
('522229954', 'W11014519', 'W11014519', 'UT01', 'Jordan Valley Physical Therapy LLC', 'Brian', NULL, 'Rodriguez', 'PT', 'Physical Therapy', NULL, NULL, NULL, 'O', '2700 W 8969 S', 'West Jordan', 'Salt Lake', 'UT', '84088', '8015611061', NULL, 'PO Box 74125', 'Salt Lake City', 'Salt Lake', 'UT', '84171', NULL, NULL, 'WestRehab', 'WUSTDHCPC5', NULL, '0.00', '0.00', '68.00', 3, '2009-11-01', '2009-12-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1336223007', 0, 'N', 0, '2009-11-30', NULL, NULL, 0, 0, NULL, NULL),
('522229954', 'W11014157', 'W11014157', 'UT01', 'Rocky Mountain First Med', 'Matthew', NULL, 'Wilkinson', 'DPT', 'Physical Therapy', NULL, NULL, NULL, 'O', '8822  S Redwood Rd Ste E122', 'West Jordan ', 'Salt Lake', 'UT', '84088', '8015667080', '8012561133', NULL, NULL, 'Salt Lake', NULL, NULL, NULL, NULL, 'WestRehab', 'WUSTDHCPC5', NULL, '0.00', NULL, '65.00', 3, '2000-01-01', '2000-01-01', 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1386665917', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('522229954', 'W11014483', 'W11014483', 'UT01', 'Registered Physical Therapists', 'Jeffrey', '', 'Eckert', 'PT', 'Physical Therapy', '', '', NULL, 'O', '1578 W 7000 S Ste 100', 'West Jordan', 'Salt Lake', 'UT', '84088', '8015666301', NULL, '1578 W 7000 S Ste 100', 'West Jordan', 'Salt Lake', 'UT', '84088', '8015666301', '          ', 'WestRehab', 'WUSTDHCPC5', '', '0.00', '0.00', '68.00', 3, '2009-11-01', '2009-12-31', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1144404831', 0, 'N', 0, '2011-10-20', NULL, NULL, 0, 0, NULL, NULL),
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INSERT INTO `providers_new` (`Provider_Tax_ID`, `Provider_Suffix`, `Provider_Network_ID`, `Provider_Region`, `Provider_Name`, `Provider_Doctor_First_Name`, `Provider_Doctor_Middle_Name`, `Provider_Doctor_Last_Name`, `Provider_Doctor_Degree`, `Provider_Specialty_1`, `Provider_Specialty_2`, `Provider_Specialty_3`, `Provider_Specialty_4`, `Provider_Address_Type`, `Provider_Address`, `Provider_City`, `Provider_County`, `Provider_State`, `Provider_Zip`, `Provider_Phone`, `Provider_Fax`, `Provider_Mailing_Address`, `Provider_Mailing_City`, `Provider_Mailing_County`, `Provider_Mailing_State`, `Provider_Mailing_Zip`, `Provider_Mailing_Phone`, `Provider_Mailing_Fax`, `Provider_Primary_Schedule`, `Provider_Secondary_Schedule`, `Provider_Rate_Sheet`, `Provider_Anes_Rate`, `Provider_Default_Rate`, `Provider_Max_DOS`, `Provider_Min_Match_Value`, `Provider_Effective_Date`, `Provider_Term_Date`, `Provider_Pend`, `Provider_Anes_Minutes`, `Provider_PPO`, `Provider_Hospital_1`, `Provider_Hospital_2`, `Provider_Hospital_3`, `Provider_Hospital_4`, `Provider_Type`, `Provider_NPI`, `Provider_Check_Override`, `Exclude_Dir`, `Audit_Status`, `Last_Change_Date`, `Medicare_ID`, `Provider_Lang`, `Provider_Latitude`, `Provider_Longitude`, `Provider_school`, `Provider_cert`) VALUES
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('522229954', 'W11014436', 'W11014436', 'UT01', 'Wasatch Peak Physical Therapy', 'Carlyle (Kim)', 'A', 'Brown', 'PT', 'Physical Therapy', NULL, NULL, NULL, 'B', 'PO Box 74125', 'Salt Lake City', 'Salt Lake', 'UT', '84171', '8019422729', NULL, NULL, NULL, 'Salt Lake', NULL, NULL, NULL, NULL, 'WestRehab', 'WUSTDHCPC5', NULL, '0.00', '0.00', '68.00', 3, '2009-11-01', '2009-12-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1962526293', 0, 'Y', 0, '2009-11-30', 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
('522229954', 'W11014435', 'W11014435', 'UT01', 'The Fit Stop', 'Tyler', 'Wilson', 'Bluth', 'PT', 'Physical Therapy', '', '', NULL, 'B', 'PO Box 74125', 'Salt Lake City', 'Salt Lake', 'UT', '84171', '8019422729', NULL, 'PO Box 74125', 'Salt Lake City', 'Salt Lake', 'UT', '84171', '8019422729', '          ', 'WestRehab', 'WUSTDHCPC5', '', '0.00', '0.00', '68.00', 3, '2009-11-01', '2009-12-31', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1457325672', 0, 'Y', 0, '2011-04-19', NULL, NULL, 0, 0, NULL, NULL),
('522229954', 'W11014437', 'W11014437', 'UT01', 'Peak Physical Therapy & Sports Medicine', 'Edward', 'H', 'Budge', 'PT', 'Physical Therapy', NULL, NULL, NULL, 'B', 'PO Box 74125', 'Salt Lake City', 'Salt Lake', 'UT', '84171', '8019422729', NULL, 'PO Box 74125', 'Salt Lake City', 'Salt Lake', 'UT', '84171', '8019422729', '          ', 'WestRehab', 'WUSTDHCPC5', '', '0.00', '0.00', '68.00', 3, '2009-11-01', '2009-12-31', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1417957291', 0, 'Y', 0, '2013-06-21', NULL, NULL, 0, 0, NULL, NULL),
('522229954', 'W11014438', 'W11014438', 'UT01', 'Wasatch Peak Physical Therapy', 'Sheldon', NULL, 'Cox', 'PT', 'Physical Therapy', NULL, NULL, NULL, 'B', 'PO Box 74125', 'Salt Lake City', 'Salt Lake', 'UT', '84171', '8019422729', NULL, NULL, NULL, 'Salt Lake', NULL, NULL, NULL, NULL, 'WestRehab', 'WUSTDHCPC5', NULL, '0.00', '0.00', '68.00', 3, '2009-11-01', '2009-12-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1780709022', 0, 'Y', 0, '2009-11-30', NULL, NULL, 0, 0, NULL, NULL),
('522229954', 'W11014439', 'W11014439', 'UT01', 'Advanced Motion Physical Therapy', 'Robert', 'Lance', 'Dougher', 'PT', 'Physical Therapy', NULL, NULL, NULL, 'B', 'PO Box 74125', 'Salt Lake City', 'Salt Lake', 'UT', '84171', '8019422729', NULL, NULL, NULL, 'Salt Lake', NULL, NULL, NULL, NULL, 'WestRehab', 'WUSTDHCPC5', NULL, '0.00', '0.00', '68.00', 3, '2009-11-01', '2009-12-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1669458220', 0, 'Y', 0, '2010-03-12', NULL, NULL, 0, 0, NULL, NULL),
('522229954', 'W11014440', 'W11014440', 'UT01', 'ProRehab Physical Therapy', 'Mike', 'A', 'Gagon', 'PT', 'Physical Therapy', '', '', NULL, 'B', 'PO Box 74125', 'Salt Lake City', 'Salt Lake', 'UT', '84171', '8019422729', NULL, 'PO Box 74125', 'Salt Lake City', 'Salt Lake', 'UT', '84171', '8019422729', '          ', 'WestRehab', 'WUSTDHCPC5', '', '0.00', '0.00', '68.00', 3, '2009-11-01', '2009-12-31', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1700807484', 0, 'Y', 0, '2011-04-22', NULL, NULL, 0, 0, NULL, NULL),
('522229954', 'W11014441', 'W11014441', 'UT01', 'Wasatch Peak Physical Therapy', 'Hugh', 'J', 'Hansen', 'MA SLP', 'Physical Therapy', 'Speech Therapy', NULL, NULL, 'B', 'PO Box 74125', 'Salt Lake City', 'Salt Lake', 'UT', '84171', '8019422729', NULL, NULL, NULL, 'Salt Lake', NULL, NULL, NULL, NULL, 'WestRehab', 'WUSTDHCPC5', NULL, '0.00', '0.00', '68.00', 3, '2009-11-01', '2009-12-31', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1275565830', 0, 'Y', 0, '2011-10-10', NULL, NULL, 0, 0, NULL, NULL),
('522229954', 'W11013964', 'W11013964', 'UT01', 'Rocky Mountain Therapy Services', 'Todd', 'Elliot', 'Brown', 'PT', 'Physical Therapy', '', '', NULL, 'B', 'PO Box 74125', 'Salt Lake City', 'Salt Lake', 'UT', '84171', '8019422729', NULL, 'PO Box 74125', 'Salt Lake City', 'Salt Lake', 'UT', '84171', '8019422729', '          ', 'WestRehab', 'WUSTDHCPC5', '', '0.00', '0.00', '65.00', 3, '2008-10-01', '2009-10-31', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1093708166', 0, 'Y', 0, '2011-11-01', NULL, NULL, 0, 0, NULL, NULL),
('522229954', 'W11013977', 'W11013977', 'UT01', 'Wasatch Therapy', 'Marilyn', 'Kay', 'Lyman', 'OT', 'Occupational Therapy', 'Physical Therapy', NULL, NULL, 'B', 'PO Box 74125', 'Salt Lake City', 'Salt Lake', 'UT', '84171', '8019422729', NULL, NULL, NULL, 'Salt Lake', NULL, NULL, NULL, NULL, 'WestRehab', 'WUSTDHCPC5', NULL, '0.00', '0.00', '65.00', 3, '2008-10-01', '2009-10-01', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1174615090', 0, 'Y', 0, '2008-10-03', NULL, NULL, 0, 0, NULL, NULL),
('522229954', 'W11014433', 'W11014433', 'UT01', 'Southwest Neurological Rehabilitation Center', 'Steven', 'Clark', 'Bennett', 'PT', 'Physical Therapy', '', '', NULL, 'B', 'PO Box 74125', 'Salt Lake City', 'Salt Lake', 'UT', '84171', '8019422729', NULL, 'PO Box 74125', 'Salt Lake City', 'Salt Lake', 'UT', '84171', '8019422729', '          ', 'WestRehab', 'WUSTDHCPC5', '', '0.00', '0.00', '68.00', 3, '2009-11-01', '2009-12-31', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1205911872', 0, 'Y', 0, '2013-10-16', NULL, NULL, 0, 0, NULL, NULL),
('522229954', 'W11013975', 'W11013975', 'UT01', 'Sports Medicine Clinic', 'Chris', 'H', 'Dahlberg', 'PT', 'Physical Therapy', '', '', NULL, 'B', 'PO Box 74125', 'Salt Lake City', 'Salt Lake', 'UT', '84171', '8019422729', NULL, 'PO Box 74125', 'Salt Lake City', 'Salt Lake', 'UT', '84171', '8019422729', '          ', 'WestRehab', 'WUSTDHCPC5', '', '0.00', '0.00', '65.00', 3, '2008-10-01', '2009-10-31', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1366553208', 0, 'Y', 0, '2012-01-10', NULL, NULL, 0, 0, NULL, NULL),
('522229954', 'W11013981', 'W11013981', 'UT01', 'Wasatch Therapy', 'Melissa', 'A', 'Ita Echau', 'PT', 'Physical Therapy', NULL, NULL, NULL, 'B', 'PO Box 74125', 'Salt Lake City', 'Salt Lake', 'UT', '84171', '8019422729', NULL, NULL, NULL, 'Salt Lake', NULL, NULL, NULL, NULL, 'WestRehab', 'WUSTDHCPC5', NULL, '0.00', '0.00', '65.00', 3, '2008-10-01', '2009-10-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '0000006883', 0, 'Y', 0, '2008-10-03', NULL, NULL, 0, 0, NULL, NULL),
('522229954', 'W11013980', 'W11013980', 'UT01', 'Wasatch Therapy', 'Robyn', 'M', 'Judd', 'DPT', 'Physical Therapy', '', '', NULL, 'B', 'PO Box 74125', 'Salt Lake City', 'Salt Lake', 'UT', '84171', '8019422729', NULL, 'PO Box 74125', 'Salt Lake City', 'Salt Lake', 'UT', '84171', '8019422729', '          ', 'WestRehab', 'WUSTDHCPC5', '', '0.00', '0.00', '65.00', 3, '2008-10-01', '2009-10-31', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1295834679', 0, 'Y', 0, '2011-11-01', NULL, NULL, 0, 0, NULL, NULL),
('522229954', 'W11013979', 'W11013979', 'UT01', 'Wasatch Therapy', 'Ernest', 'Casias', 'Chavez', 'PT', 'Physical Therapy', '', '', NULL, 'B', 'PO Box 74125', 'Salt Lake City', 'Salt Lake', 'UT', '84171', '8019422729', NULL, 'PO Box 74125', 'Salt Lake City', 'Salt Lake', 'UT', '84171', '8019422729', '          ', 'WestRehab', 'WUSTDHCPC5', '', '0.00', '0.00', '65.00', 3, '2008-10-01', '2009-10-31', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1013016559', 0, 'Y', 0, '2011-04-21', NULL, NULL, 0, 0, NULL, NULL),
('522229954', 'W11013978', 'W11013978', 'UT01', 'Wasatch Therapy', 'Elizabeth', 'A', 'Hall', 'PT', 'Physical Therapy', NULL, NULL, NULL, 'B', 'PO Box 74125', 'Salt Lake City', 'Salt Lake', 'UT', '84171', '8019422729', NULL, NULL, NULL, 'Salt Lake', NULL, NULL, NULL, NULL, 'WestRehab', 'WUSTDHCPC5', NULL, '0.00', '0.00', '65.00', 3, '2008-10-01', '2008-10-01', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1457443376', 0, 'Y', 0, '2008-10-03', NULL, NULL, 0, 0, NULL, NULL),
('522229954', 'W11014455', 'W11014455', 'UT01', 'Wasatch Peak Physical Therapy', 'Kent', 'C', 'Logan', 'PT', 'Physical Therapy', '', '', NULL, 'B', 'PO Box 74125', 'Salt Lake City', 'Salt Lake', 'UT', '84171', '8019422729', NULL, NULL, NULL, 'Salt Lake', NULL, NULL, NULL, NULL, 'WestRehab', 'WUSTDHCPC5', NULL, '0.00', '0.00', '68.00', 3, '2009-11-01', '2009-12-31', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1467577718', 0, 'Y', 0, '2011-09-13', NULL, NULL, 0, 0, NULL, NULL),
('522229954', 'W11014458', 'W11014458', 'UT01', 'Registered Physical Therapists', 'Drew', 'Richard', 'Norwood', 'PT', 'Physical Therapy', '', '', NULL, 'B', 'PO Box 74125', 'Salt Lake City', 'Salt Lake', 'UT', '84171', '8019422729', NULL, 'PO Box 74125', 'Salt Lake City', 'Salt Lake', 'UT', '84171', '8019422729', '          ', 'WestRehab', 'WUSTDHCPC5', '', '0.00', '0.00', '68.00', 3, '2009-11-01', '2009-12-31', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1851378830', 0, 'Y', 0, '2011-10-20', NULL, NULL, 0, 0, NULL, NULL),
('522229954', 'W11014434', 'W11014434', 'UT01', 'The Fit Stop', 'Alan', 'Wilson', 'Bluth', 'PT', 'Physical Therapy', NULL, NULL, NULL, 'B', 'PO Box 74125', 'Salt Lake City', 'Salt Lake', 'UT', '84171', '8019422729', NULL, 'PO Box 74125', 'Salt Lake City', 'Salt Lake', 'UT', '84171', '8019422729', '          ', 'WestRehab', 'WUSTDHCPC5', '', '0.00', '0.00', '68.00', 3, '2009-11-01', '2009-12-31', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1568436681', 0, 'Y', 0, '2012-04-18', NULL, NULL, 0, 0, NULL, NULL),
('522229954', 'W11013976', 'W11013976', 'UT01', 'Summit Valley Physical Therapy', 'Byron', 'H', 'Horner', 'PT', 'Physical Therapy', '', '', NULL, 'B', 'PO Box 74125', 'Salt Lake City', 'Salt Lake', 'UT', '84171', '8019422729', NULL, 'PO Box 74125', 'Salt Lake City', 'Salt Lake', 'UT', '84171', '8019422729', '          ', 'WestRehab', 'WUSTDHCPC5', '', '0.00', '0.00', '65.00', 3, '2008-10-01', '2009-10-31', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1710061460', 0, 'Y', 0, '2013-12-30', NULL, NULL, 0, 0, NULL, NULL),
