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
('841401924', 'W77004813', 'W77004813', 'UT01', 'Alpine Medical Group Ob/Gyn & Pediatrics', 'Sharon', 'K', 'Schriewer', 'MD', 'Pediatrics', NULL, NULL, NULL, 'O', '1060 E 100 S Ste 400', 'Salt Lake City', 'Salt Lake', 'UT', '84102', '8015212640', '8013636407', NULL, NULL, '', NULL, NULL, '', '', 'USTDMULT', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2000-01-01', '2006-11-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1538137625', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('841401924', 'W77004814', 'W77004814', 'UT01', 'Alpine Medical Anesthesia & Pain Management', 'Wayne', NULL, 'Sexton', 'CRNA', 'Nurse Anesthetist', 'Anesthesiology', NULL, NULL, 'O', '1050 E S Temple', 'Salt Lake City', 'Salt Lake', 'UT', '84102', '8019931566', '8017335618', '1954 E Fort Union Blvd', 'Salt Lake City', '', 'UT', '84121', '', '', NULL, NULL, '1000', '47.25', NULL, NULL, 3, '2001-07-02', '2007-04-01', 1, 12, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1649264664', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('841401924', 'W77004815', 'W77004815', 'UT01', 'Alpine Medical Anesthesia & Pain Management', 'Todd', 'C', 'Seymour', 'MD', 'Anesthesiology', NULL, NULL, NULL, 'O', '1050 E S Temple', 'Salt Lake City', 'Salt Lake', 'UT', '84102', '8019931566', '8017335618', NULL, NULL, '', NULL, NULL, '', '', '135', NULL, '1000', '44.10', NULL, NULL, 3, '2003-02-01', '2005-06-01', 1, 12, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '832221', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('841401924', 'W77004816', 'W77004816', 'UT01', 'Alpine Medical Anesthesia & Pain Management', 'Kathryn', NULL, 'Young', 'CRNA', 'Anesthesiology', NULL, NULL, NULL, 'O', '1050 E S Temple', 'Salt Lake City', 'Salt Lake', 'UT', '84102', '8019931566', '8017335618', NULL, NULL, '', NULL, NULL, '', '', '135', NULL, '1000', '44.10', NULL, NULL, 3, '1999-09-01', '2005-08-01', 1, 12, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '834315', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('841407804', 'W77004817', 'W77004817', 'UT01', NULL, 'Christine', 'A', 'Cheng', 'MD', 'Plastic Surgery', NULL, NULL, NULL, 'B', 'PO Box 1529', 'Layton', 'Davis', 'UT', '84041', '8015939223', '8015939626', NULL, NULL, '', NULL, NULL, '', '', 'USTDPLAS', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '1999-09-01', '2006-12-31', 0, 0, 0, 'Lakeview Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1306848338', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870494130', 'W77004818', 'W77004818', 'UT01', 'Salt Lake Womens Center', 'Dale', 'A', 'Sundwall', 'MD', 'Obstetrics and Gynecology', NULL, NULL, NULL, 'O', '10011 Centennial Pkwy Ste 350', 'Sandy', 'Salt Lake', 'UT', '84070', '8015763922', '8015698710', NULL, NULL, '', NULL, NULL, '', '', 'USTDOBG', NULL, NULL, '0.00', '35.00', NULL, 3, '2002-04-01', '2006-04-18', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '831260', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870498345', 'W77004819', 'W77004819', 'UT01', NULL, 'Michael', 'R', 'Swinyer', 'PA', NULL, NULL, NULL, NULL, 'O', '3920 S 1100 E Ste 310', 'Salt Lake City', 'Salt Lake', 'UT', '84124', '8012668841', '8012660449', NULL, NULL, '', NULL, NULL, '', '', 'USTDDERM', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2005-10-28', '2006-11-30', 0, 0, 0, 'St Marks Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1790724847', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870498495', 'W77004820', 'W77004820', 'UT01', 'Spencer, David A', 'David', 'A', 'Spencer', 'MD', 'Ophthalmology', NULL, NULL, NULL, 'O', '164 E 5900 S', 'Murray', 'Salt Lake', 'UT', '84107', '8012623344', NULL, NULL, NULL, '', NULL, NULL, '', '', 'USTDOPHT', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2002-04-01', '2006-10-31', 0, 0, 0, 'University Health Care University Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1841225828', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870498727', 'W77004821', 'W77004821', 'UT01', 'The Avenues Womens Clinic', 'Lucinda', 'J', 'Robinson', 'MD', 'Obstetrics and Gynecology', 'Obstetrics and Gynecology', NULL, NULL, 'O', '455 E S Temple Ste 202', 'Salt Lake City', 'Salt Lake', 'UT', '84111', '8013559951', NULL, NULL, NULL, '', NULL, NULL, '', '', 'USTDOBG', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2002-04-01', '2006-11-30', 0, 0, 0, 'Salt Lake Regional Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1700894375', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870500059', 'W77004823', 'W77004823', 'UT01', 'American Fork Vision Center', 'Paul', 'A', 'Paxman', 'OD', 'Optometry', NULL, NULL, NULL, 'O', '24 W Main St', 'American Fork', 'Utah', 'UT', '84003', '8017567996', '8017561690', NULL, NULL, '', NULL, NULL, '', '', 'UTALBERT', NULL, NULL, '0.00', '25.00', NULL, 3, '2002-03-29', '2006-08-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1124097068', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870501344', 'W77004824', 'W77004824', 'UT01', 'Pediatric Care', 'Todd', 'L', 'Chidester', 'NP', 'Pediatrics', NULL, NULL, NULL, 'O', '1888 W 800 N', 'Pleasant Grove', 'Utah', 'UT', '84062', '8014927851', NULL, NULL, NULL, '', NULL, NULL, '', '', 'USTDPEDE', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2001-03-02', '2005-08-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '908425', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870501344', 'W77004825', 'W77004825', 'UT01', 'Pediatric Care', 'Marsena', 'E', 'Conner', 'MD', 'Pediatrics', NULL, NULL, NULL, 'O', '1055 N 300 W Ste 311', 'Provo', 'Utah', 'UT', '84604', '8013577800', NULL, NULL, NULL, '', NULL, NULL, '', '', 'UUVPN', NULL, NULL, '0.00', '35.00', NULL, 3, '2002-04-01', '2004-08-15', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1609812122', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870501344', 'W77004826', 'W77004826', 'UT01', 'Pediatric Care', 'Ronald', 'C', 'Jones', 'MD', 'Pediatrics', NULL, NULL, NULL, 'B', '1055 N 300 W Ste 311', 'Provo', 'Utah', 'UT', '84604', '8013577800', NULL, NULL, NULL, '', NULL, NULL, '', '', 'USTDPEDE', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2002-04-01', '2005-08-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1245290295', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870501344', 'W77004827', 'W77004827', 'UT01', 'Pediatric Care', 'Kenneth', 'A', 'Zollo', 'MD', 'Pediatrics', NULL, NULL, NULL, 'O', '1055 N 300 W Ste 311', 'Provo', 'Utah', 'UT', '84604', '8013577800', NULL, NULL, NULL, '', NULL, NULL, '', '', 'USTDPEDE', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2002-10-21', '2006-09-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1770545931', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870502207', 'W77004828', 'W77004828', 'UT01', 'Wasatch Therapy', 'Therapy', NULL, 'Wasatch', 'GROUP', 'Occupational Therapy', 'Physical Therapy', NULL, NULL, 'O', '5405 S 500 E Ste 100', 'Ogden', 'Weber', 'UT', '84405', '8014799865', NULL, NULL, NULL, '', NULL, NULL, '', '', 'UPTWAS', NULL, NULL, '0.00', '35.00', NULL, 3, '1999-09-01', '2006-12-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '834788', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870502207', 'W77004829', 'W77004829', 'UT01', 'Wasatch Therapy', 'Crystal', NULL, 'Bennett', 'OT', 'Occupational Therapy', NULL, NULL, NULL, 'O', '5349 S Adams Ave Ste A', 'Ogden', 'Weber', 'UT', '84405', '8014799865', '8014795846', NULL, NULL, '', NULL, NULL, '', '', 'SELECT', NULL, NULL, '0.00', NULL, NULL, 3, '2004-01-30', '2004-10-27', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '832852', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870483582', 'W77004830', 'W77004830', 'UT01', 