('522229954', 'W11013942', 'W11013942', 'UT01', 'Performance West Physical Therapy', 'Klementina', '', 'Buchheister', 'PT', 'Physical Therapy', '', '', NULL, 'B', 'PO Box 74125', 'Salt Lake City', 'Salt Lake', 'UT', '84171', '8019422729', NULL, 'PO Box 74125', 'Salt Lake City', 'Salt Lake', 'UT', '84171', '8019422729', '          ', 'WestRehab', 'WUSTDHCPC5', '', '0.00', '0.00', '65.00', 3, '2008-10-01', '2009-10-31', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1447242847', 0, 'Y', 0, '2012-11-01', NULL, NULL, 0, 0, NULL, NULL),
('522229954', 'W11013902', 'W11013902', 'UT01', 'Meier & Marsh Professional Therapies', 'Charles', 'Wade', 'Meier', 'PT', 'Physical Therapy', '', '', NULL, 'B', 'PO Box 74125', 'Salt Lake City', 'Salt Lake', 'UT', '84171', '8019422729', NULL, 'PO Box 74125', 'Salt Lake City', 'Salt Lake', 'UT', '84171', '8019422729', '          ', 'WestRehab', 'WUSTDHCPC5', '', '0.00', '0.00', '65.00', 3, '2008-10-01', '2009-10-31', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1699767954', 0, 'Y', 0, '2011-04-22', NULL, NULL, 0, 0, NULL, NULL),
('522229954', 'W11013891', 'W11013891', 'UT01', 'Hand & Orthopedic Rehabilitation Specialists', 'John', 'Michael', 'Orr', 'PT', 'Physical Therapy', NULL, NULL, NULL, 'B', 'PO Box 74125', 'Salt Lake City', 'Salt Lake', 'UT', '84171', '8019422729', NULL, 'PO Box 74125', 'Salt Lake City', 'Salt Lake', 'UT', '84171', '8019422729', '          ', 'WestRehab', 'WUSTDHCPC5', '', '0.00', '0.00', '65.00', 3, '2008-10-01', '2009-10-31', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1518942291', 0, 'Y', 0, '2013-08-26', NULL, NULL, 0, 0, NULL, NULL),
('522229954', 'W11013892', 'W11013892', 'UT01', 'Hand & Orthopedic Rehabilitation Specialists', 'Susan', 'S', 'Ozaki', 'OT', 'Occupational Therapy', 'Physical Therapy', '', NULL, 'B', 'PO Box 74125', 'Salt Lake City', 'Salt Lake', 'UT', '84171', '8019422729', NULL, 'PO Box 74125', 'Salt Lake City', 'Salt Lake', 'UT', '84171', '8019422729', '          ', 'WestRehab', 'WUSTDHCPC5', '', '0.00', '0.00', '65.00', 3, '2008-10-01', '2009-10-31', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1386645075', 0, 'Y', 0, '2011-04-20', NULL, NULL, 0, 0, NULL, NULL),
('522229954', 'W11013893', 'W11013893', 'UT01', 'Hand & Orthopedic Rehabilitation Specialists', 'Kimberly', 'M', 'Ross', 'OT', 'Occupational Therapy', 'Physical Therapy', NULL, NULL, 'B', 'PO Box 74125', 'Salt Lake City', 'Salt Lake', 'UT', '84171', '8019422729', NULL, 'PO Box 74125', 'Salt Lake City', 'Salt Lake', 'UT', '84171', '8019422729', '          ', 'WestRehab', 'WUSTDHCPC5', '', '0.00', '0.00', '65.00', 3, '2008-10-01', '2009-10-31', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1174524862', 0, 'Y', 0, '2011-11-29', NULL, NULL, 0, 0, NULL, NULL),
('522229954', 'W11013894', 'W11013894', 'UT01', 'Hand & Orthopedic Rehabilitation Specialists', 'Donna', 'Marie', 'Tiley', 'OT', 'Physical Therapy', 'Occupational Therapy', NULL, NULL, 'B', 'PO Box 74125', 'Salt Lake City', 'Salt Lake', 'UT', '84171', '8019422729', NULL, 'PO Box 74125', 'Salt Lake City', 'Salt Lake', 'UT', '84171', '8019422729', '          ', 'WestRehab', 'WUSTDHCPC5', '', '0.00', '0.00', '65.00', 3, '2008-10-01', '2009-10-31', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1194726786', 0, 'Y', 0, '2011-04-20', NULL, NULL, 0, 0, NULL, NULL),
('522229954', 'W11013895', 'W11013895', 'UT01', 'Hand & Orthopedic Rehabilitation Specialists', 'Steven', 'M', 'Wixom', 'PT', 'Physical Therapy', '', '', NULL, 'B', 'PO Box 74125', 'Salt Lake City', 'Salt Lake', 'UT', '84171', '8019422729', NULL, 'PO Box 74125', 'Salt Lake City', 'Salt Lake', 'UT', '84171', '8019422729', '          ', 'WestRehab', 'WUSTDHCPC5', '', '0.00', '0.00', '65.00', 3, '2008-10-01', '2009-10-31', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1093716680', 0, 'Y', 0, '2011-04-22', NULL, NULL, 0, 0, NULL, NULL),
('522229954', 'W11013896', 'W11013896', 'UT01', 'Herriman Physical Therapy', 'Shaun', 'S', 'Schultz', 'PT', 'Physical Therapy', '', '', NULL, 'B', 'PO Box 74125', 'Salt Lake City', 'Salt Lake', 'UT', '84171', '8019422729', NULL, 'PO Box 74125', 'Salt Lake City', 'Salt Lake', 'UT', '84171', '8019422729', '          ', 'WestRehab', 'WUSTDHCPC5', '', '0.00', '0.00', '65.00', 3, '2008-10-01', '2009-10-31', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1295783702', 0, 'Y', 0, '2011-04-19', NULL, NULL, 0, 0, NULL, NULL),
('522229954', 'W11013897', 'W11013897', 'UT01', 'Horizon Balance & Dizziness Centers', 'Brent', 'A', 'Webb', 'PT', 'Physical Therapy', NULL, NULL, NULL, 'B', 'PO Box 74125', 'Salt Lake City', 'Salt Lake', 'UT', '84171', '8019422729', NULL, NULL, NULL, 'Salt Lake', NULL, NULL, NULL, NULL, 'WestRehab', 'WUSTDHCPC5', NULL, '0.00', '0.00', '65.00', 3, '2008-10-01', '2009-10-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1154376838', 0, 'Y', 0, '2009-11-30', NULL, NULL, 0, 0, NULL, NULL),
('522229954', 'W11013898', 'W11013898', 'UT01', 'Human Performance Institute', 'Russell', 'Jack', 'Gatenby', 'PT', 'Physical Therapy', '', '', NULL, 'B', 'PO Box 74125', 'Salt Lake City', 'Salt Lake', 'UT', '84171', '8019422729', NULL, 'PO Box 74125', 'Salt Lake City', 'Salt Lake', 'UT', '84171', '8019422729', '          ', 'WestRehab', 'WUSTDHCPC5', '', '0.00', '0.00', '65.00', 3, '2008-10-01', '2009-10-31', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1134241904', 0, 'Y', 0, '2011-04-20', NULL, NULL, 0, 0, NULL, NULL),
('522229954', 'W11013899', 'W11013899', 'UT01', 'Human Performance Institute', 'John', 'Robert', 'Sumsion', 'PT', 'Physical Therapy', NULL, NULL, NULL, 'B', 'PO Box 74125', 'Salt Lake City', 'Salt Lake', 'UT', '84171', '8019422729', NULL, 'PO Box 74125', 'Salt Lake City', 'Salt Lake', 'UT', '84171', '8019422729', '          ', 'WestRehab', 'WUSTDHCPC5', '', '0.00', '0.00', '65.00', 3, '2008-10-01', '2009-10-31', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1598887069', 0, 'Y', 0, '2011-04-20', NULL, NULL, 0, 0, NULL, NULL),
('522229954', 'W11013944', 'W11013944', 'UT01', 'Performance West Physical Therapy', 'Kim', 'W', 'Reid', 'PT', 'Physical Therapy', '', '', NULL, 'B', 'PO Box 74125', 'Salt Lake City', 'Salt Lake', 'UT', '84171', '8019422729', NULL, 'PO Box 74125', 'Salt Lake City', 'Salt Lake', 'UT', '84171', '8019422729', '          ', 'WestRehab', 'WUSTDHCPC5', '', '0.00', '0.00', '65.00', 3, '2008-10-01', '2008-12-31', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1558362434', 0, 'Y', 0, '2011-11-01', NULL, NULL, 0, 0, NULL, NULL),
('522229954', 'W11013901', 'W11013901', 'UT01', 'Logan Physical Therapy', 'Susan', 'A', 'Doucette', 'PT', 'Physical Therapy', '', '', NULL, 'B', 'PO Box 74125', 'Salt Lake City', 'Salt Lake', 'UT', '84171', '8019422729', NULL, 'PO Box 74125', 'Salt Lake City', 'Salt Lake', 'UT', '84171', '8019422729', '          ', 'WestRehab', 'WUSTDHCPC5', '', '0.00', '0.00', '65.00', 3, '2008-10-01', '2009-10-31', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1972613099', 0, 'N', 0, '2011-04-20', NULL, NULL, 0, 0, NULL, NULL),
('522229954', 'W11013888', 'W11013888', 'UT01', 'Hand & Orthopedic Rehabilitation Specialists', 'Tyler', 'M', 'Hansen', 'PT', 'Physical Therapy', '', '', NULL, 'B', 'PO Box 74125', 'Salt Lake City', 'Salt Lake', 'UT', '84171', '8019422729', NULL, 'PO Box 74125', 'Salt Lake City', 'Salt Lake', 'UT', '84171', '8019422729', '          ', 'WestRehab', 'WUSTDHCPC5', '', '0.00', '0.00', '65.00', 3, '2008-10-01', '2009-10-31', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1922009695', 0, 'Y', 0, '2012-09-17', NULL, NULL, 0, 0, NULL, NULL),
('522229954', 'W11013903', 'W11013903', 'UT01', 'Morgan Valley Physical Therapy', 'Alan', 'John', 'Kerbs', 'PT', 'Physical Therapy', '', '', NULL, 'B', 'PO Box 74125', 'Salt Lake City', 'Salt Lake', 'UT', '84171', '8019422729', NULL, 'PO Box 74125', 'Salt Lake City', 'Salt Lake', 'UT', '84171', '8019422729', '          ', 'WestRehab', 'WUSTDHCPC5', '', '0.00', '0.00', '65.00', 3, '2008-10-01', '2009-10-31', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1952485625', 0, 'Y', 0, '2012-02-08', NULL, NULL, 0, 0, NULL, NULL),
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('522229954', 'W11013941', 'W11013941', 'UT01', 'Orem Sports Medicine', 'Ned', 'B', 'Bushnell', 'PT', 'Physical Therapy', '', '', NULL, 'B', 'PO Box 74125', 'Salt Lake City', 'Salt Lake', 'UT', '84171', '8019422729', NULL, 'PO Box 74125', 'Salt Lake City', 'Salt Lake', 'UT', '84171', '8019422729', '          ', 'WestRehab', 'WUSTDHCPC5', '', '0.00', '0.00', '65.00', 3, '2008-10-01', '2009-10-31', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1528050861', 0, 'Y', 0, '2012-06-21', NULL, NULL, 0, 0, NULL, NULL),
('522229954', 'W11014071', 'W11014071', 'UT01', 'Peak Physical Therapy & Sports Medicine', 'Steven', 'Edward', 'Robbins', 'PT', 'Physical Therapy', '', '', NULL, 'B', 'PO Box 74125', 'Salt Lake City', 'Salt Lake', 'UT', '84171', '8019422729', NULL, 'PO Box 74125', 'Salt Lake City', 'Salt Lake', 'UT', '84171', '8019422729', '          ', 'WestRehab', 'WUSTDHCPC5', '', '0.00', '0.00', '65.00', 3, '2008-10-01', '2009-10-31', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1225038474', 0, 'Y', 0, '2013-06-21', NULL, NULL, 0, 0, NULL, NULL),
('522229954', 'W11013943', 'W11013943', 'UT01', 'Performance West Physical Therapy', 'Curtis', 'B', 'Jolley', 'PT', 'Physical Therapy', '', '', NULL, 'B', 'PO Box 74125', 'Salt Lake City', 'Salt Lake', 'UT', '84171', '8019422729', NULL, 'PO Box 74125', 'Salt Lake City', 'Salt Lake', 'UT', '84171', '8019422729', '          ', 'WestRehab', 'WUSTDHCPC5', '', '0.00', '0.00', '65.00', 3, '2008-10-01', '2009-10-31', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1548261431', 0, 'Y', 0, '2011-11-01', NULL, NULL, 0, 0, NULL, NULL),
('522229954', 'W11014467', 'W11014467', 'UT01', 'Professional Physical Therapy & Sports Medicine', 'Wendell', 'Buck', 'Mendenhall', 'PT', 'Physical Therapy', '', '', NULL, 'B', 'PO Box 74125', 'Salt Lake City', 'Salt Lake', 'UT', '84171', '8019422729', NULL, 'PO Box 74125', 'Salt Lake City', 'Salt Lake', 'UT', '84171', '8019422729', '          ', 'WestRehab', 'WUSTDHCPC5', '', '0.00', '0.00', '68.00', 3, '2009-11-01', '2009-12-31', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1275682262', 0, 'Y', 0, '2011-12-19', NULL, NULL, 0, 0, NULL, NULL),
('522229954', 'W11013945', 'W11013945', 'UT01', 'Performance West Physical Therapy', 'Stephen', 'Reese', 'Spencer', 'PT', 'Physical Therapy', '', '', NULL, 'B', 'PO Box 74125', 'Salt Lake City', 'Salt Lake', 'UT', '84171', '8019422729', NULL, NULL, NULL, 'Salt Lake', NULL, NULL, NULL, NULL, 'WestRehab', 'WUSTDHCPC5', NULL, '0.00', '0.00', '65.00', 3, '2008-10-01', '2009-10-31', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1003894379', 0, 'Y', 0, '2010-11-11', NULL, NULL, 0, 0, NULL, NULL),
('522229954', 'W11013946', 'W11013946', 'UT01', 'Physical & Sports Therapy Services', 'Darren', '', 'Averett', 'PT', 'Physical Therapy', '', '', NULL, 'B', 'PO Box 74125', 'Salt Lake City', 'Salt Lake', 'UT', '84171', '8019422729', NULL, 'PO Box 74125', 'Salt Lake City', 'Salt Lake', 'UT', '84171', '8019422729', '          ', 'WestRehab', 'WUSTDHCPC5', '', '0.00', '0.00', '65.00', 3, '2008-10-01', '2009-10-31', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1548232549', 0, 'Y', 0, '2011-04-21', NULL, NULL, 0, 0, NULL, NULL),
('522229954', 'W11013947', 'W11013947', 'UT01', 'Physical & Sports Therapy Services', 'Douglas', 'K', 'Bagley', 'PT', 'Physical Therapy', '', '', NULL, 'B', 'PO Box 74125', 'Salt Lake City', 'Salt Lake', 'UT', '84171', '8019422729', NULL, 'PO Box 74125', 'Salt Lake City', 'Salt Lake', 'UT', '84171', '8019422729', '          ', 'WestRehab', 'WUSTDHCPC5', '', '0.00', '0.00', '65.00', 3, '2008-10-01', '2009-10-31', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1538155411', 0, 'Y', 0, '2013-08-20', NULL, NULL, 0, 0, NULL, NULL),
('522229954', 'W11013948', 'W11013948', 'UT01', 'Physical & Sports Therapy Services', 'Brian', 'B', 'Lambert', 'PT', 'Physical Therapy', '', '', NULL, 'B', 'PO Box 74125', 'Salt Lake City', 'Salt Lake', 'UT', '84171', '8019422729', NULL, 'PO Box 74125', 'Salt Lake City', 'Salt Lake', 'UT', '84171', '8019422729', '          ', 'WestRehab', 'WUSTDHCPC5', '', '0.00', '0.00', '65.00', 3, '2008-10-01', '2009-10-31', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1639165707', 0, 'Y', 0, '2011-04-21', NULL, NULL, 0, 0, NULL, NULL),
('522229954', 'W11013949', 'W11013949', 'UT01', 'Physical & Sports Therapy Services', 'Brad', 'A', 'Mangum', 'PT', 'Physical Therapy', '', '', NULL, 'B', 'PO Box 74125', 'Salt Lake City', 'Salt Lake', 'UT', '84171', '8019422729', NULL, 'PO Box 74125', 'Salt Lake City', 'Salt Lake', 'UT', '84171', '8019422729', '          ', 'WestRehab', 'WUSTDHCPC5', '', '0.00', '0.00', '65.00', 3, '2008-10-01', '2009-10-31', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1316992548', 0, 'Y', 0, '2013-04-16', NULL, NULL, 0, 0, NULL, NULL),
('522229954', 'W11013939', 'W11013939', 'UT01', '', 'Noall', 'H', 'Latimer', 'PT', 'Physical Therapy', NULL, NULL, NULL, 'B', 'PO Box 74125', 'Salt Lake City', 'Salt Lake', 'UT', '84171', '8019422729', NULL, 'PO Box 74125', 'Salt Lake City', 'Salt Lake', 'UT', '84171', '8019422729', '          ', 'WestRehab', 'WUSTDHCPC5', '', '0.00', '0.00', '65.00', 3, '2008-10-01', '2009-10-31', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1932167665', 0, 'Y', 0, '2012-06-21', NULL, NULL, 0, 0, NULL, NULL),
('522229954', 'W11013951', 'W11013951', 'UT01', 'Physical & Sports Therapy Services', 'William', '', 'Sumsion', 'PT', 'Physical Therapy', '', '', NULL, 'B', 'PO Box 74125', 'Salt Lake City', 'Salt Lake', 'UT', '84171', '8019422729', NULL, 'PO Box 74125', 'Salt Lake City', 'Salt Lake', 'UT', '84171', '8019422729', '          ', 'WestRehab', 'WUSTDHCPC5', '', '0.00', '0.00', '65.00', 3, '2008-10-01', '2009-10-31', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1659367845', 0, 'Y', 0, '2011-10-26', NULL, NULL, 0, 0, NULL, NULL),
('522229954', 'W11013938', 'W11013938', 'UT01', 'Neuroworx', 'Jan', 'R', 'Black', 'PT', 'Physical Therapy', '', '', NULL, 'B', 'PO Box 74125', 'Salt Lake City', 'Salt Lake', 'UT', '84171', '8019422729', NULL, 'PO Box 74125', 'Salt Lake City', 'Salt Lake', 'UT', '84171', '8019422729', '          ', 'WestRehab', 'WUSTDHCPC5', '', '0.00', '0.00', '65.00', 3, '2008-10-01', '2009-10-31', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1568429967', 0, 'Y', 0, '2014-01-31', NULL, NULL, 0, 0, NULL, NULL),
('522229954', 'W11013953', 'W11013953', 'UT01', 'Physical Therapy @ The Crossroads', 'Michael', 'R', 'Bond', 'PT', 'Physical Therapy', NULL, NULL, NULL, 'B', 'PO Box 74125', 'Salt Lake City', 'Salt Lake', 'UT', '84171', '8019422729', NULL, NULL, NULL, 'Salt Lake', NULL, NULL, NULL, NULL, 'WestRehab', 'WUSTDHCPC5', NULL, '0.00', '0.00', '65.00', 3, '2008-10-01', '2009-04-01', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1518990183', 0, 'Y', 0, '2008-10-03', NULL, NULL, 0, 0, NULL, NULL),
('522229954', 'W11013954', 'W11013954', 'UT01', 'Registered Physical Therapists', 'Brent', 'L', 'Miller', 'PT', 'Physical Therapy', '', '', NULL, 'B', 'PO Box 74125', 'Salt Lake City', 'Salt Lake', 'UT', '84171', '8019422729', NULL, 'PO Box 74125', 'Salt Lake City', 'Salt Lake', 'UT', '84171', '8019422729', '          ', 'WestRehab', 'WUSTDHCPC5', '', '0.00', '0.00', '65.00', 3, '2008-10-01', '2009-10-31', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1720065840', 0, 'Y', 0, '2011-10-20', NULL, NULL, 0, 0, NULL, NULL),
('522229954', 'W11013955', 'W11013955', 'UT01', 'Registered Physical Therapists', 'Scott', 'C', 'Benson', 'PT', 'Physical Therapy', '', '', NULL, 'B', 'PO Box 74125', 'Salt Lake City', 'Salt Lake', 'UT', '84171', '8019422729', NULL, 'PO Box 74125', 'Salt Lake City', 'Salt Lake', 'UT', '84171', '8019422729', '          ', 'WestRehab', 'WUSTDHCPC5', '', '0.00', '0.00', '65.00', 3, '2008-10-01', '2009-10-31', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1447237490', 0, 'Y', 0, '2011-10-20', NULL, NULL, 0, 0, NULL, NULL),
('522229954', 'W11013956', 'W11013956', 'UT01', 'Registered Physical Therapists', 'Greg', 'Jonathon', 'Baker', 'PT', 'Physical Therapy', '', '', NULL, 'B', 'PO Box 74125', 'Salt Lake City', 'Salt Lake', 'UT', '84171', '8019422729', NULL, 'PO Box 74125', 'Salt Lake City', 'Salt Lake', 'UT', '84171', '8019422729', '          ', 'WestRehab', 'WUSTDHCPC5', '', '0.00', '0.00', '65.00', 3, '2008-10-01', '2009-10-31', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1558348516', 0, 'Y', 0, '2011-10-20', NULL, NULL, 0, 0, NULL, NULL),
('522229954', 'W11013957', 'W11013957', 'UT01', 'Registered Physical Therapists', 'Josh', 'Douglas', 'Boulton', 'PT', 'Physical Therapy', NULL, NULL, NULL, 'B', 'PO Box 74125', 'Salt Lake City', 'Salt Lake', 'UT', '84171', '8019422729', NULL, NULL, NULL, 'Salt Lake', NULL, NULL, NULL, NULL, 'WestRehab', 'WUSTDHCPC5', NULL, '0.00', '0.00', '65.00', 3, '2008-10-01', '2009-10-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1457338550', 0, 'Y', 0, '2008-10-03', NULL, NULL, 0, 0, NULL, NULL),
('522229954', 'W11013958', 'W11013958', 'UT01', 'Registered Physical Therapists', 'Larry', 'Don', 'Fullmer', 'PT', 'Physical Therapy', '', '', NULL, 'B', 'PO Box 74125', 'Salt Lake City', 'Salt Lake', 'UT', '84171', '8019422729', NULL, 'PO Box 74125', 'Salt Lake City', 'Salt Lake', 'UT', '84171', '8019422729', '          ', 'WestRehab', 'WUSTDHCPC5', '', '0.00', '0.00', '65.00', 3, '2008-10-01', '2009-10-31', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1821075912', 0, 'Y', 0, '2011-04-20', NULL, NULL, 0, 0, NULL, NULL),
('522229954', 'W11013959', 'W11013959', 'UT01', 'Registered Physical Therapists', 'Steven', 'R', 'Verhaaren', 'PT', 'Physical Therapy', NULL, NULL, NULL, 'B', 'PO Box 74125', 'Salt Lake City', 'Salt Lake', 'UT', '84171', '8019422729', NULL, 'PO Box 74125', 'Salt Lake City', 'Salt Lake', 'UT', '84171', '8019422729', '          ', 'WestRehab', 'WUSTDHCPC5', '', '0.00', '0.00', '65.00', 3, '2008-10-01', '2009-10-31', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1174500268', 0, 'Y', 0, '2011-10-20', NULL, NULL, 0, 0, NULL, NULL),
('522229954', 'W11013960', 'W11013960', 'UT01', 'Registered Physical Therapists', 'Stanford', 'K', 'Hirai', 'PT', 'Physical Therapy', '', '', NULL, 'B', 'PO Box 74125', 'Salt Lake City', 'Salt Lake', 'UT', '84171', '8019422729', NULL, 'PO Box 74125', 'Salt Lake City', 'Salt Lake', 'UT', '84171', '8019422729', '          ', 'WestRehab', 'WUSTDHCPC5', '', '0.00', '0.00', '65.00', 3, '2008-10-01', '2009-10-31', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1972580074', 0, 'Y', 0, '2011-10-20', NULL, NULL, 0, 0, NULL, NULL),
('522229954', 'W11013961', 'W11013961', 'UT01', 'Rocky Mountain Therapy Services', 'Paul', 'G', 'Wortley', 'PT', 'Physical Therapy', '', '', NULL, 'B', 'PO Box 74125', 'Salt Lake City', 'Salt Lake', 'UT', '84171', '8019422729', NULL, 'PO Box 74125', 'Salt Lake City', 'Salt Lake', 'UT', '84171', '8019422729', '          ', 'WestRehab', 'WUSTDHCPC5', '', '0.00', '0.00', '65.00', 3, '2008-10-01', '2009-10-31', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1417940586', 0, 'Y', 0, '2011-11-01', NULL, NULL, 0, 0, NULL, NULL),
('522229954', 'W11013962', 'W11013962', 'UT01', 'Rocky Mountain Therapy Services', 'Richard', 'D', 'Wortley', 'PT', 'Physical Therapy', '', '', NULL, 'B', 'PO Box 74125', 'Salt Lake City', 'Salt Lake', 'UT', '84171', '8019422729', NULL, 'PO Box 74125', 'Salt Lake City', 'Salt Lake', 'UT', '84171', '8019422729', '          ', 'WestRehab', 'WUSTDHCPC5', '', '0.00', '0.00', '65.00', 3, '2008-10-01', '2009-10-31', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1689667859', 0, 'Y', 0, '2011-11-01', NULL, NULL, 0, 0, NULL, NULL),
('522229954', 'W11013950', 'W11013950', 'UT01', 'Physical & Sports Therapy Services', 'Craig', 'Alan', 'Schultz', 'PT', 'Physical Therapy', '', '', NULL, 'B', 'PO Box 74125', 'Salt Lake City', 'Salt Lake', 'UT', '84171', '8019422729', NULL, 'PO Box 74125', 'Salt Lake City', 'Salt Lake', 'UT', '84171', '8019422729', '          ', 'WestRehab', 'WUSTDHCPC5', '', '0.00', '0.00', '65.00', 3, '2008-10-01', '2009-10-31', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1508852484', 0, 'Y', 0, '2011-10-26', NULL, NULL, 0, 0, NULL, NULL),
('522229954', 'W11013927', 'W11013927', 'UT01', 'Mountain Land Rehabilitation Home Health', 'Curt', 'D', 'Myrick', 'PT', 'Physical Therapy', '', '', NULL, 'B', 'PO Box 74125', 'Salt Lake City', 'Salt Lake', 'UT', '84171', '8019422729', NULL, 'PO Box 74125', 'Salt Lake City', 'Salt Lake', 'UT', '84171', '8019422729', '          ', 'WestRehab', 'WUSTDHCPC5', '', '0.00', '0.00', '65.00', 3, '2008-10-01', '2009-10-31', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1548364979', 0, 'Y', 0, '2012-10-22', 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
('522229954', 'W11013963', 'W11013963', 'UT01', 'Rocky Mountain Therapy Services', 'Kristen', 'V', 'Nielsen-Jones', 'OT', 'Occupational Therapy', '', '', NULL, 'B', 'PO Box 74125', 'Salt Lake City', 'Salt Lake', 'UT', '84171', '8019422729', NULL, 'PO Box 74125', 'Salt Lake City', 'Salt Lake', 'UT', '84171', '8019422729', '          ', 'WestRehab', 'WUSTDHCPC5', '', '0.00', '0.00', '65.00', 3, '2008-10-01', '2009-10-31', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1568457000', 0, 'Y', 0, '2011-12-19', NULL, NULL, 0, 0, NULL, NULL),
('522229954', 'W11013916', 'W11013916', 'UT01', 'Mountain Land Rehabilitation', 'Kirk', 'L', 'Terry', 'PT', 'Physical Therapy', '', '', NULL, 'B', 'PO Box 74125', 'Salt Lake City', 'Salt Lake', 'UT', '84171', '8019422729', NULL, 'PO Box 74125', 'Salt Lake City', 'Salt Lake', 'UT', '84171', '8019422729', '          ', 'WestRehab', 'WUSTDHCPC5', '', '0.00', '0.00', '65.00', 3, '2008-10-01', '2009-05-15', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1013011261', 0, 'Y', 0, '2012-04-18', NULL, NULL, 0, 0, NULL, NULL),
('522229954', 'W11013917', 'W11013917', 'UT01', 'Mountain Land Rehabilitation', 'Jill', '', 'Thurber', 'PT', 'Physical Therapy', '', '', NULL, 'B', 'PO Box 74125', 'Salt Lake City', 'Salt Lake', 'UT', '84171', '8019422729', NULL, 'PO Box 74125', 'Salt Lake City', 'Salt Lake', 'UT', '84171', '8019422729', '          ', 'WestRehab', 'WUSTDHCPC5', '', '0.00', '0.00', '65.00', 3, '2008-10-01', '2009-10-31', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1336242924', 0, 'Y', 0, '2011-10-26', NULL, NULL, 0, 0, NULL, NULL),
('522229954', 'W11013918', 'W11013918', 'UT01', 'Mountain Land Rehabilitation', 'Richard', 'T', 'Ward', 'PT', 'Physical Therapy', '', '', NULL, 'B', 'PO Box 74125', 'Salt Lake City', 'Salt Lake', 'UT', '84171', '8019422729', NULL, 'PO Box 74125', 'Salt Lake City', 'Salt Lake', 'UT', '84171', '8019422729', '', 'WestRehab', 'WUSTDHCPC5', '', '0.00', '0.00', '65.00', 3, '2008-10-01', '2009-10-31', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1144223413', 0, 'Y', 0, '2014-06-24', NULL, NULL, 0, 0, NULL, NULL),
('522229954', 'W11013919', 'W11013919', 'UT01', 'Mountain Land Rehabilitation', 'Adam', 'Boyd', 'Webb', 'PT', 'Physical Therapy', '', '', NULL, 'B', 'PO Box 74125', 'Salt Lake City', 'Salt Lake', 'UT', '84171', '8019422729', NULL, 'PO Box 74125', 'Salt Lake City', 'Salt Lake', 'UT', '84171', '8019422729', '          ', 'WestRehab', 'WUSTDHCPC5', '', '0.00', '0.00', '65.00', 3, '2008-10-01', '2009-10-31', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1720180599', 0, 'Y', 0, '2013-10-16', NULL, NULL, 0, 0, NULL, NULL),
('522229954', 'W11013920', 'W11013920', 'UT01', 'Mountain Land Rehabilitation Home Health', 'Alan', 'Jeffrey', 'Acord', 'PT', 'Physical Therapy', '', '', NULL, 'B', 'PO Box 74125', 'Salt Lake City', 'Salt Lake', 'UT', '84171', '8019422729', NULL, 'PO Box 74125', 'Salt Lake City', 'Salt Lake', 'UT', '84171', '8019422729', '          ', 'WestRehab', 'WUSTDHCPC5', '', '0.00', '0.00', '65.00', 3, '2008-10-01', '2009-10-31', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1184728511', 0, 'Y', 0, '2012-08-03', NULL, NULL, 0, 0, NULL, NULL),
('522229954', 'W11013921', 'W11013921', 'UT01', 'Mountain Land Rehabilitation Home Health', 'Jerri', 'Lynn', 'Adams-Price', 'PT', 'Physical Therapy', '', '', NULL, 'B', 'PO Box 74125', 'Salt Lake City', 'Salt Lake', 'UT', '84171', '8019422729', NULL, NULL, NULL, 'Salt Lake', NULL, NULL, '8019422729', '          ', 'WestRehab', 'WUSTDHCPC5', '', '0.00', '0.00', '65.00', 3, '2008-10-01', '2009-10-31', NULL, 0, NULL, '', '', '', '', 'HCFA|UB|', '0000004912', 0, 'Y', 0, '2010-05-18', NULL, NULL, 0, 0, NULL, NULL),
('522229954', 'W11013922', 'W11013922', 'UT01', 'Mountain Land Rehabilitation Home Health', 'Kimberly', 'Ann', 'Hoth', 'MPT', 'Physical Therapy', NULL, NULL, NULL, 'B', 'PO Box 74125', 'Salt Lake City', 'Salt Lake', 'UT', '84171', '8019422729', NULL, 'PO Box 74125', 'Salt Lake City', 'Salt Lake', 'UT', '84171', '8019422729', '          ', 'WestRehab', 'WUSTDHCPC5', '', '0.00', '0.00', '65.00', 3, '2008-10-01', '2009-10-31', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1790888394', 0, 'Y', 0, '2013-06-21', NULL, NULL, 0, 0, NULL, NULL),