'University Of Utah Orthopedic Consultants', 'Michael', 'D', 'Miller', 'MD', 'Orthopedic Surgery', NULL, NULL, NULL, 'B', 'PO Box 58108', 'Salt Lake City', 'Salt Lake', 'UT', '84158', NULL, NULL, NULL, NULL, '', NULL, NULL, '', '', 'UUUMG', NULL, NULL, '0.00', '25.00', NULL, 3, '2003-08-01', '2003-08-01', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '832685', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870483582', 'W77004831', 'W77004831', 'UT01', 'University Of Utah Orthopedic Consultants', 'David', 'J', 'Petron', 'MD', 'Orthopedic Surgery', 'Sports Medicine', NULL, NULL, 'O', '50 N Medical Dr', 'Salt Lake City', 'Salt Lake', 'UT', '84132', '8015812218', NULL, NULL, NULL, '', NULL, NULL, '', '', 'UUUMG', NULL, NULL, '0.00', '25.00', NULL, 3, '1999-09-01', '2006-07-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1881775062', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870483582', 'W77004833', 'W77004833', 'UT01', 'University Of Utah Orthopedic Consultants', 'Robert', 'Lor', 'Randall', 'MD', 'Orthopedic Surgery', 'Oncology', NULL, NULL, 'B', 'PO Box 58108', 'Salt Lake City', 'Salt Lake', 'UT', '84158', '8015813998', NULL, NULL, NULL, '', NULL, NULL, '', '', 'UUUMG', NULL, NULL, '0.00', '25.00', NULL, 3, '1999-09-01', '2006-07-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '833795', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870483582', 'W77004834', 'W77004834', 'UT01', 'University of Utah Orthopedic Consultants', 'Charles', 'L', 'Saltzman', 'MD', 'Orthopedic Surgery', NULL, NULL, NULL, 'B', 'PO Box 58108', 'Salt Lake City', 'Salt Lake', 'UT', '84158', '8015813998', NULL, NULL, NULL, '', NULL, NULL, '', '', 'UUUMG', NULL, NULL, '0.00', '25.00', NULL, 3, '2005-11-03', '2006-07-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1962583146', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870483582', 'W77004835', 'W77004835', 'UT01', 'Orthopedic Consultants', 'Mark', 'D', 'Scholl', 'MD', 'Orthopedic Surgery', NULL, NULL, NULL, 'O', '546 Chipeta Way', 'Salt Lake City', 'Salt Lake', 'UT', '84108', '8015817555', NULL, NULL, NULL, '', NULL, NULL, '', '', 'UUUMG', NULL, NULL, '0.00', '25.00', NULL, 3, '2003-08-14', '2006-01-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1396713020', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870483582', 'W77004836', 'W77004836', 'UT01', 'University Of Utah Orthopedic Consultants', 'Brayton', 'R', 'Shirley', 'MD', 'Orthopedic Surgery', 'Orthopedic Surgery', NULL, NULL, 'O', '50 N Medical Dr', 'Salt Lake City', 'Salt Lake', 'UT', '84132', '8015812218', NULL, NULL, NULL, '', NULL, NULL, '', '', 'UUUMG', NULL, NULL, '0.00', '25.00', NULL, 3, '2004-08-09', '2005-07-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '906557', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870483582', 'W77004837', 'W77004837', 'UT01', 'University Of Utah Orthopedic Consultants', 'Brayton', 'R', 'Shirley', 'MD', 'Orthopedic Surgery', 'Orthopedic Surgery', NULL, NULL, 'B', 'PO Box 58108', 'Salt Lake City', 'Salt Lake', 'UT', '84158', '8015813998', NULL, NULL, NULL, '', NULL, NULL, '', '', 'UUUMG', NULL, NULL, '0.00', '25.00', NULL, 3, '2004-08-09', '2005-07-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '906557', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870483582', 'W77004838', 'W77004838', 'UT01', 'University Of Utah Orthopedic Consultants', 'Gregg', 'Alan', 'Vagner', 'MD', NULL, 'Orthopedic Surgery', 'Orthopedic Surgery', NULL, 'B', 'PO Box 58108', 'Salt Lake City', 'Salt Lake', 'UT', '84158', '8015813998', NULL, NULL, NULL, '', NULL, NULL, '', '', 'UUUMG', NULL, NULL, '0.00', '25.00', NULL, 3, '2004-11-01', '2005-08-01', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '911489', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870483582', 'W77004839', 'W77004839', 'UT01', 'University Of Utah Orthopedic Consultants', 'Angela', NULL, 'Wang', 'MD', 'Orthopedic Surgery', 'Pediatric Orthopedic Surgery', NULL, NULL, 'O', '50 N Medical Dr', 'Salt Lake City', 'Salt Lake', 'UT', '84132', '8015812041', NULL, NULL, NULL, '', NULL, NULL, '', '', 'UUUMG', NULL, NULL, '0.00', '25.00', NULL, 3, '1999-10-22', '2006-07-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1922198514', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870484010', 'W77004840', 'W77004840', 'UT01', 'Salt Lake Physical Therapy Associates', 'herapy Associat', 'es', 'Salt Lake Physical T', 'GROUP', 'Physical Therapy', NULL, NULL, NULL, 'O', '4888 Highland Dr', 'Holladay', 'Salt Lake', 'UT', '84117', '8012649855', '8012649858', NULL, NULL, '', NULL, NULL, '', '', NULL, NULL, NULL, '0.00', '0.00', '57.75', 3, '2004-05-01', '2006-12-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '833473', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870484010', 'W77004841', 'W77004841', 'UT01', 'Salt Lake Physical Therapy Associates', 'John', 'Michael', 'Orr', 'PT', 'Physical Therapy', NULL, NULL, NULL, 'O', '4888 Highland Dr', 'Holladay', 'Salt Lake', 'UT', '84117', '8012649855', '8012649858', NULL, NULL, '', NULL, NULL, '', '', '1831', NULL, NULL, '0.00', NULL, '42.00', 3, '1999-09-01', '2005-09-25', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1518942291', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870484603', 'W77004842', 'W77004842', 'UT01', 'Christensen, Scott', 'Scott', 'K', 'Christensen', 'MD', 'Anesthesiology', NULL, NULL, NULL, 'O', '3580 W 9000 S', 'West Jordan', 'Salt Lake', 'UT', '84088', '8015833395', NULL, NULL, NULL, '', NULL, NULL, '', '', 'USTDMULT', NULL, '2459', '0.00', NULL, NULL, 3, '2002-01-01', '2006-10-31', 1, 0, 0, 'Jordan Valley Medical Center', 'Pioneer Valley Hospital', NULL, NULL, 'HCFA|UB|', '1770512238', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870515631', 'W77004843', 'W77004843', 'UT01', 'U Of U Rehabilitation Medicine', 'Jeffrey', 'P', 'Rosenbluth', 'MD', 'Physical Medicine and Rehabilitation', NULL, NULL, NULL, 'B', 'PO Box 58609', 'Salt Lake City', 'Salt Lake', 'UT', '84158', '8015817267', NULL, NULL, NULL, '', NULL, NULL, '', '', 'UUUMG', NULL, NULL, '0.00', '25.00', NULL, 3, '2001-08-06', '2006-07-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1578653192', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870515631', 'W77004844', 'W77004844', 'UT01', 'U Of U Rehabilitation Medicine', 'Theresa', 'L', 'Such-Neibar', 'DO', 'Physical Medicine and Rehabilitation', NULL, NULL, NULL, 'B', 'PO Box 58609', 'Salt Lake City', 'Salt Lake', 'UT', '84158', NULL, NULL, NULL, NULL, '', NULL, NULL, '', '', 'UUUMG', NULL, NULL, '0.00', '25.00', NULL, 3, '1999-09-01', '1999-09-01', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '834283', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870515631', 'W77004845', 'W77004845', 'UT01', 'U Of U Rehabilitation Medicine', 'Joseph', 'B', 'Webster', 'MD', 'Physical Medicine and Rehabilitation', NULL, NULL, NULL, 'B', 'PO Box 58609', 'Salt Lake City', 'Salt Lake', 'UT', '84158', '8015817267', NULL, NULL, NULL, '', NULL, NULL, '', '', 'UUUMG', NULL, NULL, '0.00', '25.00', NULL, 3, '2003-03-17', '2006-07-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1386734978', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870515631', 'W77004846', 'W77004846', 'UT01', 'U Of U Rehabilitation Medicine', 'Stuart', 'E', 'Willick', 'MD', 'Physical Medicine and Rehabilitation', NULL, NULL, NULL, 'O', '50 N Medical Dr', 'Salt Lake City', 'Salt Lake', 'UT', '84132', '8015812267', NULL, NULL, NULL, '', NULL, NULL, '', '', 'UUUMG', NULL, NULL, '0.00', '25.00', NULL, 3, '1999-09-01', '2006-07-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1720169915', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870515631', 'W77004847', 'W77004847', 'UT01', 'University