('522229954', 'W11013923', 'W11013923', 'UT01', 'Mountain Land Rehabilitation Home Health', 'Suzanne', 'Elizabeth', 'Critchley', 'PT', 'Physical Therapy', NULL, NULL, NULL, 'B', 'PO Box 74125', 'Salt Lake City', 'Salt Lake', 'UT', '84171', '8019422729', NULL, NULL, NULL, 'Salt Lake', NULL, NULL, NULL, NULL, 'WestRehab', 'WUSTDHCPC5', NULL, '0.00', '0.00', '65.00', 3, '2008-10-01', '2009-10-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '0000005836', 0, 'Y', 0, '2008-10-03', NULL, NULL, 0, 0, NULL, NULL),
('522229954', 'W11013924', 'W11013924', 'UT01', 'Mountain Land Rehabilitation Home Health', 'Douglas', NULL, 'Flint', 'PT', 'Physical Therapy', '', '', NULL, 'B', 'PO Box 74125', 'Salt Lake City', 'Salt Lake', 'UT', '84171', '8019422729', NULL, NULL, NULL, 'Salt Lake', NULL, NULL, NULL, NULL, 'WestRehab', 'WUSTDHCPC5', NULL, '0.00', '0.00', '65.00', 3, '2008-10-01', '2009-10-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1588794374', 0, 'Y', 0, '2009-11-30', NULL, NULL, 0, 0, NULL, NULL),
('522229954', 'W11013940', 'W11013940', 'UT01', 'North View Physical Therapy', 'John', 'N', 'Hall', 'PT', 'Physical Therapy', '', '', NULL, 'B', 'PO Box 74125', 'Salt Lake City', 'Salt Lake', 'UT', '84171', '8019422729', NULL, 'PO Box 74125', 'Salt Lake City', 'Salt Lake', 'UT', '84171', '8019422729', '          ', 'WestRehab', 'WUSTDHCPC5', '', '0.00', '0.00', '65.00', 3, '2008-10-01', '2009-10-31', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1598746984', 0, 'Y', 0, '2014-02-10', NULL, NULL, 0, 0, NULL, NULL),
('522229954', 'W11013926', 'W11013926', 'UT01', 'Mountain Land Rehabilitation Home Health', 'Robert', 'Craig', 'Lloyd', 'PT', 'Physical Therapy', '', '', NULL, 'B', 'PO Box 74125', 'Salt Lake City', 'Salt Lake', 'UT', '84171', '8019422729', NULL, 'PO Box 74125', 'Salt Lake City', 'Salt Lake', 'UT', '84171', '8019422729', '          ', 'WestRehab', 'WUSTDHCPC5', '', '0.00', '0.00', '65.00', 3, '2008-10-01', '2009-10-31', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1922102177', 0, 'Y', 0, '2011-04-20', NULL, NULL, 0, 0, NULL, NULL),
('522229954', 'W11013914', 'W11013914', 'UT01', 'Mountain Land Rehabilitation', 'Craig', 'A', 'Packham', 'PA-C', 'Orthopedic Surgery', 'Physical Therapy', NULL, NULL, 'B', 'PO Box 74125', 'Salt Lake City', 'Salt Lake', 'UT', '84171', '8019422729', NULL, NULL, NULL, 'Salt Lake', NULL, NULL, NULL, NULL, 'WestRehab', 'WUSTDHCPC5', NULL, '0.00', '0.00', '65.00', 3, '2008-10-01', '2009-10-31', 0, 0, 0, 'Mountain West Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1104920354', 0, 'Y', 0, '2009-09-15', NULL, NULL, 0, 0, NULL, NULL),
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('522229954', 'W11014275', 'W11014275', 'UT01', 'Canyon Rim Physical Therapy', 'Dede', '', 'Lewis', 'PT', 'Physical Therapy', '', '', NULL, 'B', 'PO Box 74125', 'Salt Lake City', 'Salt Lake', 'UT', '84171', '8019422729', NULL, 'PO Box 74125', 'Salt Lake City', 'Salt Lake', 'UT', '84171', '8019422729', '          ', 'WestRehab', 'WUSTDHCPC5', '', '0.00', '0.00', '68.00', 3, '2009-11-01', '2009-12-31', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1023123627', 0, 'Y', 0, '2011-05-04', NULL, NULL, 0, 0, NULL, NULL),
('522229954', 'W11014299', 'W11014299', 'UT01', 'Mountain Land Orthopedic & Sports Physical Therapy', 'Eric', 'D', 'Lybbert', 'PT', 'Physical Therapy', NULL, NULL, NULL, 'B', 'PO Box 74125', 'Salt Lake City', 'Salt Lake', 'UT', '84171', '8019422729', NULL, NULL, NULL, 'Salt Lake', NULL, NULL, NULL, NULL, 'WestRehab', 'WUSTDHCPC5', NULL, '0.00', '0.00', '68.00', 3, '2009-11-01', '2009-12-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1285728402', 0, 'Y', 0, '2009-11-30', NULL, NULL, 0, 0, NULL, NULL),
('522229954', 'W11014334', 'W11014334', 'UT01', 'Performance West Physical Therapy', 'Klementina', '', 'Buchheister', 'PT', 'Physical Therapy', '', '', NULL, 'B', 'PO Box 74125', 'Salt Lake City', 'Salt Lake', 'UT', '84171', '8019422729', NULL, 'PO Box 74125', 'Salt Lake City', 'Salt Lake', 'UT', '84171', '8019422729', '          ', 'WestRehab', 'WUSTDHCPC5', '', '0.00', '0.00', '68.00', 3, '2009-11-01', '2009-12-31', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1447242847', 0, 'Y', 0, '2012-11-01', NULL, NULL, 0, 0, NULL, NULL),
('522229954', 'W11014308', 'W11014308', 'UT01', 'Mountain Land Rehabilitation', 'Kirk', 'L', 'Terry', 'PT', 'Physical Therapy', '', '', NULL, 'B', 'PO Box 74125', 'Salt Lake City', 'Salt Lake', 'UT', '84171', '8019422729', NULL, 'PO Box 74125', 'Salt Lake City', 'Salt Lake', 'UT', '84171', '8019422729', '          ', 'WestRehab', 'WUSTDHCPC5', '', '0.00', '0.00', '68.00', 3, '2009-11-01', '2009-05-15', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1013011261', 0, 'Y', 0, '2012-04-18', NULL, NULL, 0, 0, NULL, NULL),
('522229954', 'W11014307', 'W11014307', 'UT01', 'Mountain Land Rehabilitation', 'Jack', 'W', 'Rolfe', 'PT', 'Physical Therapy', '', '', NULL, 'B', 'PO Box 74125', 'Salt Lake City', 'Salt Lake', 'UT', '84171', '8019422729', NULL, 'PO Box 74125', 'Salt Lake City', 'Salt Lake', 'UT', '84171', '8019422729', '          ', 'WestRehab', 'WUSTDHCPC5', '', '0.00', '0.00', '68.00', 3, '2009-11-01', '2009-12-31', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1558463323', 0, 'Y', 0, '2011-11-01', NULL, NULL, 0, 0, NULL, NULL),
('522229954', 'W11014306', 'W11014306', 'UT01', 'Mountain Land Rehabilitation', 'Craig', 'A', 'Packham', 'PA-C', 'Orthopedic Surgery', 'Physical Therapy', NULL, NULL, 'B', 'PO Box 74125', 'Salt Lake City', 'Salt Lake', 'UT', '84171', '8019422729', NULL, NULL, NULL, 'Salt Lake', NULL, NULL, NULL, NULL, 'WestRehab', 'WUSTDHCPC5', NULL, '0.00', '0.00', '68.00', 3, '2009-11-01', '2009-12-31', 0, 0, 0, 'Mountain West Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1104920354', 0, 'Y', 0, '2009-09-15', NULL, NULL, 0, 0, NULL, NULL),
('522229954', 'W11014305', 'W11014305', 'UT01', 'Mountain Land Rehabilitation', 'James', 'A', 'Lewis', 'PT', 'Physical Therapy', '', '', NULL, 'B', 'PO Box 74125', 'Salt Lake City', 'Salt Lake', 'UT', '84171', '8019422729', NULL, 'PO Box 74125', 'Salt Lake City', 'Salt Lake', 'UT', '84171', '8019422729', '          ', 'WestRehab', 'WUSTDHCPC5', '', '0.00', '0.00', '68.00', 3, '2009-11-01', '2009-12-31', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1992899116', 0, 'Y', 0, '2011-06-03', NULL, NULL, 0, 0, NULL, NULL),
('522229954', 'W11014304', 'W11014304', 'UT01', 'Mountain Land Rehabilitation', 'Dawn', 'L', 'Kliarsky', 'PT', 'Physical Therapy', NULL, NULL, NULL, 'B', 'PO Box 74125', 'Salt Lake City', 'Salt Lake', 'UT', '84171', '8019422729', NULL, NULL, NULL, 'Salt Lake', NULL, NULL, NULL, NULL, 'WestRehab', 'WUSTDHCPC5', NULL, '0.00', '0.00', '68.00', 3, '2009-11-01', '2009-11-01', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1215002548', 0, 'Y', 0, '2008-10-03', NULL, NULL, 0, 0, NULL, NULL);
INSERT INTO `providers_new` (`Provider_Tax_ID`, `Provider_Suffix`, `Provider_Network_ID`, `Provider_Region`, `Provider_Name`, `Provider_Doctor_First_Name`, `Provider_Doctor_Middle_Name`, `Provider_Doctor_Last_Name`, `Provider_Doctor_Degree`, `Provider_Specialty_1`, `Provider_Specialty_2`, `Provider_Specialty_3`, `Provider_Specialty_4`, `Provider_Address_Type`, `Provider_Address`, `Provider_City`, `Provider_County`, `Provider_State`, `Provider_Zip`, `Provider_Phone`, `Provider_Fax`, `Provider_Mailing_Address`, `Provider_Mailing_City`, `Provider_Mailing_County`, `Provider_Mailing_State`, `Provider_Mailing_Zip`, `Provider_Mailing_Phone`, `Provider_Mailing_Fax`, `Provider_Primary_Schedule`, `Provider_Secondary_Schedule`, `Provider_Rate_Sheet`, `Provider_Anes_Rate`, `Provider_Default_Rate`, `Provider_Max_DOS`, `Provider_Min_Match_Value`, `Provider_Effective_Date`, `Provider_Term_Date`, `Provider_Pend`, `Provider_Anes_Minutes`, `Provider_PPO`, `Provider_Hospital_1`, `Provider_Hospital_2`, `Provider_Hospital_3`, `Provider_Hospital_4`, `Provider_Type`, `Provider_NPI`, `Provider_Check_Override`, `Exclude_Dir`, `Audit_Status`, `Last_Change_Date`, `Medicare_ID`, `Provider_Lang`, `Provider_Latitude`, `Provider_Longitude`, `Provider_school`, `Provider_cert`) VALUES
('522229954', 'W11014303', 'W11014303', 'UT01', 'Mountain Land Rehabilitation', 'Cynthia', 'J', 'Indergard', 'PT', 'Physical Therapy', '', '', NULL, 'B', 'PO Box 74125', 'Salt Lake City', 'Salt Lake', 'UT', '84171', '8019422729', NULL, 'PO Box 74125', 'Salt Lake City', 'Salt Lake', 'UT', '84171', '8019422729', '          ', 'WestRehab', 'WUSTDHCPC5', '', '0.00', '0.00', '68.00', 3, '2009-11-01', '2009-12-31', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1972606572', 0, 'Y', 0, '2011-04-20', NULL, NULL, 0, 0, NULL, NULL),
('522229954', 'W11014302', 'W11014302', 'UT01', 'Mountain Land Rehabilitation', 'Christopher', 'W', 'Harper', 'PT', 'Physical Therapy', '', '', NULL, 'B', 'PO Box 74125', 'Salt Lake City', 'Salt Lake', 'UT', '84171', '8019422729', NULL, 'PO Box 74125', 'Salt Lake City', 'Salt Lake', 'UT', '84171', '8019422729', '          ', 'WestRehab', 'WUSTDHCPC5', '', '0.00', '0.00', '68.00', 3, '2009-11-01', '2009-12-31', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1902900426', 0, 'Y', 0, '2013-05-06', NULL, NULL, 0, 0, NULL, NULL),
('522229954', 'W11014288', 'W11014288', 'UT01', 'Herriman Physical Therapy', 'Shaun', 'S', 'Schultz', 'PT', 'Physical Therapy', '', '', NULL, 'B', 'PO Box 74125', 'Salt Lake City', 'Salt Lake', 'UT', '84171', '8019422729', NULL, 'PO Box 74125', 'Salt Lake City', 'Salt Lake', 'UT', '84171', '8019422729', '          ', 'WestRehab', 'WUSTDHCPC5', '', '0.00', '0.00', '68.00', 3, '2009-11-01', '2009-12-31', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1295783702', 0, 'Y', 0, '2011-04-19', NULL, NULL, 0, 0, NULL, NULL),
('522229954', 'W11014300', 'W11014300', 'UT01', 'Mountain Land Rehabilitation', 'Shaun', 'B', 'Adams', 'PT', 'Physical Therapy', '', '', NULL, 'B', 'PO Box 74125', 'Salt Lake City', 'Salt Lake', 'UT', '84171', '8019422729', NULL, 'PO Box 74125', 'Salt Lake City', 'Salt Lake', 'UT', '84171', '8019422729', '          ', 'WestRehab', 'WUSTDHCPC5', '', '0.00', '0.00', '68.00', 3, '2009-11-01', '2009-12-31', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1699879106', 0, 'Y', 0, '2013-12-30', NULL, NULL, 0, 0, NULL, NULL),
('522229954', 'W11013767', 'W11013767', 'UT01', 'Wasatch Therapy', 'Sherman', 'D', 'Stanley', 'OT', 'Physical Therapy', 'Occupational Therapy', '', NULL, 'B', 'PO Box 74125', 'Salt Lake City', 'Salt Lake', 'UT', '84171', '8019422729', NULL, 'PO Box 74125', 'Salt Lake City', 'Salt Lake', 'UT', '84171', '8019422729', '          ', 'WestRehab', 'WUSTDHCPC5', '', '0.00', '0.00', '65.00', 3, '2008-10-01', '2009-10-31', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1285685420', 0, 'Y', 0, '2010-11-09', NULL, NULL, 0, 0, NULL, NULL),
('522229954', 'W11014298', 'W11014298', 'UT01', 'Mountain Land Orthopedic & Sports Physical Therapy', 'Jason', 'David', 'Lobb', 'PT', 'Physical Therapy', '', '', NULL, 'B', 'PO Box 74125', 'Salt Lake City', 'Salt Lake', 'UT', '84171', '8019422729', NULL, 'PO Box 74125', 'Salt Lake City', 'Salt Lake', 'UT', '84171', '8019422729', '          ', 'WestRehab', 'WUSTDHCPC5', '', '0.00', '0.00', '68.00', 3, '2009-11-01', '2009-12-31', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1982706750', 0, 'Y', 0, '2011-04-20', NULL, NULL, 0, 0, NULL, NULL),
('522229954', 'W11014297', 'W11014297', 'UT01', 'Mountain Land Orthopedic & Sports Physical Therapy', 'Mark', 'Alan', 'Flinders', 'PT', 'Physical Therapy', '', '', NULL, 'B', 'PO Box 74125', 'Salt Lake City', 'Salt Lake', 'UT', '84171', '8019422729', NULL, 'PO Box 74125', 'Salt Lake City', 'Salt Lake', 'UT', '84171', '8019422729', '          ', 'WestRehab', 'WUSTDHCPC5', '', '0.00', '0.00', '68.00', 3, '2009-11-01', '2009-12-31', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1184736951', 0, 'Y', 0, '2011-04-20', NULL, NULL, 0, 0, NULL, NULL),
('522229954', 'W11014296', 'W11014296', 'UT01', 'Mountain Land Orthopedic & Sports Physical Therapy', 'Damon', 'L', 'Aguirre', 'PT', 'Physical Therapy', NULL, NULL, NULL, 'B', 'PO Box 74125', 'Salt Lake City', 'Salt Lake', 'UT', '84171', '8019422729', NULL, NULL, NULL, 'Salt Lake', NULL, NULL, NULL, NULL, 'WestRehab', 'WUSTDHCPC5', NULL, '0.00', '0.00', '68.00', 3, '2009-11-01', '2009-05-29', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1588730220', 0, 'Y', 0, '2008-10-03', NULL, NULL, 0, 0, NULL, NULL),
('522229954', 'W11014295', 'W11014295', 'UT01', 'Morgan Valley Physical Therapy', 'Alan', 'John', 'Kerbs', 'PT', 'Physical Therapy', '', '', NULL, 'B', 'PO Box 74125', 'Salt Lake City', 'Salt Lake', 'UT', '84171', '8019422729', NULL, 'PO Box 74125', 'Salt Lake City', 'Salt Lake', 'UT', '84171', '8019422729', '          ', 'WestRehab', 'WUSTDHCPC5', '', '0.00', '0.00', '68.00', 3, '2009-11-01', '2009-12-31', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1952485625', 0, 'Y', 0, '2012-02-08', NULL, NULL, 0, 0, NULL, NULL),