Orthopedic Clinic', 'Stuart', 'E', 'Willick', 'MD', 'Physical Medicine and Rehabilitation', NULL, NULL, NULL, 'O', '590 Wakara Way', 'Salt Lake City', 'Salt Lake', 'UT', '84108', '8015877100', NULL, NULL, NULL, '', NULL, NULL, '', '', 'UUUMG', NULL, NULL, '0.00', '25.00', NULL, 3, '1999-09-01', '2006-07-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1720169915', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870516127', 'W77004848', 'W77004848', 'UT01', 'U Of U Pediatric Surgery', 'Richard', 'E', 'Black', 'MD', 'Pediatric Surgery', NULL, NULL, NULL, 'O', '100 N Medical Dr Ste 2600', 'Salt Lake City', 'Salt Lake', 'UT', '84113', '8015883350', NULL, NULL, NULL, '', NULL, NULL, '', '', 'UUMGPED', NULL, NULL, '0.00', '15.00', NULL, 3, '2000-01-01', '2006-07-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1316028103', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870516127', 'W77004849', 'W77004849', 'UT01', 'U Of U Pediatric Surgery', 'Michael', 'E', 'Matlak', 'MD', 'Pediatric Surgery', NULL, NULL, NULL, 'O', '100 N Medical Dr Ste 2600', 'Salt Lake City', 'Salt Lake', 'UT', '84113', '8015883350', NULL, NULL, NULL, '', NULL, NULL, '', '', 'UUMGPED', NULL, NULL, '0.00', '15.00', NULL, 3, '2000-01-02', '2006-07-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1134200926', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870516127', 'W77004850', 'W77004850', 'UT01', 'U Of U Pediatric Surgery', 'Peter', 'F', 'Nichol', 'MD', 'General Surgery', 'Pediatric Surgery', NULL, NULL, 'O', '100 N Medical Dr Ste 2600', 'Salt Lake City', 'Salt Lake', 'UT', '84113', '8015883350', NULL, NULL, NULL, '', NULL, NULL, '', '', 'UUMGPED', NULL, NULL, '0.00', '15.00', NULL, 3, '2005-09-01', '2006-07-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1245320852', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870516127', 'W77004851', 'W77004851', 'UT01', 'U Of U Pediatric Surgery', 'Eric', 'R', 'Scaife', 'MD', 'Pediatric Surgery', NULL, NULL, NULL, 'O', '100 N Medical Dr Ste 2600', 'Salt Lake City', 'Salt Lake', 'UT', '84113', '8015883364', NULL, NULL, NULL, '', NULL, NULL, '', '', 'UUMGPED', NULL, NULL, '0.00', '15.00', NULL, 3, '2001-07-02', '2006-07-31', 0, 0, 0, 'Primary Childrens Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1902996523', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870516127', 'W77004852', 'W77004852', 'UT01', 'U Of U Pediatric Surgery', 'Mark', 'H', 'Stevens', 'MD', 'Pediatric Surgery', NULL, NULL, NULL, 'O', '100 N Medical Dr Ste 2600', 'Salt Lake City', 'Salt Lake', 'UT', '84113', '8015883350', NULL, NULL, NULL, '', NULL, NULL, '', '', 'UUMGPED', NULL, NULL, '0.00', '15.00', NULL, 3, '2003-05-01', '2006-07-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1770504953', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
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('870517255', 'W77004899', 'W77004899', 'UT01', 'Pediatric Orthopedic Associates', 'Peter', 'M', 'Stevens', 'MD', 'Pediatric Orthopedic Surgery', 'Pediatric Orthopedic Radiology', 'Orthopedic Surgery', NULL, 'O', '100 N Medical Dr Ste 4550', 'Salt Lake City', 'Salt Lake', 'UT', '84113', '8015883900', NULL, NULL, NULL, '', NULL, NULL, '', '', 'USTDORTH', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2000-01-01', '2006-07-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1881649929', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870518224', 'W77004900', 'W77004900', 'UT01', 'Physical & Sports Therapy', 'Craig', 'A', 'Schultz', 'PT', 'Physical Therapy', NULL, NULL, NULL, 'B', '380 E 400 S', 'Springville', 'Utah', 'UT', '84663', '8012242250', '8014895783', NULL, NULL, '', NULL, NULL, '', '', NULL, NULL, NULL, '0.00', '0.00', '57.75', 3, '1999-09-01', '1999-09-01', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '833814', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
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('870518374', 'W77004902', 'W77004902', 'UT01', 'Palmer, David K', 'David', 'K', 'Palmer', 'MD', 'Ear, Nose and Throat', NULL, NULL, NULL, 'B', '4000 S 700 E Ste 10', 'Murray', 'Salt Lake', 'UT', '84107', '8012684141', NULL, NULL, NULL, '', NULL, NULL, '', '', 'USTDENT', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2002-04-01', '2002-04-01', 0, 0, 0, 'Mountain West Medical Center', 'St Marks Hospital', NULL, NULL, 'HCFA|UB|', '1427018191', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870518391', 'W77004903', 'W77004903', 'UT01', 'Sue A Montiel CNM', 'Sue', 'A', 'Montiel', 'CNM', 'Obstetrics and Gynecology', NULL, NULL, NULL, 'O', '1002 E S Temple Ste 201', 'Salt Lake City', 'Salt Lake', 'UT', '84102', '8019080930', NULL, NULL, NULL, '', NULL, NULL, '', '', 'USTDOBG', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '1999-09-01', '2006-10-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '831172', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870518863', 'W77004904', 'W77004904', 'UT01', NULL, 'Frederic', 'M', 'Civish', 'MD', 'Family Practice', NULL, NULL, NULL, 'B', '3534 S 6000 W', 'Salt Lake City', 'Salt Lake', 'UT', '84128', '8019696264', '8019696333', NULL, NULL, '', NULL, NULL, '', '', 'USTDFAM', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2002-04-01', '2006-05-31', 0, 0, 0, 'Pioneer Valley Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1124137278', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870518919', 'W77004905', 'W77004905', 'UT01', 'Allen, James F', 'James', 'F', 'Allen', 'MD', 'Family Practice', NULL, NULL, NULL, 'O', '175 N 100 W Ste 101', 'Vernal', 'Uintah', 'UT', '84078', '4357894797', '4357894958', NULL, NULL, '', NULL, NULL, '', '', 'USTDFAM', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2003-04-01', '2006-11-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1902833148', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870519172', 'W77004906', 'W77004906', 'UT01', 'Utah Heart Clinic', 'James', 'Lee', 'Burke', 'MD', 'Cardiovascular Disease', 'Internal Medicine', NULL, NULL, 'O', '324 10th Ave Ste 206', 'Salt Lake City', 'Salt Lake', 'UT', '84103', '8014083900', '8014083909', NULL, NULL, '', NULL, NULL, '', '', 'USTDCARD', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2005-04-29', '2006-05-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1154399459', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870519172', 'W77004907', 'W77004907', 'UT01', 'Utah Heart Clinic', 'Peter', 'J', 'Casterella', 'MD', 'Cardiovascular Disease', NULL, NULL, NULL, 'O', '324 10th Ave Ste 206', 'Salt Lake City', 'Salt Lake', 'UT', '84103', '8014083900', '8014083909', NULL, NULL, '', NULL, NULL, '', '', 'USTDCARD', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2005-04-29', '2006-05-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1063480655', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870519172', 'W77004909', 'W77004909', 'UT01', 'Utah Heart Clinic', 'Peter', 'J', 'Casterella', 'MD', 'Cardiovascular Disease', NULL, NULL, NULL, 'O', '5323 WooDrow St Ste 200', 'Salt Lake City', 'Salt Lake', 'UT', '84107', '8014083900', '8014083909', NULL, NULL, '', NULL, NULL, '', '', 'USTDCARD', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2005-04-29', '2006-05-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1063480655', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870519172', 'W77004910', 'W77004910', 'UT01', 'Utah Heart Clinic', 'John', 'D', 'Day', 'MD', 'Cardiovascular Disease', NULL, NULL, NULL, 'O', '324 10th Ave Ste 206', 'Salt Lake City', 'Salt Lake', 'UT', '84103', '8014083900', '8014083909', NULL, NULL, '', NULL, NULL, '', '', 'USTDCARD', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2005-04-29', '2006-05-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1811965122', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('841411398', 'W77004911', 'W77004911', 'UT01', 'Foothill Family Clinic', 'Sharon', NULL, 'Strong', 'MD', 'Family Practice', NULL, NULL, NULL, 'O', '2295 Foothill Dr', 'Salt Lake City', 'Salt Lake', 'UT', '84109', '8014863021', '8014856339', NULL, NULL, '', NULL, NULL, '', '', 'UFOOTHIL', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2002-11-01', '2006-12-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1053343566', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('841411398', 'W77004912', 'W77004912', 'UT01', 'Foothill Family Clinic', 'Sharon', NULL, 'Strong', 'MD', 'Family Practice', NULL, NULL, NULL, 'B', '6360 S 3000 E Ste 100', 'Salt Lake City', 'Salt Lake', 'UT', '84121', '8013651032', '8013651033', NULL, NULL, '', NULL, NULL, '', '', 'UFOOTHIL', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2002-11-01', '2002-11-01', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1053343566', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('841411398', 'W77004913', 'W77004913', 'UT01', 'Foothill Family Clinic', 'Robert', 'P', 'Vickerman', 'MD', 'General Surgery', NULL, NULL, NULL, 'O', '6360 S 3000 E Ste 100', 'Salt Lake City', 'Salt Lake', 'UT', '84121', '8013651032', '8013651033', NULL, NULL, '', NULL, NULL, '', '', 'UFOOTHIL', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2002-04-01', '2006-12-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '832110', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('841411398', 'W77004914', 'W77004914', 'UT01', 'Foothill Family Clinic', 'Dorothy', 'L', 'Williams', 'MD', 'Neurology', 'Family Practice', NULL, NULL, 'O', '2295 Foothill Dr', 'Salt Lake City', 'Salt Lake', 'UT', '84109', '8014863021', '8014856339', NULL, NULL, '', NULL, NULL, '', '', 'UFOOTHIL', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2002-04-01', '2006-12-31', 0, 0, 0, 'St Marks Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1619992708', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('841428839', 'W77004915', 'W77004915', 'UT01', 'Matheson, Evan J', 'Evan', 'J', 'Matheson', 'MD', 'Allergy', NULL, NULL, NULL, 'O', '745 N 500 W', 'Provo', 'Utah', 'UT', '84601', '8013759292', NULL, NULL, NULL, '', NULL, NULL, '', '', 'USTDALLE', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2003-04-01', '2006-09-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1649251646', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('841429813', 'W77004916', 'W77004916', 'UT01', 'Intermountain Pain Specialists-Nephi', 'Gordon', 'P', 'George', 'MD', 'Pain Management', NULL, NULL, NULL, 'O', '48 W 1500 N', 'Nephi', 'Juab', 'UT', '84648', '8014310100', '8014317354', NULL, NULL, '', NULL, NULL, '', '', 'USTDPAIN', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2003-03-01', '2006-10-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1730109158', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('841429813', 'W77004917', 'W77004917', 'UT01', 'Intermountain Pain Specialists-Orem', 'Gordon', 'P', 'George', 'MD', 'Pain Management', NULL, NULL, NULL, 'O', '700 W 800 N Ste 340A', 'Orem', 'Utah', 'UT', '84057', '8014310100', NULL, NULL, NULL, '', NULL, NULL, '', '', 'USTDPAIN', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2003-03-01', '2006-10-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1730109158', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('841433992', 'W77004918', 'W77004918', 'UT01', 'Rosenberg,Cooley, Metcalf', 'Troy', 'S', 'Johnson', 'PA', 'Orthopedic Surgery', 'Family Practice', NULL, NULL, 'O', '1820 Sidewinder Dr', 'Park City', 'Summit', 'UT', '84060', '4356556600', '4356552388', NULL, NULL, '', NULL, NULL, '', '', 'UROCOCL', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2005-02-25', '2006-12-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1730197252', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('841433992', 'W77004919', 'W77004919', 'UT01', 'Rosenberg,Cooley, Metcalf', 'R Steven', NULL, 'Klatt', 'PA', NULL, NULL, NULL, NULL, 'O', '1820 Sidewinder Dr', 'Park City', 'Summit', 'UT', '84060', '4356556600', '4356552388', NULL, NULL, '', NULL, NULL, '', '', 'UROCOCL', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2004-10-29', '2006-12-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1710995386', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('841433992', 'W77004920', 'W77004920', 'UT01', 'Rosenberg,Cooley, Metcalf', 'Thomas', 'D', 'Rosenberg', 'MD', 'Orthopedic Surgery', NULL, NULL, NULL, 'O', '1820 Sidewinder Dr', 'Park City', 'Summit', 'UT', '84060', '4356556600', '4356552388', NULL, NULL, '', NULL, NULL, '', '', 'UROCOCL', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2003-04-01', '2006-12-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1144273905', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('860750222', 'W77004921', 'W77004921', 'UT01', 'Concentra Medical Centers', 'nters', NULL, 'Concentra Medical Ce', 'GROUP', 'Physical Therapy', NULL, NULL, NULL, 'O', '1735 S Redwood Rd Ste 115', 'Salt Lake City', 'Salt Lake', 'UT', '84104', NULL, NULL, NULL, NULL, '', NULL, NULL, '', '', NULL, NULL, NULL, '0.00', '0.00', '57.75', 3, '2005-08-22', '2006-12-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '939391', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL);
INSERT INTO `providers_new` (`Provider_Tax_ID`, `Provider_Suffix`, `Provider_Network_ID`, `Provider_Region`, `Provider_Name`, `Provider_Doctor_First_Name`, `Provider_Doctor_Middle_Name`, `Provider_Doctor_Last_Name`, `Provider_Doctor_Degree`, `Provider_Specialty_1`, `Provider_Specialty_2`, `Provider_Specialty_3`, `Provider_Specialty_4`, `Provider_Address_Type`, `Provider_Address`, `Provider_City`, `Provider_County`, `Provider_State`, `Provider_Zip`, `Provider_Phone`, `Provider_Fax`, `Provider_Mailing_Address`, `Provider_Mailing_City`, `Provider_Mailing_County`, `Provider_Mailing_State`, `Provider_Mailing_Zip`, `Provider_Mailing_Phone`, `Provider_Mailing_Fax`, `Provider_Primary_Schedule`, `Provider_Secondary_Schedule`, `Provider_Rate_Sheet`, `Provider_Anes_Rate`, `Provider_Default_Rate`, `Provider_Max_DOS`, `Provider_Min_Match_Value`, `Provider_Effective_Date`, `Provider_Term_Date`, `Provider_Pend`, `Provider_Anes_Minutes`, `Provider_PPO`, `Provider_Hospital_1`, `Provider_Hospital_2`, `Provider_Hospital_3`, `Provider_Hospital_4`, `Provider_Type`, `Provider_NPI`, `Provider_Check_Override`, `Exclude_Dir`, `Audit_Status`, `Last_Change_Date`, `Medicare_ID`, `Provider_Lang`, `Provider_Latitude`, `Provider_Longitude`, `Provider_school`, `Provider_cert`) VALUES