('522229954', 'W11014294', 'W11014294', 'UT01', 'Meier & Marsh Professional Therapies', 'Charles', 'Wade', 'Meier', 'PT', 'Physical Therapy', '', '', NULL, 'B', 'PO Box 74125', 'Salt Lake City', 'Salt Lake', 'UT', '84171', '8019422729', NULL, 'PO Box 74125', 'Salt Lake City', 'Salt Lake', 'UT', '84171', '8019422729', '          ', 'WestRehab', 'WUSTDHCPC5', '', '0.00', '0.00', '68.00', 3, '2009-11-01', '2009-12-31', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1699767954', 0, 'Y', 0, '2011-04-22', NULL, NULL, 0, 0, NULL, NULL),
('522229954', 'W11014293', 'W11014293', 'UT01', 'Logan Physical Therapy', 'Susan', 'A', 'Doucette', 'PT', 'Physical Therapy', '', '', NULL, 'B', 'PO Box 74125', 'Salt Lake City', 'Salt Lake', 'UT', '84171', '8019422729', NULL, 'PO Box 74125', 'Salt Lake City', 'Salt Lake', 'UT', '84171', '8019422729', '          ', 'WestRehab', 'WUSTDHCPC5', '', '0.00', '0.00', '68.00', 3, '2009-11-01', '2009-12-31', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1972613099', 0, 'Y', 0, '2011-04-20', NULL, NULL, 0, 0, NULL, NULL),
('522229954', 'W11014292', 'W11014292', 'UT01', 'Life Center Physical Therapy', 'David', 'George', 'Strand', 'PT', 'Physical Therapy', NULL, NULL, NULL, 'B', 'PO Box 74125', 'Salt Lake City', 'Salt Lake', 'UT', '84171', '8019422729', NULL, NULL, NULL, 'Salt Lake', NULL, NULL, NULL, NULL, 'WestRehab', 'WUSTDHCPC5', NULL, '0.00', '0.00', '68.00', 3, '2009-11-01', '2009-11-01', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1821155219', 0, 'Y', 0, '2008-10-03', NULL, NULL, 0, 0, NULL, NULL),
('522229954', 'W11014291', 'W11014291', 'UT01', 'Human Performance Institute', 'John', 'Robert', 'Sumsion', 'PT', 'Physical Therapy', NULL, NULL, NULL, 'B', 'PO Box 74125', 'Salt Lake City', 'Salt Lake', 'UT', '84171', '8019422729', NULL, 'PO Box 74125', 'Salt Lake City', 'Salt Lake', 'UT', '84171', '8019422729', '          ', 'WestRehab', 'WUSTDHCPC5', '', '0.00', '0.00', '68.00', 3, '2009-11-01', '2009-12-31', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1598887069', 0, 'Y', 0, '2011-04-20', NULL, NULL, 0, 0, NULL, NULL),
('522229954', 'W11014301', 'W11014301', 'UT01', 'Mountain Land Rehabilitation', 'Mark', 'D', 'Anderson', 'PT', 'Physical Therapy', '', '', NULL, 'B', 'PO Box 74125', 'Salt Lake City', 'Salt Lake', 'UT', '84171', '8019422729', NULL, 'PO Box 74125', 'Salt Lake City', 'Salt Lake', 'UT', '84171', '8019422729', '          ', 'WestRehab', 'WUSTDHCPC5', '', '0.00', '0.00', '68.00', 3, '2009-11-01', '2009-12-31', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1790889889', 0, 'Y', 0, '2012-01-10', NULL, NULL, 0, 0, NULL, NULL),
('522229954', 'W11014451', 'W11014451', 'UT01', 'ProRehab Physical Therapy', 'Scott', 'Ross', 'Labrum', 'PT', 'Physical Therapy', '', '', NULL, 'B', 'PO Box 74125', 'Salt Lake City', 'Salt Lake', 'UT', '84171', '8019422729', NULL, 'PO Box 74125', 'Salt Lake City', 'Salt Lake', 'UT', '84171', '8019422729', '          ', 'WestRehab', 'WUSTDHCPC5', '', '0.00', '0.00', '68.00', 3, '2009-11-01', '2009-12-31', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1457343725', 0, 'Y', 0, '2013-06-21', NULL, NULL, 0, 0, NULL, NULL),
('522229954', 'W11014060', 'W11014060', 'UT01', 'Wasatch Peak Physical Therapy', 'Mathew', 'D', 'Larsen', 'PT', 'Physical Therapy', '', '', NULL, 'B', 'PO Box 74125', 'Salt Lake City', 'Salt Lake', 'UT', '84171', '8019422729', NULL, 'PO Box 74125', 'Salt Lake City', 'Salt Lake', 'UT', '84171', '8019422729', '          ', 'WestRehab', 'WUSTDHCPC5', '', '0.00', '0.00', '65.00', 3, '2008-10-01', '2009-10-31', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1528183878', 0, 'Y', 0, '2012-01-05', NULL, NULL, 0, 0, NULL, NULL),
('522229954', 'W11014061', 'W11014061', 'UT01', 'Wasatch Peak Physical Therapy', 'Royce', '', 'Larsen', 'PT', 'Physical Therapy', '', '', NULL, 'B', 'PO Box 74125', 'Salt Lake City', 'Salt Lake', 'UT', '84171', '8019422729', NULL, 'PO Box 74125', 'Salt Lake City', 'Salt Lake', 'UT', '84171', '8019422729', '          ', 'WestRehab', 'WUSTDHCPC5', '', '0.00', '0.00', '65.00', 3, '2008-10-01', '2009-10-31', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1790800431', 0, 'Y', 0, '2012-01-05', NULL, NULL, 0, 0, NULL, NULL),
('522229954', 'W11014062', 'W11014062', 'UT01', 'Peak Physical Therapy', 'Jason', 'S', 'Littledike', 'PT', 'Physical Therapy', '', '', NULL, 'B', 'PO Box 74125', 'Salt Lake City', 'Salt Lake', 'UT', '84171', '8019422729', NULL, 'PO Box 74125', 'Salt Lake City', 'Salt Lake', 'UT', '84171', '8019422729', '          ', 'WestRehab', 'WUSTDHCPC5', '', '0.00', '0.00', '65.00', 3, '2008-10-01', '2009-10-31', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1386644524', 0, 'Y', 0, '2013-06-21', NULL, NULL, 0, 0, NULL, NULL),
('522229954', 'W11014063', 'W11014063', 'UT01', 'Wasatch Peak Physical Therapy', 'Kent', 'C', 'Logan', 'PT', 'Physical Therapy', '', '', NULL, 'B', 'PO Box 74125', 'Salt Lake City', 'Salt Lake', 'UT', '84171', '8019422729', NULL, NULL, NULL, 'Salt Lake', NULL, NULL, NULL, NULL, 'WestRehab', 'WUSTDHCPC5', NULL, '0.00', '0.00', '65.00', 3, '2008-10-01', '2009-10-31', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1467577718', 0, 'Y', 0, '2011-09-13', NULL, NULL, 0, 0, NULL, NULL),
('522229954', 'W11014065', 'W11014065', 'UT01', 'Wasatch Therapy', 'Adam', 'D', 'Morris', 'PT', 'Physical Therapy', NULL, NULL, NULL, 'B', 'PO Box 74125', 'Salt Lake City', 'Salt Lake', 'UT', '84171', '8019422729', NULL, NULL, NULL, 'Salt Lake', NULL, NULL, NULL, NULL, 'WestRehab', 'WUSTDHCPC5', NULL, '0.00', '0.00', '65.00', 3, '2008-10-01', '2008-10-01', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1427140342', 0, 'Y', 0, '2008-10-03', NULL, NULL, 0, 0, NULL, NULL),
('522229954', 'W11014066', 'W11014066', 'UT01', 'Registered Physical Therapists', 'Drew', 'Richard', 'Norwood', 'PT', 'Physical Therapy', '', '', NULL, 'B', 'PO Box 74125', 'Salt Lake City', 'Salt Lake', 'UT', '84171', '8019422729', NULL, 'PO Box 74125', 'Salt Lake City', 'Salt Lake', 'UT', '84171', '8019422729', '          ', 'WestRehab', 'WUSTDHCPC5', '', '0.00', '0.00', '65.00', 3, '2008-10-01', '2009-10-31', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1851378830', 0, 'Y', 0, '2011-10-20', NULL, NULL, 0, 0, NULL, NULL),
('522229954', 'W11014372', 'W11014372', 'UT01', 'Wasatch Therapy', 'Robyn', 'M', 'Judd', 'DPT', 'Physical Therapy', '', '', NULL, 'B', 'PO Box 74125', 'Salt Lake City', 'Salt Lake', 'UT', '84171', '8019422729', NULL, 'PO Box 74125', 'Salt Lake City', 'Salt Lake', 'UT', '84171', '8019422729', '          ', 'WestRehab', 'WUSTDHCPC5', '', '0.00', '0.00', '68.00', 3, '2009-11-01', '2009-12-31', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1295834679', 0, 'Y', 0, '2011-11-01', NULL, NULL, 0, 0, NULL, NULL),
('522229954', 'W11014068', 'W11014068', 'UT01', 'Wasatch Peak Physical Therapy', 'Christopher', 'Greg', 'Packard', 'PT', 'Physical Therapy', NULL, NULL, NULL, 'B', 'PO Box 74125', 'Salt Lake City', 'Salt Lake', 'UT', '84171', '8019422729', NULL, NULL, NULL, 'Salt Lake', NULL, NULL, NULL, NULL, 'WestRehab', 'WUSTDHCPC5', NULL, '0.00', '0.00', '65.00', 3, '2008-10-01', '2009-01-01', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '0000008025', 0, 'Y', 0, '2008-10-03', NULL, NULL, 0, 0, NULL, NULL),
('522229954', 'W11014057', 'W11014057', 'UT01', 'Bear Lake Physical Therapy', 'Kam', 'E', 'Jarman', 'PT', 'Physical Therapy', '', '', NULL, 'B', 'PO Box 74125', 'Salt Lake City', 'Salt Lake', 'UT', '84171', '8019422729', NULL, 'PO Box 74125', 'Salt Lake City', 'Salt Lake', 'UT', '84171', '8019422729', '          ', 'WestRehab', 'WUSTDHCPC5', '', '0.00', '0.00', '65.00', 3, '2008-10-01', '2009-10-31', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1710073523', 0, 'Y', 0, '2012-06-29', NULL, NULL, 0, 0, NULL, NULL),
('522229954', 'W11014070', 'W11014070', 'UT01', 'Hand & Orthopedic Rehabilitation Specialists', 'Seth', 'M', 'Riley', 'DPT', 'Physical Therapy', NULL, NULL, NULL, 'B', 'PO Box 74125', 'Salt Lake City', 'Salt Lake', 'UT', '84171', '8019422729', NULL, 'PO Box 74125', 'Salt Lake City', 'Salt Lake', 'UT', '84171', '8019422729', '          ', 'WestRehab', 'WUSTDHCPC5', '', '0.00', '0.00', '65.00', 3, '2008-10-01', '2009-10-31', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1427033109', 0, 'Y', 0, '2011-11-29', NULL, NULL, 0, 0, NULL, NULL),
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('522229954', 'W11014359', 'W11014359', 'UT01', 'Rocky Mountain Therapy Services', 'Braden', 'J', 'Taylor', 'PT', 'Physical Therapy', '', '', NULL, 'B', 'PO Box 74125', 'Salt Lake City', 'Salt Lake', 'UT', '84171', '8019422729', NULL, 'PO Box 74125', 'Salt Lake City', 'Salt Lake', 'UT', '84171', '8019422729', '          ', 'WestRehab', 'WUSTDHCPC5', '', '0.00', '0.00', '68.00', 3, '2009-11-01', '2009-12-31', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1598788036', 0, 'Y', 0, '2013-08-15', NULL, NULL, 0, 0, NULL, NULL),
('522229954', 'W11014349', 'W11014349', 'UT01', 'Registered Physical Therapists', 'Josh', 'Douglas', 'Boulton', 'PT', 'Physical Therapy', NULL, NULL, NULL, 'B', 'PO Box 74125', 'Salt Lake City', 'Salt Lake', 'UT', '84171', '8019422729', NULL, NULL, NULL, 'Salt Lake', NULL, NULL, NULL, NULL, 'WestRehab', 'WUSTDHCPC5', NULL, '0.00', '0.00', '68.00', 3, '2009-11-01', '2009-12-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1457338550', 0, 'Y', 0, '2008-10-03', NULL, NULL, 0, 0, NULL, NULL),
('522229954', 'W11014348', 'W11014348', 'UT01', 'Registered Physical Therapists', 'Greg', 'Jonathon', 'Baker', 'PT', 'Physical Therapy', '', '', NULL, 'B', 'PO Box 74125', 'Salt Lake City', 'Salt Lake', 'UT', '84171', '8019422729', NULL, 'PO Box 74125', 'Salt Lake City', 'Salt Lake', 'UT', '84171', '8019422729', '          ', 'WestRehab', 'WUSTDHCPC5', '', '0.00', '0.00', '68.00', 3, '2009-11-01', '2009-12-31', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1558348516', 0, 'Y', 0, '2011-10-20', NULL, NULL, 0, 0, NULL, NULL),
('522229954', 'W11014347', 'W11014347', 'UT01', 'Registered Physical Therapists', 'Scott', 'C', 'Benson', 'PT', 'Physical Therapy', '', '', NULL, 'B', 'PO Box 74125', 'Salt Lake City', 'Salt Lake', 'UT', '84171', '8019422729', NULL, 'PO Box 74125', 'Salt Lake City', 'Salt Lake', 'UT', '84171', '8019422729', '          ', 'WestRehab', '', '', '0.00', '0.00', '68.00', 3, '2009-11-01', '2009-12-31', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1447237490', 0, 'Y', 0, '2011-10-20', NULL, NULL, 0, 0, NULL, NULL),
('522229954', 'W11014346', 'W11014346', 'UT01', 'Registered Physical Therapists', 'Brent', 'L', 'Miller', 'PT', 'Physical Therapy', '', '', NULL, 'B', 'PO Box 74125', 'Salt Lake City', 'Salt Lake', 'UT', '84171', '8019422729', NULL, 'PO Box 74125', 'Salt Lake City', 'Salt Lake', 'UT', '84171', '8019422729', '          ', 'WestRehab', 'WUSTDHCPC5', '', '0.00', '0.00', '68.00', 3, '2009-11-01', '2009-12-31', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1720065840', 0, 'Y', 0, '2011-10-20', NULL, NULL, 0, 0, NULL, NULL),
('522229954', 'W11014345', 'W11014345', 'UT01', 'Physical Therapy @ The Crossroads', 'Michael', 'R', 'Bond', 'PT', 'Physical Therapy', NULL, NULL, NULL, 'B', 'PO Box 74125', 'Salt Lake City', 'Salt Lake', 'UT', '84171', '8019422729', NULL, NULL, NULL, 'Salt Lake', NULL, NULL, NULL, NULL, 'WestRehab', 'WUSTDHCPC5', NULL, '0.00', '0.00', '68.00', 3, '2009-11-01', '2009-11-01', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1518990183', 0, 'Y', 0, '2008-10-03', NULL, NULL, 0, 0, NULL, NULL),
('522229954', 'W11014344', 'W11014344', 'UT01', 'Physical & Sports Therapy Services', 'Greg', 'R', 'Thorpe', 'PT', 'Physical Therapy', NULL, NULL, NULL, 'B', 'PO Box 74125', 'Salt Lake City', 'Salt Lake', 'UT', '84171', '8019422729', NULL, 'PO Box 74125', 'Salt Lake City', 'Salt Lake', 'UT', '84171', '8019422729', '          ', 'WestRehab', 'WUSTDHCPC5', '', '0.00', '0.00', '68.00', 3, '2009-11-01', '2009-12-31', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1316933500', 0, 'Y', 0, '2011-04-21', NULL, NULL, 0, 0, NULL, NULL),
('522229954', 'W11014343', 'W11014343', 'UT01', 'Physical & Sports Therapy Services', 'William', '', 'Sumsion', 'PT', 'Physical Therapy', '', '', NULL, 'B', 'PO Box 74125', 'Salt Lake City', 'Salt Lake', 'UT', '84171', '8019422729', NULL, 'PO Box 74125', 'Salt Lake City', 'Salt Lake', 'UT', '84171', '8019422729', '          ', 'WestRehab', 'WUSTDHCPC5', '', '0.00', '0.00', '68.00', 3, '2009-11-01', '2009-12-31', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1659367845', 0, 'Y', 0, '2011-10-26', NULL, NULL, 0, 0, NULL, NULL),