('870503286', 'W77004922', 'W77004922', 'UT01', 'Hearing Zone', 'G Chad', NULL, 'Daniels', 'AUD', 'Audiology', NULL, NULL, NULL, 'B', '129 E 1400 N', 'Logan', 'Cache', 'UT', '84341', NULL, NULL, NULL, NULL, '', NULL, NULL, '', '', 'USTDOTHR', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2003-06-20', '2005-06-15', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '832579', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870503286', 'W77004923', 'W77004923', 'UT01', 'Hearing Zone', 'G Chad', NULL, 'Daniels', 'AUD', 'Audiology', NULL, NULL, NULL, 'B', '129 E 1400 N', 'Logan', 'Cache', 'UT', '84341', NULL, NULL, NULL, NULL, '', NULL, NULL, '', '', 'USTDOTHR', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2003-06-20', '2004-05-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '832579', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870503286', 'W77004924', 'W77004924', 'UT01', 'Hearing Zone', 'G Chad', NULL, 'Daniels', 'AUD', 'Audiology', NULL, NULL, NULL, 'O', '1660 W Antelope Dr Ste 315', 'Layton', 'Davis', 'UT', '84041', '8017762180', NULL, NULL, NULL, '', NULL, NULL, '', '', 'USTDOTHR', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2003-06-20', '2004-05-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '832579', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870503286', 'W77004925', 'W77004925', 'UT01', 'Hearing Zone', 'G Chad', NULL, 'Daniels', 'AUD', 'Audiology', NULL, NULL, NULL, 'O', '3651 Wall Ave Ste 1127', 'Ogden', 'Weber', 'UT', '84405', '8016120202', NULL, NULL, NULL, '', NULL, NULL, '', '', 'USTDOTHR', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2003-06-20', '2005-06-15', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '832579', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870503286', 'W77004926', 'W77004926', 'UT01', 'Hearing Zone', 'G Chad', NULL, 'Daniels', 'AUD', 'Audiology', NULL, NULL, NULL, 'O', '70 S Fairfield Rd Ste 10', 'Layton', 'Davis', 'UT', '84041', '8014440300', NULL, NULL, NULL, '', NULL, NULL, '', '', 'USTDOTHR', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2003-06-20', '2005-06-15', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '832579', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870503286', 'W77004927', 'W77004927', 'UT01', 'Hearing Zone', 'Kent', 'Jay', 'Nielsen', 'AUD', 'Audiology', NULL, NULL, NULL, 'O', '74 E 500 S Ste 112', 'Bountiful', 'Davis', 'UT', '84010', '8012946200', '8012940750', NULL, NULL, '', NULL, NULL, '', '', 'USTDORTH', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2003-07-25', '2006-10-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1689744138', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870504725', 'W77004928', 'W77004928', 'UT01', 'Lone Peak Dermatology', 'Robert', 'L', 'Orme', 'MD', 'Dermatology', NULL, NULL, NULL, 'O', '1434 E 9400 S Ste 105', 'Sandy', 'Salt Lake', 'UT', '84093', '8015728043', '8015764285', NULL, NULL, '', NULL, NULL, '', '', 'USTDDERM', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2004-02-27', '2006-11-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1174635403', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870504828', 'W77004929', 'W77004929', 'UT01', 'South Mountain Sports Medicine & Rehab', 's Medicine & Re', 'hab', 'South Mountain Sport', 'GROUP', 'Physical Therapy', NULL, NULL, NULL, 'O', '12226 S 1000 E Ste 1', 'Draper', 'Salt Lake', 'UT', '84020', '8015233415', NULL, NULL, NULL, '', NULL, NULL, '', '', NULL, NULL, NULL, '0.00', '0.00', '57.75', 3, '2004-05-01', '2006-12-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '833008', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870509414', 'W77004930', 'W77004930', 'UT01', 'Mountain Utah Family Medicine', 'Bret', 'D', 'Hilton', 'PA', NULL, NULL, NULL, NULL, 'O', '850 N Main St Ste 3', 'Richfield', 'Sevier', 'UT', '84701', '4358969561', '4358969564', NULL, NULL, '', NULL, NULL, '', '', 'URURAL', NULL, NULL, '0.00', '35.00', NULL, 3, '2005-04-01', '2006-06-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1467451609', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870510192', 'W77004931', 'W77004931', 'UT01', 'Performance West Physical Therapy', 'sical Therapy', NULL, 'Performance West Phy', 'GROUP', 'Physical Therapy', NULL, NULL, NULL, 'O', '1551 S Renaissance Towne Dr Ste 350', 'Bountiful', 'Davis', 'UT', '84010', '8012953553', '8012953599', NULL, NULL, '', NULL, NULL, '', '', NULL, NULL, NULL, '0.00', '0.00', '57.75', 3, '2004-05-01', '2006-12-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '833016', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870510192', 'W77004932', 'W77004932', 'UT01', 'Performance West Physical Therapy', 'Curtis', 'B', 'Jolley', 'PT', 'Physical Therapy', NULL, NULL, NULL, 'O', '4920 E 2550 N Ste C', 'Eden', 'Weber', 'UT', '84310', '8017453200', NULL, NULL, NULL, '', NULL, NULL, '', '', NULL, NULL, NULL, '0.00', '0.00', '57.75', 3, '1999-09-01', '2006-12-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1548261431', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870510192', 'W77004933', 'W77004933', 'UT01', 'Performance West Physical Therapy', 'Kim', 'W', 'Reid', 'PT', 'Physical Therapy', NULL, NULL, NULL, 'O', '4920 E 2550 N Ste C', 'Eden', 'Weber', 'UT', '84310', '8017453200', NULL, NULL, NULL, '', NULL, NULL, '', '', NULL, NULL, NULL, '0.00', '0.00', '57.75', 3, '1999-09-01', '2006-12-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1558362434', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
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('870218917', 'W77005022', 'W77005022', 'UT01', 'Tanner Memorial Clinic', 'Stephen', 'M', 'Foote', 'DO', 'Family Practice', NULL, NULL, NULL, 'O', '380 N 400 W', 'Kaysville', 'Davis', 'UT', '84037', '8017734840', NULL, NULL, NULL, '', NULL, NULL, '', '', 'UTANNER', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2002-07-01', '2006-06-30', 0, 0, 0, 'Davis Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1689650632', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870218917', 'W77005024', 'W77005024', 'UT01', 'Tanner Memorial Clinic', 'Stephen', 'M', 'Foote', 'DO', 'Family Practice', NULL, NULL, NULL, 'B', 'PO Box 337', 'Layton', 'Davis', 'UT', '84041', '8017734840', '8015258151', NULL, NULL, '', NULL, NULL, '', '', 'UTANNER', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2002-07-01', '2006-06-30', 0, 0, 0, 'Davis Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1689650632', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870218917', 'W77005025', 'W77005025', 'UT01', 'Tanner Memorial Clinic', 'Charles', 'C', 'Harpe', 'MD', 'Internal Medicine', NULL, NULL, NULL, 'B', 'PO Box 337', 'Layton', 'Davis', 'UT', '84041', '8017734840', '8015258151', NULL, NULL, '', NULL, NULL, '', '', 'UTANNER', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2001-01-01', '2006-06-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1063498004', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870218917', 'W77005026', 'W77005026', 'UT01', 'Tanner Memorial Clinic', 'Kenneth', 'W', 'Jee', 'DPM', 'Orthopedic Surgery', NULL, NULL, NULL, 'O', '2121 Robins Dr', 'Layton', 'Davis', 'UT', '84041', '8017734840', '8015258151', NULL, NULL, '', NULL, NULL, '', '', 'UTANNER', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2002-11-01', '2006-06-30', 0, 0, 0, 'Davis Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1679559538', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870218917', 'W77005027', 'W77005027', 'UT01', 'Tanner Memorial Clinic', 'Rodney', 'M', 'Jex', 'DPM', 'Podiatry', NULL, NULL, NULL, 'B', 'PO Box 337', 'Layton', 'Davis', 'UT', '84041', '8017734840', '8015258151', NULL, NULL, '', NULL, NULL, '', '', 'USTDPOD', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '1999-09-01', '2006-06-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1912986662', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870218917', 'W77005028', 'W77005028', 'UT01', 'Tanner Memorial Clinic', 'Steven', 'L', 'Johnson', 'MD', 'Obstetrics and Gynecology', NULL, NULL, NULL, 'O', '2121 Robins Dr', 'Layton', 'Davis', 'UT', '84041', '8017734840', '8015258151', NULL, NULL, '', NULL, NULL, '', '', 'UTANNER', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2001-01-01', '2006-06-30', 0, 0, 0, 'Davis Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1477539245', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870218917', 'W77005029', 'W77005029', 'UT01', 'Tanner Memorial Clinic', 'Mark', 'D', 'Kirkham', 'MD', 'Family Practice', NULL, NULL, NULL, 'O', '2121 Robins Dr', 'Layton', 'Davis', 'UT', '84041', '8017734840', '8015258151', NULL, NULL, '', NULL, NULL, '', '', 'UTANNER', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2001-01-01', '2006-06-30', 0, 0, 0, 'Davis Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1689650459', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870516127', 'W77005030', 'W77005030', 'UT01', 'U Of U Pediatric Surgery', 'Earl', 'C', 'Downey', 'MD', 'Pediatric Surgery', NULL, NULL, NULL, 'O', '100 N Medical Dr Ste 2600', 'Salt Lake City', 'Salt Lake', 'UT', '84113', '8015883364', NULL, NULL, NULL, '', NULL, NULL, '', '', 'UUMGPED', NULL, NULL, '0.00', '15.00', NULL, 3, '2001-07-02', '2006-07-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1225119019', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870516127', 'W77005031', 'W77005031', 'UT01', 'U Of U Pediatric Surgery', 'Rebecka', 'L', 'Meyers', 'MD', 'Pediatric Surgery', NULL, NULL, NULL, 'O', '100 N Medical Dr Ste 2600', 'Salt Lake City', 'Salt Lake', 'UT', '84113', '8015883350', NULL, NULL, NULL, '', NULL, NULL, '', '', 'UUMGPED', NULL, NULL, '0.00', '15.00', NULL, 3, '2000-01-01', '2006-07-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1902996515', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870516127', 'W77005032', 'W77005032', 'UT01', 'U Of U Pediatric Surgery', 'Stephen', 'E', 'Morris', 'MD', 'General Surgery', 'Pediatric Surgery', NULL, NULL, 'O', '100 N Medical Dr Ste 2600', 'Salt Lake City', 'Salt Lake', 'UT', '84113', '8015883350', NULL, NULL, NULL, '', NULL, NULL, '', '', 'UUMGPED', NULL, NULL, '0.00', '15.00', NULL, 3, '1999-09-01', '2006-07-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1083704696', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL);
INSERT INTO `providers_new` (`Provider_Tax_ID`, `Provider_Suffix`, `Provider_Network_ID`, `Provider_Region`, `Provider_Name`, `Provider_Doctor_First_Name`, `Provider_Doctor_Middle_Name`, `Provider_Doctor_Last_Name`, `Provider_Doctor_Degree`, `Provider_Specialty_1`, `Provider_Specialty_2`, `Provider_Specialty_3`, `Provider_Specialty_4`, `Provider_Address_Type`, `Provider_Address`, `Provider_City`, `Provider_County`, `Provider_State`, `Provider_Zip`, `Provider_Phone`, `Provider_Fax`, `Provider_Mailing_Address`, `Provider_Mailing_City`, `Provider_Mailing_County`, `Provider_Mailing_State`, `Provider_Mailing_Zip`, `Provider_Mailing_Phone`, `Provider_Mailing_Fax`, `Provider_Primary_Schedule`, `Provider_Secondary_Schedule`, `Provider_Rate_Sheet`, `Provider_Anes_Rate`, `Provider_Default_Rate`, `Provider_Max_DOS`, `Provider_Min_Match_Value`, `Provider_Effective_Date`, `Provider_Term_Date`, `Provider_Pend`, `Provider_Anes_Minutes`, `Provider_PPO`, `Provider_Hospital_1`, `Provider_Hospital_2`, `Provider_Hospital_3`, `Provider_Hospital_4`, `Provider_Type`, `Provider_NPI`, `Provider_Check_Override`, `Exclude_Dir`, `Audit_Status`, `Last_Change_Date`, `Medicare_ID`, `Provider_Lang`, `Provider_Latitude`, `Provider_Longitude`, `Provider_school`, `Provider_cert`) VALUES
('870516264', 'W77005033', 'W77005033', 'UT01', 'Utah County Surgical Associates', 'Douglas', NULL, 'Lichti', 'MD', 'General Surgery', NULL, NULL, NULL, 'O', '3550 N University Ave Ste 250', 'Provo', 'Utah', 'UT', '84604', '8013749625', NULL, NULL, NULL, '', NULL, NULL, '', '', 'UUVPN', NULL, NULL, '0.00', '35.00', NULL, 3, '1999-09-01', '2005-12-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1417995325', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870517201', 'W77005034', 'W77005034', 'UT01', 'Central Utah Radiology', 'Bevan', 'V', 'Bastian', 'MD', 'Radiologist', NULL, NULL, NULL, 'O', '48 W 1500 N', 'Nephi', 'Juab', 'UT', '84648', '4356233000', '4355287358', NULL, NULL, '', NULL, NULL, '', '', 'USTDRAD', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2003-04-01', '2006-12-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1821098088', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870517255', 'W77005035', 'W77005035', 'UT01', 'Pediatric Orthopedic Associates', 'John', 'Thomas', 'Braun', 'MD', 'Orthopedic Surgery', NULL, NULL, NULL, 'O', '100 N Medical Dr Ste 4550', 'Salt Lake City', 'Salt Lake', 'UT', '84113', '8015883900', NULL, NULL, NULL, '', NULL, NULL, '', '', 'UUUMG', NULL, NULL, '0.00', '25.00', NULL, 3, '1999-12-06', '2006-07-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '834162', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870517255', 'W77005036', 'W77005036', 'UT01', 'Pediatric Orthopedic Associates', 'John', 'Thomas', 'Braun', 'MD', 'Orthopedic Surgery', NULL, NULL, NULL, 'B', 'PO Box 58886', 'Salt Lake City', 'Salt Lake', 'UT', '84158', NULL, NULL, NULL, NULL, '', NULL, NULL, '', '', 'UUUMG', NULL, NULL, '0.00', '25.00', NULL, 3, '1999-12-06', '2006-07-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '834162', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870517255', 'W77005037', 'W77005037', 'UT01', 'Pediatric Orthopedic Associates', 'Stephanie', 'M', 'Holmes', 'MD', 'Pediatric Orthopedic Surgery', 'Pediatric Orthopedic Radiology', 'Orthopedic Surgery', NULL, 'B', 'PO Box 58886', 'Salt Lake City', 'Salt Lake', 'UT', '84158', '8015883900', NULL, NULL, NULL, '', NULL, NULL, '', '', 'USTDORTH', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2004-08-06', '2006-07-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1720033079', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870517255', 'W77005038', 'W77005038', 'UT01', 'Pediatric Orthopedic Associates', 'Douglas', 'T', 'Hutchinson', 'MD', 'Orthopedic Surgery', 'Hand Surgery', 'Pediatric Orthopedic Surgery', NULL, 'O', '100 N Medical Dr Ste 4550', 'Salt Lake City', 'Salt Lake', 'UT', '84113', '8015883900', NULL, NULL, NULL, '', NULL, NULL, '', '', 'USTDORTH', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '1999-09-01', '2006-07-31', 0, 0, 0, 'University Health Care University Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1972557825', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870517255', 'W77005039', 'W77005039', 'UT01', 'Pediatric Orthopedic Associates', 'Robert', 'Lor', 'Randall', 'MD', 'Orthopedic Surgery', 'Oncology', NULL, NULL, 'B', 'PO Box 58886', 'Salt Lake City', 'Salt Lake', 'UT', '84158', NULL, NULL, NULL, NULL, '', NULL, NULL, '', '', 'USTDORTH', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '1999-09-01', '2006-07-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '833795', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870517255', 'W77005040', 'W77005040', 'UT01', 'Pediatric Orthopedic Associates', 'John', 'T', 'Smith', 'MD', 'Pediatric Orthopedic Surgery', 'Pediatric Orthopedic Radiology', 'Orthopedic Surgery', NULL, 'O', '100 N Medical Dr Ste 4550', 'Salt Lake City', 'Salt Lake', 'UT', '84113', '8015883900', NULL, NULL, NULL, '', NULL, NULL, '', '', 'USTDORTH', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2000-01-01', '2006-07-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1255432001', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870517255', 'W77005041', 'W77005041', 'UT01', 'Pediatric Orthopedic Associates', 'Alan', 'K', 'Stotts', 'MD', 'Pediatric Orthopedic Surgery', 'Pediatric Orthopedic Radiology', 'Orthopedic Surgery', NULL, 'O', '100 N Medical Dr Ste 4550', 'Salt Lake City', 'Salt Lake', 'UT', '84113', '8015883900', NULL, NULL, NULL, '', NULL, NULL, '', '', 'USTDORTH', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2001-08-02', '2006-07-31', 0, 0, 0, 'Primary Childrens Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1902859473', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870517255', 'W77005042', 'W77005042', 'UT01', 'Pediatric Orthopedic Associates', 'Alan', 'K', 'Stotts', 'MD', 'Pediatric Orthopedic Surgery', 'Pediatric Orthopedic Radiology', 'Orthopedic Surgery', NULL, 'B', 'PO Box 58886', 'Salt Lake City', 'Salt Lake', 'UT', '84158', NULL, NULL, NULL, NULL, '', NULL, NULL, '', '', 'USTDORTH', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2001-08-02', '2006-07-31', 0, 0, 0, 'Primary