('522229954', 'W11014342', 'W11014342', 'UT01', 'Physical & Sports Therapy Services', 'Craig', 'Alan', 'Schultz', 'PT', 'Physical Therapy', '', '', NULL, 'B', 'PO Box 74125', 'Salt Lake City', 'Salt Lake', 'UT', '84171', '8019422729', NULL, 'PO Box 74125', 'Salt Lake City', 'Salt Lake', 'UT', '84171', '8019422729', '          ', 'WestRehab', 'WUSTDHCPC5', '', '0.00', '0.00', '68.00', 3, '2009-11-01', '2009-12-31', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1508852484', 0, 'Y', 0, '2011-10-26', NULL, NULL, 0, 0, NULL, NULL),
('522229954', 'W11014341', 'W11014341', 'UT01', 'Physical & Sports Therapy Services', 'Brad', 'A', 'Mangum', 'PT', 'Physical Therapy', '', '', NULL, 'B', 'PO Box 74125', 'Salt Lake City', 'Salt Lake', 'UT', '84171', '8019422729', NULL, 'PO Box 74125', 'Salt Lake City', 'Salt Lake', 'UT', '84171', '8019422729', '          ', 'WestRehab', 'WUSTDHCPC5', '', '0.00', '0.00', '68.00', 3, '2009-11-01', '2009-12-31', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1316992548', 0, 'Y', 0, '2013-04-16', NULL, NULL, 0, 0, NULL, NULL),
('522229954', 'W11014340', 'W11014340', 'UT01', 'Physical & Sports Therapy Services', 'Brian', 'B', 'Lambert', 'PT', 'Physical Therapy', '', '', NULL, 'B', 'PO Box 74125', 'Salt Lake City', 'Salt Lake', 'UT', '84171', '8019422729', NULL, 'PO Box 74125', 'Salt Lake City', 'Salt Lake', 'UT', '84171', '8019422729', '          ', 'WestRehab', 'WUSTDHCPC5', '', '0.00', '0.00', '68.00', 3, '2009-11-01', '2009-12-31', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1639165707', 0, 'Y', 0, '2011-04-21', NULL, NULL, 0, 0, NULL, NULL),
('522229954', 'W11014352', 'W11014352', 'UT01', 'Registered Physical Therapists', 'Stanford', 'K', 'Hirai', 'PT', 'Physical Therapy', '', '', NULL, 'B', 'PO Box 74125', 'Salt Lake City', 'Salt Lake', 'UT', '84171', '8019422729', NULL, 'PO Box 74125', 'Salt Lake City', 'Salt Lake', 'UT', '84171', '8019422729', '          ', 'WestRehab', 'WUSTDHCPC5', '', '0.00', '0.00', '68.00', 3, '2009-11-01', '2009-12-31', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1972580074', 0, 'Y', 0, '2011-10-20', NULL, NULL, 0, 0, NULL, NULL),
('522229954', 'W11014366', 'W11014366', 'UT01', 'Sports Medicine Clinic', 'Roger', 'L', 'Colvin', 'PT', 'Physical Therapy', '', '', NULL, 'B', 'PO Box 74125', 'Salt Lake City', 'Salt Lake', 'UT', '84171', '8019422729', NULL, 'PO Box 74125', 'Salt Lake City', 'Salt Lake', 'UT', '84171', '8019422729', '          ', 'WestRehab', 'WUSTDHCPC5', '', '0.00', '0.00', '68.00', 3, '2009-11-01', '2009-07-06', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1740390988', 0, 'Y', 0, '2011-04-20', NULL, NULL, 0, 0, NULL, NULL),
('522229954', 'W11014368', 'W11014368', 'UT01', 'Summit Valley Physical Therapy', 'Byron', 'H', 'Horner', 'PT', 'Physical Therapy', '', '', NULL, 'B', 'PO Box 74125', 'Salt Lake City', 'Salt Lake', 'UT', '84171', '8019422729', NULL, 'PO Box 74125', 'Salt Lake City', 'Salt Lake', 'UT', '84171', '8019422729', '          ', 'WestRehab', 'WUSTDHCPC5', '', '0.00', '0.00', '68.00', 3, '2009-11-01', '2009-12-31', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1710061460', 0, 'Y', 0, '2013-12-30', NULL, NULL, 0, 0, NULL, NULL),
('522229954', 'W11014363', 'W11014363', 'UT01', 'Spine, Orthopedic & Sports Physical Therapy', 'Rogan', 'L', 'Taylor', 'PT', 'Physical Therapy', NULL, NULL, NULL, 'B', 'PO Box 74125', 'Salt Lake City', 'Salt Lake', 'UT', '84171', '8019422729', NULL, 'PO Box 74125', 'Salt Lake City', 'Salt Lake', 'UT', '84171', '8019422729', '          ', 'WestRehab', 'WUSTDHCPC5', '', '0.00', '0.00', '68.00', 3, '2009-11-01', '2009-12-31', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1356333611', 0, 'Y', 0, '2011-04-20', NULL, NULL, 0, 0, NULL, NULL),
('522229954', 'W11014364', 'W11014364', 'UT01', 'Spine, Orthopedic & Sports Physical Therapy', 'Mark', 'H', 'Peterson', 'DPT', 'Physical Therapy', '', '', NULL, 'B', 'PO Box 74125', 'Salt Lake City', 'Salt Lake', 'UT', '84171', '8019422729', NULL, 'PO Box 74125', 'Salt Lake City', 'Salt Lake', 'UT', '84171', '8019422729', '          ', 'WestRehab', 'WUSTDHCPC5', '', '0.00', '0.00', '68.00', 3, '2009-11-01', '2009-12-31', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1528089224', 0, 'Y', 0, '2011-04-20', NULL, NULL, 0, 0, NULL, NULL),
('522229954', 'W11014365', 'W11014365', 'UT01', 'South Mountain Sports & Rehab', 'Kevin', 'L', 'Shepherd', 'PT', 'Physical Therapy', NULL, NULL, NULL, 'B', 'PO Box 74125', 'Salt Lake City', 'Salt Lake', 'UT', '84171', '8019422729', NULL, 'PO Box 74125', 'Salt Lake City', 'Salt Lake', 'UT', '84171', '8019422729', '          ', 'WestRehab', 'WUSTDHCPC5', '', '0.00', '0.00', '68.00', 3, '2009-11-01', '2009-12-31', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1679621254', 0, 'Y', 0, '2011-04-20', NULL, NULL, 0, 0, NULL, NULL),
('522229954', 'W11014367', 'W11014367', 'UT01', 'Sports Medicine Clinic', 'Chris', 'H', 'Dahlberg', 'PT', 'Physical Therapy', '', '', NULL, 'B', 'PO Box 74125', 'Salt Lake City', 'Salt Lake', 'UT', '84171', '8019422729', NULL, 'PO Box 74125', 'Salt Lake City', 'Salt Lake', 'UT', '84171', '8019422729', '          ', 'WestRehab', 'WUSTDHCPC5', '', '0.00', '0.00', '68.00', 3, '2009-11-01', '2009-12-31', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1366553208', 0, 'Y', 0, '2012-01-10', NULL, NULL, 0, 0, NULL, NULL),
('522229954', 'W11014369', 'W11014369', 'UT01', 'Wasatch Therapy', 'Marilyn', 'Kay', 'Lyman', 'OT', 'Occupational Therapy', 'Physical Therapy', NULL, NULL, 'B', 'PO Box 74125', 'Salt Lake City', 'Salt Lake', 'UT', '84171', '8019422729', NULL, NULL, NULL, 'Salt Lake', NULL, NULL, NULL, NULL, 'WestRehab', 'WUSTDHCPC5', NULL, '0.00', '0.00', '68.00', 3, '2009-11-01', '2009-11-01', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1174615090', 0, 'Y', 0, '2008-10-03', NULL, NULL, 0, 0, NULL, NULL),
('522229954', 'W11014370', 'W11014370', 'UT01', 'Wasatch Therapy', 'Elizabeth', 'A', 'Hall', 'PT', 'Physical Therapy', NULL, NULL, NULL, 'B', 'PO Box 74125', 'Salt Lake City', 'Salt Lake', 'UT', '84171', '8019422729', NULL, NULL, NULL, 'Salt Lake', NULL, NULL, NULL, NULL, 'WestRehab', 'WUSTDHCPC5', NULL, '0.00', '0.00', '68.00', 3, '2009-11-01', '2009-11-01', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1457443376', 0, 'Y', 0, '2008-10-03', NULL, NULL, 0, 0, NULL, NULL),
('522229954', 'W11014266', 'W11014266', 'UT01', 'Sports Medicine Clinic', 'Roger', 'L', 'Colvin', 'PT', 'Physical Therapy', '', '', NULL, 'O', '990 S Medical Dr Ste U-4', 'Brigham City', 'Box Elder', 'UT', '84302', '4357236487', NULL, '990 S Medical Dr Ste U-4', 'Brigham City', 'Box Elder', 'UT', '84302', '4357236487', '          ', 'WestRehab', 'WUSTDHCPC5', '', '0.00', '0.00', '68.00', 3, '2009-11-01', '2009-07-06', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1740390988', 0, 'N', 0, '2011-04-20', NULL, NULL, 0, 0, NULL, NULL),
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('522229954', 'W11013847', 'W11013847', 'UT01', 'Performance West Physical Therapy', 'Stephen', 'Reese', 'Spencer', 'PT', 'Physical Therapy', '', '', NULL, 'O', '4920 E 2550 N Ste C', 'Eden', 'Weber', 'UT', '84310', '8017453200', NULL, '4920 E 2550 N', 'Eden', 'Weber', 'UT', '84310', NULL, NULL, 'WestRehab', 'WUSTDHCPC5', NULL, '0.00', '0.00', '65.00', 3, '2008-10-01', '2009-10-31', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1003894379', 0, 'N', 0, '2010-11-11', NULL, NULL, 0, 0, NULL, NULL),
('522229954', 'W11013846', 'W11013846', 'UT01', 'Performance West Physical Therapy', 'Kim', 'W', 'Reid', 'PT', 'Physical Therapy', '', '', NULL, 'O', '4920 E 2550 N Ste C', 'Eden', 'Weber', 'UT', '84310', '8017453200', NULL, '4920 E 2550 N Ste C', 'Eden', 'Weber', 'UT', '84310', '8017453200', '          ', 'WestRehab', 'WUSTDHCPC5', '', '0.00', '0.00', '65.00', 3, '2008-10-01', '2008-12-31', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1558362434', 0, 'N', 0, '2011-11-01', NULL, NULL, 0, 0, NULL, NULL),
('522229954', 'W11014238', 'W11014238', 'UT01', 'Performance West Physical Therapy', 'Kim', 'W', 'Reid', 'PT', 'Physical Therapy', '', '', NULL, 'O', '4920 E 2550 N Ste C', 'Eden', 'Weber', 'UT', '84310', '8017453200', NULL, '4920 E 2550 N Ste C', 'Eden', 'Weber', 'UT', '84310', '8017453200', '          ', 'WestRehab', 'WUSTDHCPC5', '', '0.00', '0.00', '68.00', 3, '2009-11-01', '2009-11-01', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1558362434', 0, 'N', 0, '2011-11-01', NULL, NULL, 0, 0, NULL, NULL),
('522229954', 'W11014239', 'W11014239', 'UT01', 'Performance West Physical Therapy', 'Stephen', 'Reese', 'Spencer', 'PT', 'Physical Therapy', '', '', NULL, 'O', '4920 E 2550 N Ste C', 'Eden', 'Weber', 'UT', '84310', '8017453200', NULL, '4920 E 2550 N', 'Eden', 'Weber', 'UT', '84310', NULL, NULL, 'WestRehab', 'WUSTDHCPC5', NULL, '0.00', '0.00', '68.00', 3, '2009-11-01', '2009-12-31', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1003894379', 0, 'N', 0, '2010-11-11', NULL, NULL, 0, 0, NULL, NULL),
('522229954', 'W11014088', 'W11014088', 'UT01', 'Mountain West Physical Therapy', 'Perry', 'Raymond', 'Crawford', 'PT', 'Physical Therapy', '', '', NULL, 'O', '451 W 600 N', 'Tremonton', 'Box Elder', 'UT', '84337', '4352573809', NULL, '451 W 600 N', 'Tremonton', 'Box Elder', 'UT', '84337', '4352573809', '          ', 'WestRehab', 'WUSTDHCPC5', '', '0.00', '0.00', '65.00', 3, '2008-10-01', '2009-10-31', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1740328798', 0, 'N', 0, '2011-04-21', NULL, NULL, 0, 0, NULL, NULL),
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('522229954', 'W11013807', 'W11013807', 'UT01', 'Logan Physical Therapy', 'Susan', 'A', 'Doucette', 'PT', 'Physical Therapy', '', '', NULL, 'O', '2310 N 400 E', 'N Logan', 'Cache', 'UT', '84341', '4357878797', NULL, '2310 N 400 E', 'N Logan', 'Cache', 'UT', '84341', '4357878797', '          ', 'WestRehab', 'WUSTDHCPC5', '', '0.00', '0.00', '65.00', 3, '2008-10-01', '2009-10-31', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1972613099', 0, 'N', 0, '2011-04-20', NULL, NULL, 0, 0, NULL, NULL),
('522229954', 'W11014100', 'W11014100', 'UT01', 'Mountain West Physical Therapy', 'Ryan', '', 'Godfrey', 'OT CHT', 'Physical Therapy', NULL, NULL, NULL, 'O', '2380 N 400 E', 'North Logan', 'Cache', 'UT', '84341', '4357139680', NULL, '2380 N 400 E', 'North Logan', 'Cache', 'UT', '84341', '4357139680', '          ', 'WestRehab', 'WUSTDHCPC5', '', '0.00', '0.00', '65.00', 3, '2008-10-01', '2009-10-31', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1942348875', 0, 'N', 0, '2011-10-25', NULL, NULL, 0, 0, NULL, NULL),
('522229954', 'W11014492', 'W11014492', 'UT01', 'Mountain West Physical Therapy', 'Ryan', '', 'Godfrey', 'OT CHT', 'Physical Therapy', NULL, NULL, NULL, 'O', '2380 N 400 E', 'North Logan', 'Cache', 'UT', '84341', '4357139680', NULL, '2380 N 400 E', 'North Logan', 'Cache', 'UT', '84341', '4357139680', '          ', 'WestRehab', 'WUSTDHCPC5', '', '0.00', '0.00', '68.00', 3, '2009-11-01', '2009-12-31', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1942348875', 0, 'N', 0, '2011-10-25', NULL, NULL, 0, 0, NULL, NULL),
('522229954', 'W11014199', 'W11014199', 'UT01', 'Logan Physical Therapy', 'Susan', 'A', 'Doucette', 'PT', 'Physical Therapy', '', '', NULL, 'O', '2310 N 400 E', 'N Logan', 'Cache', 'UT', '84341', '4357878797', NULL, '2310 N 400 E', 'N Logan', 'Cache', 'UT', '84341', '4357878797', '          ', 'WestRehab', 'WUSTDHCPC5', '', '0.00', '0.00', '68.00', 3, '2009-11-01', '2009-12-31', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1972613099', 0, 'N', 0, '2011-04-20', 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
('522229954', 'W11014108', 'W11014108', 'UT01', 'Mountain West Physical Therapy', 'Larry', 'D', 'Hunter', 'PT', 'Physical Therapy', '', '', NULL, 'O', '2380 N 400 E', 'North Logan', 'Cache', 'UT', '84341', '4357139680', NULL, '2380 N 400 E', 'North Logan', 'Cache', 'UT', '84341', '4357139680', '          ', 'WestRehab', 'WUSTDHCPC5', '', '0.00', '0.00', '65.00', 3, '2008-10-01', '2009-10-31', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1689712598', 0, 'N', 0, '2011-12-19', NULL, NULL, 0, 0, NULL, NULL),
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('522229954', 'W11014242', 'W11014242', 'UT01', 'Physical & Sports Therapy Services', 'Brian', 'B', 'Lambert', 'PT', 'Physical Therapy', '', '', NULL, 'O', '380 E 400 S', 'Springville', 'Utah', 'UT', '84663', '8014895669', NULL, '380 E 400 S', 'Springville', 'Utah', 'UT', '84663', '8014895669', '          ', 'WestRehab', 'WUSTDHCPC5', '', '0.00', '0.00', '68.00', 3, '2009-11-01', '2009-12-31', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1639165707', 0, 'N', 0, '2011-04-21', NULL, NULL, 0, 0, NULL, NULL),