Childrens Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1902859473', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870518224', 'W77005043', 'W77005043', 'UT01', 'Physical & Sports Therapy', 'erapy', NULL, 'Physical & Sports Th', 'GROUP', 'Physical Therapy', NULL, NULL, NULL, 'O', '380 E 400 S', 'Springville', 'Utah', 'UT', '84663', '8014895669', '8014895783', NULL, NULL, '', NULL, NULL, '', '', NULL, NULL, NULL, '0.00', '0.00', '57.75', 3, '2004-05-01', '2006-12-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '833017', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870494577', 'W77005044', 'W77005044', 'UT01', 'Sadler, William T', 'William', 'T', 'Sadler', 'MD', 'Internal Medicine', 'Pulmonary', NULL, NULL, 'B', '415 Medical Dr Ste 202-C', 'Bountiful', 'Davis', 'UT', '84010', '8012958523', '8012953309', NULL, NULL, '', NULL, NULL, '', '', 'USTDINT', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '1999-09-01', '2006-10-31', 0, 0, 0, 'Lakeview Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1154543155', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870494577', 'W77005045', 'W77005045', 'UT01', 'Sadler, William T', 'William', 'T', 'Sadler', 'MD', 'Internal Medicine', 'Pulmonary', NULL, NULL, 'O', '415 Medical Dr Ste C202', 'Bountiful', 'Davis', 'UT', '84010', '8012958523', '8012953309', NULL, NULL, '', NULL, NULL, '', '', 'USTDINT', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '1999-09-01', '2006-10-31', 0, 0, 0, 'Lakeview Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1154543155', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870498345', 'W77005046', 'W77005046', 'UT01', NULL, 'Hugh', 'J', 'Davis', 'PA', 'Dermatology', NULL, NULL, NULL, 'O', '3920 S 1100 E Ste 310', 'Salt Lake City', 'Salt Lake', 'UT', '84124', '8012668841', '8012660449', NULL, NULL, '', NULL, NULL, '', '', 'USTDDERM', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2002-12-01', '2005-07-22', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '832389', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870498345', 'W77005047', 'W77005047', 'UT01', NULL, 'Laurie', 'J', 'Ellis', 'NP', 'Dermatology', NULL, NULL, NULL, 'O', '3920 S 1100 E Ste 310', 'Salt Lake City', 'Salt Lake', 'UT', '84124', '8012668841', '8012660449', NULL, NULL, '', NULL, NULL, '', '', 'USTDDERM', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2002-12-01', '2006-11-30', 0, 0, 0, 'St Marks Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1770578254', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870498495', 'W77005048', 'W77005048', 'UT01', 'Spencer, David A', 'David', 'A', 'Spencer', 'MD', 'Ophthalmology', NULL, NULL, NULL, 'B', '164 E 5900 S Ste A101', 'Murray', 'Salt Lake', 'UT', '84107', '8012623344', NULL, NULL, NULL, '', NULL, NULL, '', '', 'USTDOPHT', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2002-04-01', '2006-10-31', 0, 0, 0, 'University Health Care University Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1841225828', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870498921', 'W77005049', 'W77005049', 'UT01', NULL, 'Duane', 'E', 'Townsend', 'MD', 'Gynecologic Oncology', 'Gynecology', NULL, NULL, 'O', '1205 Iron Horse Dr', 'Park City', 'Summit', 'UT', '84060', '4359018123', NULL, NULL, NULL, '', NULL, NULL, '', '', 'USTDONC', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2004-02-27', '2006-01-01', 0, 0, 0, 'Timpanogos Regional Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1114986502', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870498921', 'W77005050', 'W77005050', 'UT01', NULL, 'Duane', 'E', 'Townsend', 'MD', 'Gynecologic Oncology', 'Gynecology', NULL, NULL, 'O', '1485 S Highway 40', 'Heber City', 'Wasatch', 'UT', '84032', '4359018123', NULL, NULL, NULL, '', NULL, NULL, '', '', 'USTDONC', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2004-02-27', '2006-11-30', 0, 0, 0, 'Timpanogos Regional Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1114986502', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870499080', 'W77005051', 'W77005051', 'UT01', 'Jones, Harold K', 'H Kim', NULL, 'Jones', 'DPM', 'Podiatry', 'Foot and Ankle', NULL, NULL, 'O', '210 W 300 N', 'Roosevelt', 'Duchesne', 'UT', '84066', '4357223971', '4357892063', NULL, NULL, '', NULL, NULL, '', '', 'URURAL', NULL, NULL, '0.00', '35.00', NULL, 3, '2003-04-01', '2005-07-28', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1518932995', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870499080', 'W77005052', 'W77005052', 'UT01', 'Jones, Harold K', 'H Kim', NULL, 'Jones', 'DPM', 'Podiatry', 'Foot and Ankle', NULL, NULL, 'B', '75 N 200 W Ste 1', 'Vernal', 'Uintah', 'UT', '84078', '4357892062', '4357892063', NULL, NULL, '', NULL, NULL, '', '', 'URURAL', NULL, NULL, '0.00', '35.00', NULL, 3, '2003-04-01', '2005-07-28', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1518932995', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870519691', 'W77005053', 'W77005053', 'UT01', 'Utah Cancer Specialists', 'William', 'E', 'Nibley', 'MD', 'Hematology and Oncology', 'Pediatric Hematology and Oncolocy', NULL, NULL, 'O', '3838 S 700 E Ste 100', 'Salt Lake City', 'Salt Lake', 'UT', '84106', '8012690231', '8012690304', NULL, NULL, '', NULL, NULL, '', '', 'USTDONC', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2003-04-01', '2006-10-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1437108974', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870519691', 'W77005054', 'W77005054', 'UT01', 'Utah Cancer Specialists', 'Nancy', NULL, 'Weber', 'PA', 'Hematology and Oncology', NULL, NULL, NULL, 'O', '1492 W Antelope Dr Ste 125', 'Layton', 'Davis', 'UT', '84041', '8015253022', NULL, NULL, NULL, '', NULL, NULL, '', '', 'USTDONC', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2003-04-01', '2006-10-31', 0, 0, 0, 'Davis Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1194774554', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870519691', 'W77005055', 'W77005055', 'UT01', 'Utah Cancer Specialists', 'Nancy', NULL, 'Weber', 'PA', 'Hematology and Oncology', NULL, NULL, NULL, 'O', '3838 S 700 E Ste 100', 'Salt Lake City', 'Salt Lake', 'UT', '84106', '8012690231', '8012690304', NULL, NULL, '', NULL, NULL, '', '', 'USTDONC', NULL, NULL, '0.00', '35.00', NULL, 3, '2003-04-01', '2006-03-23', 0, 0, 0, 'Davis Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1194774554', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870519691', 'W77005056', 'W77005056', 'UT01', 'Utah Cancer Specialists', 'Jonathan', 'R', 'Whisenant', 'MD', NULL, NULL, NULL, NULL, 'B', '1121 E 3900 S Bldg C Ste 240', 'Salt Lake City', 'Salt Lake', 'UT', '84124', '8012660878', '8012662074', NULL, NULL, '', NULL, NULL, '', '', 'USTDONC', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2005-08-26', '2005-08-26', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1861441974', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870520042', 'W77005057', 'W77005057', 'UT01', 'Nephrology Associates', 'Phyllis', 'T', 'Aseltine', 'NP', 'Nephrology', NULL, NULL, NULL, 'O', '650 E 4500 S Ste 210', 'Salt Lake City', 'Salt Lake', 'UT', '84107', '8012882634', NULL, NULL, NULL, '', NULL, NULL, '', '', 'USTDNEPH', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2004-09-24', '2006-10-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1376545251', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
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('870519691', 'W77005142', 'W77005142', 'UT01', 'Utah Cancer Specialists', 'Anna', 'C', 'Beck', 'MD', 'Hematology and Oncology', NULL, NULL, NULL, 'O', '2490 S State St Ste 218', 'Salt Lake City', 'Salt Lake', 'UT', '84115', '8014660556', NULL, NULL, NULL, '', NULL, NULL, '', '', 'USTDONC', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2003-04-01', '2006-10-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1710936265', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL);