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('522229954', 'W11014094', 'W11014094', 'UT01', 'Southern Utah Physical Therapy', 'Brady', '', 'Englestead', 'PT', 'Physical Therapy', '', '', NULL, 'O', '166 W 1325 N Ste 100', 'Cedar City', 'Iron', 'UT', '84720', '4355862665', '', '166 W 1325 N Ste 100', 'Cedar City', 'Iron', 'UT', '84720', '4355862665', '', 'WestRehab', 'WUSTDHCPC5', '', '0.00', '0.00', '65.00', 3, '2008-10-01', '2009-02-01', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1164455887', 0, 'N', 0, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
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('522229954', 'W11014101', 'W11014101', 'UT01', 'Gublers Physical Therapy', 'Troy', 'Cal', 'Gubler', 'PT', 'Physical Therapy', NULL, NULL, NULL, 'O', '68 S 700 W', 'Hurricane', 'Washington', 'UT', '84737', '4356359333', NULL, '68 S 700 W', 'Hurricane', 'Washington', 'UT', '84737', '4356359333', '          ', 'WestRehab', 'WUSTDHCPC5', '', '0.00', '0.00', '65.00', 3, '2008-10-01', '2009-10-31', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1033210067', 0, 'N', 0, '2013-11-13', NULL, NULL, 0, 0, NULL, NULL),
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('522229954', 'W11014537', 'W11014537', 'UT01', 'Mountain Land Rehabilitation', 'Robert', 'Craig', 'Lloyd', 'PT', 'Physical Therapy', '', '', NULL, 'O', '575 S 200 E Ste 2', 'Ivins', 'Washington', 'UT', '84738', '4356741269', NULL, '575 S 200 E Ste 2', 'Ivins', 'Washington', 'UT', '84738', '4356741269', '          ', 'WestRehab', 'WUSTDHCPC5', '', '0.00', '0.00', '68.00', 3, '2009-11-01', '2009-12-31', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1922102177', 0, 'N', 0, '2011-04-20', NULL, NULL, 0, 0, NULL, NULL),
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('522229954', 'W11014542', 'W11014542', 'UT01', 'Frandsen Physical Therapy', 'David', '', 'Frandsen', 'PT', 'Physical Therapy', '', '', NULL, 'O', '115 N Main Ste B', 'Panguitch', 'Garfield', 'UT', '84759', '4356768840', '4356768801', '115 N Main Ste B', 'Panguitch', 'Garfield', 'UT', '84759', '4356768840', '4356768801', 'WestRehab', 'WUSTDHCPC5', '', '0.00', '0.00', '68.00', 3, '2009-11-01', '2009-12-31', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1720091473', 0, 'N', 0, '2012-02-08', NULL, NULL, 0, 0, NULL, NULL),
('522229954', 'W11014150', 'W11014150', 'UT01', 'Frandsen Physical Therapy', 'David', '', 'Frandsen', 'PT', 'Physical Therapy', '', '', NULL, 'O', '115 N Main Ste B', 'Panguitch', 'Garfield', 'UT', '84759', '4356768840', '4356768801', '115 N Main Ste B', 'Panguitch', 'Garfield', 'UT', '84759', '4356768840', '4356768801', 'WestRehab', 'WUSTDHCPC5', '', '0.00', '0.00', '65.00', 3, '2008-10-01', '2009-10-31', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1720091473', 0, 'N', 0, '2012-02-08', 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
('522229954', 'W11013833', 'W11013833', 'UT01', 'Mountain Land Rehabilitation Mendenhall Physical Therapy', 'Troy', 'Lynn', 'Mendenhall', 'PT', 'Physical Therapy', '', '', NULL, 'O', '754 S Main Ste 4', 'St George', 'Washington', 'UT', '84770', '4356732781', NULL, '754 S Main Ste 4', 'St George', 'Washington', 'UT', '84770', '4356732781', '          ', 'WestRehab', 'WUSTDHCPC5', '', '0.00', '0.00', '65.00', 3, '2008-10-01', '2008-12-11', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1811009681', 0, 'N', 0, '2013-05-17', NULL, NULL, 0, 0, NULL, NULL),
('522229954', 'W11014008', 'W11014008', 'UT01', 'Southwest Neurological Rehabilitation Center', 'Steven', 'Clark', 'Bennett', 'PT', 'Physical Therapy', '', '', NULL, 'O', '301 N 200 E Ste 3E', 'St George', 'Washington', 'UT', '84770', '4356285194', NULL, '301 N 200 E Ste 3E', 'St George', 'Washington', 'UT', '84770', '4356285194', '          ', 'WestRehab', 'WUSTDHCPC5', '', '0.00', '0.00', '65.00', 3, '2008-10-01', '2009-10-31', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1205911872', 0, 'N', 0, '2013-10-16', NULL, NULL, 0, 0, NULL, NULL),
('522229954', 'W11014400', 'W11014400', 'UT01', 'Southwest Neurological Rehabilitation Center', 'Steven', 'Clark', 'Bennett', 'PT', 'Physical Therapy', '', '', NULL, 'O', '301 N 200 E Ste 3E', 'St George', 'Washington', 'UT', '84770', '4356285194', NULL, '301 N 200 E Ste 3E', 'St George', 'Washington', 'UT', '84770', '4356285194', '          ', 'WestRehab', 'WUSTDHCPC5', '', '0.00', '0.00', '68.00', 3, '2009-11-01', '2009-12-31', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1205911872', 0, 'N', 0, '2013-10-16', NULL, NULL, 0, 0, NULL, NULL),
('522229954', 'W11014530', 'W11014530', 'UT01', 'Mountain Land Rehabilitation Home Health', 'Steve', 'Eugene', 'Swinson', 'PT', 'Physical Therapy', '', '', NULL, 'O', '676 S Bluff St', 'St George', 'Washington', 'UT', '84770', '4356730191', NULL, '676 S Bluff St', 'St George', 'Washington', 'UT', '84770', '4356730191', '          ', 'WestRehab', 'WUSTDHCPC5', '', '0.00', '0.00', '68.00', 3, '2009-11-01', '2009-11-01', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1144281866', 0, 'N', 0, '2011-05-31', NULL, NULL, 0, 0, NULL, NULL),
('522229954', 'W11014225', 'W11014225', 'UT01', 'Mountain Land Rehabilitation Mendenhall Physical Therapy', 'Troy', 'Lynn', 'Mendenhall', 'PT', 'Physical Therapy', '', '', NULL, 'O', '754 S Main Ste 4', 'St George', 'Washington', 'UT', '84770', '4356732781', NULL, '754 S Main Ste 4', 'St George', 'Washington', 'UT', '84770', '4356732781', '          ', 'WestRehab', 'WUSTDHCPC5', '', '0.00', '0.00', '68.00', 3, '2009-11-01', '2009-11-01', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1811009681', 0, 'N', 0, '2013-05-17', NULL, NULL, 0, 0, NULL, NULL),
('522229954', 'W11014138', 'W11014138', 'UT01', 'Mountain Land Rehabilitation Home Health', 'Steve', 'Eugene', 'Swinson', 'PT', 'Physical Therapy', '', '', NULL, 'O', '676 S Bluff St', 'St George', 'Washington', 'UT', '84770', '4356730191', NULL, '676 S Bluff St', 'St George', 'Washington', 'UT', '84770', '4356730191', '          ', 'WestRehab', 'WUSTDHCPC5', '', '0.00', '0.00', '65.00', 3, '2008-10-01', '2008-10-01', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1144281866', 0, 'N', 0, '2011-05-31', NULL, NULL, 0, 0, NULL, NULL),
('522229954', 'W11014224', 'W11014224', 'UT01', 'Mountain Land Rehabilitation/Mendenhall Physical Therapy', 'Ronnie', 'L', 'Mendenhall', 'PT', 'Physical Therapy', '', '', NULL, 'O', '754 S Main Ste 4', 'St George', 'Washington', 'UT', '84770', '4356732781', NULL, '754 S Main Ste 4', 'St George', 'Washington', 'UT', '84770', '4356732781', '          ', 'WestRehab', 'WUSTDHCPC5', '', '0.00', '0.00', '68.00', 3, '2009-11-01', '2009-12-31', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1346310661', 0, 'N', 0, '2011-04-20', NULL, NULL, 0, 0, NULL, NULL),
('522229954', 'W11013832', 'W11013832', 'UT01', 'Mountain Land Rehabilitation/Mendenhall Physical Therapy', 'Ronnie', 'L', 'Mendenhall', 'PT', 'Physical Therapy', '', '', NULL, 'O', '754 S Main Ste 4', 'St George', 'Washington', 'UT', '84770', '4356732781', NULL, '754 S Main Ste 4', 'St George', 'Washington', 'UT', '84770', '4356732781', '          ', 'WestRehab', 'WUSTDHCPC5', '', '0.00', '0.00', '65.00', 3, '2008-10-01', '2009-10-31', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1346310661', 0, 'N', 0, '2011-04-20', NULL, NULL, 0, 0, NULL, NULL),
('522229954', 'W11013777', 'W11013777', 'UT01', 'Mountain Land Rehabilitation Home Health', 'Dean', 'C', 'Turner', 'PT', 'Physical Therapy', NULL, NULL, NULL, 'O', '1745 E 280 N', 'St George', 'Washington', 'UT', '84790', '4356285701', NULL, 'PO Box 74125', 'Salt Lake City', 'Washington', 'UT', '84171', NULL, NULL, 'WestRehab', 'WUSTDHCPC5', NULL, '0.00', '0.00', '65.00', 3, '2008-10-01', '2008-10-01', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1215025093', 0, 'N', 0, '2008-10-03', NULL, NULL, 0, 0, NULL, NULL),
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('201909762', 'W11014585', 'W11014585', 'WY01', 'Pro Physical Therapy ', 'Dallas', 'L', 'Clark', 'PT', 'Physical Therapy', '', '', NULL, 'B', 'PO Box 152', 'Laketown', 'Rich', 'UT', '84038', '3078771000', NULL, 'PO Box 152', 'Laketown', 'Rich', 'UT', '84038', '3078771000', '', 'WISEWYSTD', 'WUSTDHCPC5', NULL, '0.00', '35.00', '0.00', 3, '2008-10-03', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1972693497', 0, 'y', 0, '2011-10-04', NULL, NULL, 0, 0, NULL, NULL),
('870476076', 'W11014597', 'W11014597', 'UT01', 'Eyecare of Lehi', 'Robert', 'F', 'Gray', 'OD', 'Optometry', '', '', NULL, 'O', '785 E 200 S Ste 9', 'Lehi', 'Utah', 'UT', '84043', '8017684100', NULL, '785 E 200 S Ste 9', 'Lehi', 'Utah', 'UT', '84043', '8017684100', '          ', 'WISESTD', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 3, '2008-10-03', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1790757904', 0, 'N', 0, '2011-10-27', NULL, NULL, 40.3859, -111.835, NULL, NULL),
('200840307', 'W11014586', 'W11014586', 'UTMH1', 'Counseling and Assessments', 'Marilyn', 'N', 'Snell', 'PHD', 'Mental Health', 'Psychology', '', NULL, 'O', '11075 S State St Ste 28', 'Sandy', 'Salt Lake', 'UT', '84070', '8015018444', NULL, '11075 S State St Ste 28', 'Sandy', 'Salt Lake', 'UT', '84070', '8015018444', '', 'UTPHD', NULL, NULL, '0.00', '35.00', '0.00', 3, '2008-10-03', '2013-02-14', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1902873367', 0, 'n', 0, '2011-12-27', NULL, NULL, 0, 0, NULL, NULL),
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('870710584', 'W11014590', 'W11014590', 'UTMH1', 'Jordan West Family Counseling', 'Patricia', 'A', 'Hatala', 'LPC', 'Mental Health', 'Counseling', '', NULL, 'O', '9263 B Redwood Rd', 'West Jordan', 'Salt Lake', 'UT', '84088', '8015660749', NULL, '9263 B Redwood Rd', 'West Jordan', 'Salt Lake', 'UT', '84088', '8015660749', '', 'MA', NULL, NULL, '0.00', '35.00', '0.00', 6, '2008-10-03', '2013-02-14', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1619946357', 0, 'n', 0, '2011-11-28', NULL, NULL, 0, 0, NULL, NULL),
('200840307', 'W11014587', 'W11014587', 'UTMH1', 'Counseling and Assessments', 'Marilyn', 'N', 'Snell', 'PHD', 'Mental Health', 'Psychology', '', NULL, 'B', 'PO Box 900245', 'Sandy', 'Salt Lake', 'UT', '84090', '8015018444', NULL, 'PO Box 900245', 'Sandy', 'Salt Lake', 'UT', '84090', '8015018444', '', 'UTPHD', NULL, NULL, '0.00', '35.00', '0.00', 3, '2008-10-03', '2013-02-14', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1902873367', 0, 'Y', 0, '2011-12-27', NULL, NULL, 0, 0, NULL, NULL),
('870306646', 'W11014568', 'W11014568', 'UT01', 'Emergency Physicians Group', 'Mathew', 'B', 'Broadwater-Hollifield', 'MD', 'Emergency Medicine', '', '', NULL, 'B', 'PO Box 95970', 'South Jordan', 'Salt Lake', 'UT', '84095', '8013529500', NULL, 'PO Box 95970', 'South Jordan', 'Salt Lake', 'UT', '84095', '8013529500', '', 'WISESTD', 'WUSTDHCPC5', NULL, '0.00', '35.00', '0.00', 3, '2008-10-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1366648123', 0, 'Y', 0, '2011-07-19', NULL, NULL, 0, 0, NULL, NULL),
('294463343', 'W11014598', 'W11014598', 'UTMH1', NULL, 'Sally', 'S', 'Burgin', 'LCSW', 'Mental Health', 'Social Worker', '', NULL, 'O', '508 E S Temple Ste A30', 'Salt Lake City', 'Salt Lake', 'UT', '84102', '8015375008', NULL, '508 E S Temple Ste A30', 'Salt Lake City', 'Salt Lake', 'UT', '84102', '8015375008', '', 'MA', NULL, NULL, '0.00', '35.00', '0.00', 3, '2008-10-03', '2013-02-14', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1346219243', 0, 'n', 0, '2013-02-27', NULL, NULL, 0, 0, NULL, NULL),
('201757605', 'W11014582', 'W11014582', 'UT01', '', 'Carl', 'Kent', 'Hebdon', 'MD', 'Mental Health', 'Internal Medicine', '', NULL, 'O', '2040 E Murray Holladay Rd Ste 209', 'Salt Lake City', 'Salt Lake', 'UT', '84111', '8012730306', NULL, '2040 E Murray Holladay Rd Ste 209', 'Salt Lake City', 'Salt Lake', 'UT', '84111', '8012730306', '          ', 'WISESTD', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 3, '2008-10-03', '2011-05-01', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1215971759', 0, 'N', 0, '2011-04-29', NULL, NULL, 0, 0, NULL, NULL),
('201757605', 'W11014583', 'W11014583', 'UT01', '', 'Carl', 'Kent', 'Hebdon', 'MD', 'Mental Health', 'Internal Medicine', '', NULL, 'B', 'PO Box 1797', 'Layton', 'Salt Lake', 'UT', '84111', '8012730306', NULL, 'PO Box 1797', 'Layton', 'Salt Lake', 'UT', '84111', '8012730306', '          ', 'WISESTD', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 3, '2008-10-03', '2011-05-01', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1215971759', 0, 'N', 0, '2011-04-29', NULL, NULL, 0, 0, NULL, NULL),
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('870639098', 'W11014593', 'W11014593', 'UT01', 'After Hours Urgent Care WVC', 'William', 'D', 'Putnam', 'MD', 'Family Practice', '', '', NULL, 'O', '3451 S 5600 W Ste F', 'West Valley', 'Salt Lake', 'UT', '84120', '8019570900', NULL, '3451 S 5600 W Ste F', 'West Valley', 'Salt Lake', 'UT', '84120', '8019570900', '', 'WiseSTD', 'WUSTDHCPC5', NULL, '0.00', '35.00', '0.00', 3, '2008-10-06', '2008-10-06', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1932145968', 0, 'N', 0, '2013-10-23', NULL, NULL, 0, 0, NULL, NULL),
('870639098', 'W11014599', 'W11014599', 'UT01', 'After Hours Urgent Care WVC', 'David', 'J', 'Pombo', 'MD', 'Infectious Disease', 'Internal Medicine', '', NULL, 'O', '3451 S 5600 W Ste F', 'Salt Lake City', 'Salt Lake', 'UT', '84120', '8019570900', NULL, '3451 S 5600 W Ste F', 'Salt Lake City', 'Salt Lake', 'UT', '84120', '8019570900', '          ', 'WiseSTD', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 3, '2008-10-03', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1558720783', 0, 'Y', 0, '2013-10-23', NULL, NULL, 40.6977, -112.025, NULL, NULL),
('870306646', 'W11014567', 'W11014567', 'UT01', 'Emergency Physicians Group', 'Mathew', 'B', 'Broadwater-Hollifield', 'MD', 'Emergency Medicine', '', '', NULL, 'o', '1200 E 3900 S', 'Salt Lake City', 'Salt Lake', 'UT', '84124', '8012687975', NULL, '1200 E 3900 S', 'Salt Lake City', 'Salt Lake', 'UT', '84124', '8012687975', '          ', 'WISESTD', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 3, '2008-10-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1366648123', 0, 'Y', 0, '2011-07-19', NULL, NULL, 40.6871, -111.856, NULL, NULL),
('870682101', 'W11014575', 'W11014575', 'UT01', 'Salt Lake Orthopaedic Clinic', 'Phillip', 'D', 'Beck', 'PA', 'Orthopedic Surgery', '', '', NULL, 'O', '1160 E 3900 S Ste 5000', 'Salt Lake City', 'Salt Lake', 'UT', '84124', '8012628486', '8012629752', '1160 E 3900 S', 'Salt Lake City', 'Salt Lake', 'UT', '84124', '8012628486', '8012629752', 'WUSLORTH5', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 3, '2008-10-06', '2009-02-28', NULL, 0, NULL, '', '', '', '', 'HCFA|UB|', '1881881183', 0, 'N', 0, '2010-04-29', NULL, NULL, 0, 0, NULL, NULL),
('870649259', 'W11014579', 'W11014579', 'UT01', 'Alpine Orthopaedic Specialists', 'James', 'G', 'Welker', 'PAC', 'Orthopedic Surgery', NULL, NULL, NULL, 'O', '2310 N 400 E Ste A', 'North Logan', 'Cache', 'UT', '84341', '4357872000', NULL, 'PO Box 6250', 'North Logan', 'Cache', 'UT', '84341', NULL, NULL, 'WISESTD', 'WUSTDHCPC5', NULL, '0.00', '35.00', '0.00', 3, '2008-10-06', '2010-01-18', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1215962022', 0, 'n', 0, '2008-10-07', NULL, NULL, 0, 0, NULL, NULL),
('870649259', 'W11014581', 'W11014581', 'UT01', 'Alpine Orthopaedic Specialists', 'James', 'G', 'Welker', 'PAC', 'Orthopedic Surgery', NULL, NULL, NULL, 'B', 'PO Box 6250', 'North Logan', 'Cache', 'UT', '84341', '4357872000', NULL, 'PO Box 6250', 'North Logan', 'Cache', 'UT', '84341', NULL, NULL, 'WISESTD', 'WUSTDHCPC5', NULL, '0.00', '35.00', '0.00', 3, '2008-10-06', '2010-01-18', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1215962022', 0, 'y', 0, '2008-10-07', NULL, NULL, 0, 0, NULL, NULL),
('870454312', 'W11014601', 'W11014601', 'UT01', 'San Juan Vision Clinic', 'Ronald', 'D', 'Kirk', 'OD', 'Optometry', '', '', NULL, 'O', '46 N Main St', 'Blanding', 'San Juan', 'UT', '84511', '4356782324', NULL, '46 N Main St', 'Blanding', 'San Juan', 'UT', '84511', '4356782324', '', 'WISESTD', 'WUSTDHCPC5', NULL, '0.00', '35.00', '0.00', 3, '2008-10-03', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1780623595', 0, 'n', 0, '2014-03-19', NULL, NULL, 37.6261, -109.478, NULL, NULL),
('528450036', 'W11014591', 'W11014591', 'UTMH1', 'Voyager Therapeutic Services', 'Kory', 'L', 'Meacham', 'LPC', 'Mental Health', 'Counseling', '', NULL, 'O', '672 W 1000 S', 'Richfield', 'Sevier', 'UT', '84701', '4359792580', NULL, '672 W 1000 S', 'Richfield', 'Sevier', 'UT', '84701', '4359792580', '', 'MA', NULL, NULL, '0.00', '35.00', '0.00', 3, '2008-10-03', '2013-02-14', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1811102106', 0, 'n', 0, '2012-01-31', NULL, NULL, 0, 0, NULL, NULL),
('528450036', 'W11014592', 'W11014592', 'UTMH1', 'Voyager Therapeutic Services', 'Kory', 'L', 'Meacham', 'LPC', 'Mental Health', 'Counseling', '', NULL, 'B', 'PO Box 801', 'Richfield', 'Sevier', 'UT', '84701', '4359792580', NULL, 'PO Box 801', 'Richfield', 'Sevier', 'UT', '84701', '4359792580', '', 'MA', NULL, NULL, '0.00', '35.00', '0.00', 3, '2008-10-03', '2013-02-14', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1811102106', 0, 'y', 0, '2012-01-31', NULL, NULL, 0, 0, NULL, NULL),
('521262870', 'W11014614', 'W11014614', 'TX01', 'Dynasplint Systems Inc', NULL, NULL, 'Dynasplint Systems Inc  (Custom Braces)', 'GROUP', 'Durable Medical Equipment', 'Custom Splints', NULL, NULL, 'B', '770 Ritchie Hwy Ste W 21', 'Severna Park', 'Anne Arundel', 'MD', '21146', '8006386771', '4105449149', '770 Ritchie Highway', 'Severna Park', 'Anne Arundel', 'MD', '211463923', NULL, NULL, 'WCSTDSS5', NULL, NULL, '0.00', '100.00', '0.00', 3, '2007-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '0000006069', 0, 'Y', 0, '2008-10-08', NULL, NULL, 0, 0, NULL, NULL),
('541707322', 'W11014611', 'W11014611', 'TX01', 'Care Rehab and Orthopedic Products  (Muscle Stimulators)', '', '', 'Care Rehab and Orthopedic Products  (Muscle Stimulators)', 'GROUP', 'Durable Medical Equipment', '', '', NULL, 'B', 'PO Box 716', 'Keysville', 'Charlotte', 'VA', '23947', '8004879644', NULL, 'PO Box 716', 'Keysville', 'Charlotte', 'VA', '23947', '8004879644', '', 'WCSTCROP5', NULL, NULL, '0.00', '20.00', '0.00', 3, '2006-12-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1578562468', 0, 'y', 0, '2012-09-24', NULL, NULL, 0, 0, NULL, NULL),
('061128081', 'W11014620', 'W11014620', 'TX01', 'Dianon Systems Inc', '', '', 'Dianon Systems Inc', 'GROUP', 'Laboratory', '', '', NULL, 'B', 'PO Box 8005', 'Burlington', 'Alamance', 'NC', '27216', '8003282666', NULL, 'PO Box 8005', 'Burlington', 'Alamance', 'NC', '27216', '8003282666', '', 'WDIANON', NULL, NULL, '0.00', '35.00', '0.00', 3, '2006-12-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1003819020', 0, 'Y', 0, '2012-02-27', NULL, NULL, 0, 0, NULL, NULL),
('341650951', 'W11014615', 'W11014615', 'TX01', 'Edgepark', '', '', 'Edgepark', 'GROUP', 'Durable Medical Equipment', '', '', NULL, 'B', '1810 Summit Commerce', 'Twinsburg', 'Lorain', 'OH', '44039', '8003075930', NULL, '1810 Summit Commerce', 'Twinsburg', 'Lorain', 'OH', '44039', '8003075930', '          ', 'WCSTEPSI5', 'DME80', '', '0.00', '35.00', '0.00', 3, '2006-12-01', '2012-03-31', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1609858729', 0, 'Y', 0, '2014-01-27', NULL, NULL, 0, 0, NULL, NULL),
('411310335', 'W11014616', 'W11014616', 'TX01', 'Empi Inc (Neuromuscular Stimulator)', '', '', 'Empi Inc (Neuromuscular Stimulator)', 'GROUP', 'Durable Medical Equipment', '', '', NULL, 'B', '599 Cardigan Rd', 'St Paul', 'Ramsey', 'MN', '55126', '8003282536', NULL, '599 Cardigan Rd', 'St Paul', 'Ramsey', 'MN', '55126', '8003282536', '', 'WCSTEMPI5', 'DME90', NULL, '0.00', '15.00', '0.00', 3, '2006-12-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1174574032', 0, 'Y', 0, '2012-09-24', NULL, NULL, 0, 0, NULL, NULL),
('411694999', 'W11014612', 'W11014612', 'TX01', 'Disetronic Medical Systems (Diabetic Equipment and Supplies)', NULL, NULL, 'Disetronic Medical Systems (Diabetic Equipment and Supplies)', 'GROUP', 'Durable Medical Equipment', NULL, NULL, NULL, 'B', 'PO Box 86 SDS 12-2207', 'Minneapolis', 'Hennepin', 'MN', '55486', '8002807801', '8888100758', '11800 Exit 5 Pkwy', 'Fisher', 'Hennepin', 'IN', '46037', NULL, NULL, 'WDISETR', NULL, NULL, '0.00', '30.00', '0.00', 3, '2006-12-01', '2010-04-01', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1710980156', 0, 'Y', 0, '2008-10-08', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11014623', 'W11014623', 'WY01', 'Billings Clinic Hospital', NULL, NULL, 'Billings Clinic Hospital', 'GROUP', 'Hospital', NULL, NULL, NULL, 'O', '2800 10th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4066574000', NULL, 'PO Box 37000', 'Billings', 'Yellowstone', 'MT', '59107', NULL, NULL, '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2008-02-01', '2009-04-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '0000005301', 0, 'N', 0, '2009-05-04', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11014624', 'W11014624', 'WY01', 'Billings Clinic Home Oxygen and Medical Equipment', NULL, NULL, 'Billings Clinic Home Oxygen and Medical Equipment', 'GROUP', 'Durable Medical Equipment', NULL, NULL, NULL, 'O', '801 N 27th St', 'Billings', 'Yellowstone', 'MT', '59101', '8003251774', NULL, 'PO Box 37000', 'Billings', 'Yellowstone', 'MT', '59107', NULL, NULL, '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2008-02-01', '2009-04-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '0000005300', 0, 'N', 0, '2009-05-04', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11014625', 'W11014625', 'WY01', 'Aspen Meadows', NULL, NULL, 'Aspen Meadows', 'GROUP', 'Home Health Agency', NULL, NULL, NULL, 'O', '3155 Ave C', 'Billings', 'Yellowstone', 'MT', '59102', '4066568818', NULL, 'PO Box 37000', 'Billings', 'Yellowstone', 'MT', '59107', NULL, NULL, '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2008-02-01', '2009-04-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '0000005105', 0, 'N', 0, '2009-05-04', NULL, NULL, 0, 0, NULL, NULL),
('510123924', 'W11014619', 'W11014619', 'TX01', 'Smith Nephew Inc (Bone Stimulators)', '', '', 'Smith Nephew Inc (Bone Stimulators)', 'GROUP', 'Durable Medical Equipment', '', '', NULL, 'B', 'PO Box 22987', 'Chicago', 'Cook', 'IL', '60673', '8006374391', NULL, 'PO Box 22987', 'Chicago', 'Cook', 'IL', '60673', '8006374391', '          ', '', '', '1002', '0.00', '30.00', '0.00', 3, '2007-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '0000002531', 0, 'Y', 0, '2011-09-20', NULL, NULL, 0, 0, NULL, NULL),
('522165554', 'W11014613', 'W11014613', 'TX01', 'DJO (Orthopedic Supplies for Provider Use Only)', '', '', 'DJO (Orthopedic Supplies for Provider Use Only)', 'GROUP', 'Durable Medical Equipment', '', '', NULL, 'B', '3434 Solutions Ctr', 'Chicago', 'Cook', 'IL', '60677', '8003282536', NULL, '3434 Solutions Center', 'Chicago', 'Cook', 'IL', '60677', '8003282536', '          ', 'DME80', '', '', '0.00', '35.00', '0.00', 3, '2008-07-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1023296035', 0, 'N', 0, '2012-09-24', NULL, NULL, 0, 0, NULL, NULL),
('752608036', 'W11014617', 'W11014617', 'TX01', 'Orthofix Inc (Bone Growth Stimulators Physicians Only)', '', '', 'Orthofix Inc (Bone Growth Stimulators Physicians Only)', 'GROUP', 'Durable Medical Equipment', '', '', NULL, 'B', 'PO Box 849806', 'Dallas', 'Dallas', 'TX', '75284', '8005270404', '4697422881', 'PO Box 849806', 'Dallas', 'Dallas', 'TX', '75284', '8005270404', '4697422881', 'WCSTORFIX5', '', '', '0.00', '100.00', '0.00', 3, '2006-11-01', '2014-06-17', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '0000647859', 0, 'Y', 0, '2014-06-19', NULL, NULL, 0, 0, NULL, NULL),
('112645333', 'W11014622', 'W11014622', 'TX01', 'Gentiva Health Services', '', '', 'Gentiva Health Services USA INC', 'GROUP', 'Home Health Agency', NULL, NULL, NULL, 'B', '1040 N Walnut Ste D', 'New Braunfels', 'Comal', 'TX', '78130', '8306255795', NULL, '3 Huntington Quadrangle', 'Melville', 'Comal', 'New', '11747', NULL, NULL, NULL, NULL, '4', '0.00', '35.00', NULL, 3, '2006-11-01', '2006-11-01', 1, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '607346', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
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('870395551', 'W11014626', 'W11014626', 'UT01', NULL, 'Joel', 'D', 'Templeton', 'DC', 'Chiropractic', NULL, NULL, NULL, 'O', '10965 S River Front Pkwy', 'South Jordan', 'Salt Lake', 'UT', '84095', '8018783804', '4356491543', '867 E 9400 S', 'Sandy', 'Salt Lake', 'UT', '84094', NULL, NULL, 'WLABRAD', 'WUSTDHCPC5', NULL, '0.00', '0.00', '55.46', 3, '2008-08-25', '2010-10-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1578768172', 0, 'N', 0, '2009-05-09', NULL, NULL, 0, 0, NULL, NULL),
('870616107', 'W11014602', 'W11014602', 'UT01', 'University Health Care', 'John', 'C', 'Fang', 'MD', 'Gastroenterology', 'Internal Medicine', NULL, NULL, 'o', '1743 W Redstone Ctr Ste 115', 'Park City', 'Summit', 'UT', '84098', '4356589200', NULL, NULL, NULL, 'Summit', NULL, NULL, NULL, NULL, 'WISESTDU', 'WUSTDHCPC5', NULL, '0.00', '35.00', NULL, 6, '2007-08-01', '2007-08-01', 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1134219736', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL);