INSERT INTO `providers_new` (`Provider_Tax_ID`, `Provider_Suffix`, `Provider_Network_ID`, `Provider_Region`, `Provider_Name`, `Provider_Doctor_First_Name`, `Provider_Doctor_Middle_Name`, `Provider_Doctor_Last_Name`, `Provider_Doctor_Degree`, `Provider_Specialty_1`, `Provider_Specialty_2`, `Provider_Specialty_3`, `Provider_Specialty_4`, `Provider_Address_Type`, `Provider_Address`, `Provider_City`, `Provider_County`, `Provider_State`, `Provider_Zip`, `Provider_Phone`, `Provider_Fax`, `Provider_Mailing_Address`, `Provider_Mailing_City`, `Provider_Mailing_County`, `Provider_Mailing_State`, `Provider_Mailing_Zip`, `Provider_Mailing_Phone`, `Provider_Mailing_Fax`, `Provider_Primary_Schedule`, `Provider_Secondary_Schedule`, `Provider_Rate_Sheet`, `Provider_Anes_Rate`, `Provider_Default_Rate`, `Provider_Max_DOS`, `Provider_Min_Match_Value`, `Provider_Effective_Date`, `Provider_Term_Date`, `Provider_Pend`, `Provider_Anes_Minutes`, `Provider_PPO`, `Provider_Hospital_1`, `Provider_Hospital_2`, `Provider_Hospital_3`, `Provider_Hospital_4`, `Provider_Type`, `Provider_NPI`, `Provider_Check_Override`, `Exclude_Dir`, `Audit_Status`, `Last_Change_Date`, `Medicare_ID`, `Provider_Lang`, `Provider_Latitude`, `Provider_Longitude`, `Provider_school`, `Provider_cert`) VALUES
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('870519691', 'W77005145', 'W77005145', 'UT01', 'Utah Cancer Specialists', 'Nitin', 'B', 'Chandramouli', 'MD', 'Hematology and Oncology', NULL, NULL, NULL, 'O', '3838 S 700 E Ste 100', 'Salt Lake City', 'Salt Lake', 'UT', '84106', '8012690231', '8012690304', NULL, NULL, '', NULL, NULL, '', '', 'USTDONC', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2003-04-01', '2006-10-31', 0, 0, 0, 'Mountain West Medical Center', 'St Marks Hospital', NULL, NULL, 'HCFA|UB|', '1801845730', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870519691', 'W77005146', 'W77005146', 'UT01', 'Utah Cancer Specialists', 'Melissa', 'C', 'Corcoran', 'MD', 'Oncology', NULL, NULL, NULL, 'B', '1121 E 3900 S Bldg C Ste 240', 'Salt Lake City', 'Salt Lake', 'UT', '84124', '8012660878', '8012662074', NULL, NULL, '', NULL, NULL, '', '', 'USTDONC', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2005-04-29', '2006-10-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1114976032', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870519691', 'W77005147', 'W77005147', 'UT01', 'Utah Cancer Specialists', 'Ann', 'J', 'Eisenbraun', 'MD', 'Hematology and Oncology', NULL, NULL, NULL, 'B', '1121 E 3900 S Bldg C Ste 240', 'Salt Lake City', 'Salt Lake', 'UT', '84124', '8012660878', '8012662074', NULL, NULL, '', NULL, NULL, '', '', 'USTDONC', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2003-04-01', '2006-10-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '832028', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870519691', 'W77005148', 'W77005148', 'UT01', 'Utah Cancer Specialists', 'Ann', 'J', 'Eisenbraun', 'MD', 'Hematology and Oncology', NULL, NULL, NULL, 'O', '1492 W Antelope Dr Ste 125', 'Layton', 'Davis', 'UT', '84041', '8015253022', NULL, NULL, NULL, '', NULL, NULL, '', '', 'USTDONC', NULL, NULL, '0.00', '35.00', NULL, 3, '2003-04-01', '2004-10-18', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '832028', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870519691', 'W77005149', 'W77005149', 'UT01', 'Utah Cancer Specialists', 'Ann', 'J', 'Eisenbraun', 'MD', 'Hematology and Oncology', NULL, NULL, NULL, 'O', '2490 S State St Ste 218', 'Salt Lake City', 'Salt Lake', 'UT', '84115', '8014660556', NULL, NULL, NULL, '', NULL, NULL, '', '', 'USTDONC', NULL, NULL, '0.00', '35.00', NULL, 3, '2003-04-01', '2004-10-18', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '832028', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870503286', 'W77005150', 'W77005150', 'UT01', 'Hearing Zone', 'Dee', NULL, 'Child', 'SPT', 'Speech Therapy', NULL, NULL, NULL, 'O', '129 E 1400 N', 'Logan', 'Cache', 'UT', '84341', '4357537171', NULL, NULL, NULL, '', NULL, NULL, '', '', 'UDME', 'USTDHCPC', '2298', '0.00', '35.00', NULL, 3, '1999-09-01', '2005-09-01', 1, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '834844', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870503286', 'W77005151', 'W77005151', 'UT01', 'Hearing Zone', 'Marilyn', 'K', 'Howe', 'SPT', 'Speech Therapy', NULL, NULL, NULL, 'O', '70 S Fairfield Rd Ste 10', 'Layton', 'Davis', 'UT', '84041', '8014440300', NULL, NULL, NULL, '', NULL, NULL, '', '', 'UDME', 'USTDHCPC', '2298', '0.00', '35.00', NULL, 3, '2003-03-28', '2006-10-31', 1, 0, 0, 'Primary Childrens Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1508941543', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870503286', 'W77005152', 'W77005152', 'UT01', 'Hearing Zone', 'Dave', NULL, 'Robinson', 'AUD', 'Audiology', NULL, NULL, NULL, 'O', '973 S Main St', 'Brigham City', 'Box Elder', 'UT', '84302', '4357232727', NULL, NULL, NULL, '', NULL, NULL, '', '', 'USTDOTHR', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2002-12-01', '2006-10-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1386703767', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870503931', 'W77005153', 'W77005153', 'UT01', 'Southwestern OB/GYN', 'Steven', 'J', 'Dewey', 'MD', 'Obstetrics and Gynecology', NULL, NULL, NULL, 'O', '39 Professional Way Ste 3', 'Payson', 'Utah', 'UT', '84651', '8014659263', NULL, NULL, NULL, '', NULL, NULL, '', '', 'UUVPN', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2001-06-16', '2005-12-31', 0, 0, 0, 'Mountain View Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1356358147', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870506731', 'W77005154', 'W77005154', 'UT01', 'Clark, S Corbin', 'S Corbin', NULL, 'Clark', 'MD', 'Urology', NULL, NULL, NULL, 'O', '9690 S 1300 E Ste 100', 'Sandy', 'Salt Lake', 'UT', '84094', '8015715121', NULL, NULL, NULL, '', NULL, NULL, '', '', 'USTDURO', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2002-04-01', '2006-09-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1770591620', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870507858', 'W77005155', 'W77005155', 'UT01', 'Neurological Associates', 'Mohammad', 'Entezari', 'Taher', 'MD', 'Neurology', NULL, NULL, NULL, 'O', '50 S Medical Dr Ste 4', 'Payson', 'Utah', 'UT', '84651', '8014654809', NULL, NULL, NULL, '', NULL, NULL, '', '', 'UUVPN', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2000-09-22', '2006-05-31', 0, 0, 0, 'Evanston Regional Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1992762918', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870509414', 'W77005156', 'W77005156', 'UT01', 'Mountain Utah Family Medicine', 'Robert', 'W', 'Nentwich', 'PA', NULL, NULL, NULL, NULL, 'O', '850 N Main St Ste 3', 'Richfield', 'Sevier', 'UT', '84701', '4358969561', '4358969564', NULL, NULL, '', NULL, NULL, '', '', 'URURAL', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2005-06-24', '2006-10-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1659402774', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870509468', 'W77005157', 'W77005157', 'UT01', 'Neurology Associates', 'David', 'J', 'Smith', 'MD', 'Neurology', NULL, NULL, NULL, 'O', '3590 W 9000 S Ste 120', 'West Jordan', 'Salt Lake', 'UT', '84088', '8013528373', '8013528459', NULL, NULL, '', NULL, NULL, '', '', 'USTDNRLG', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2002-04-01', '2006-09-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1578574182', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870511278', 'W77005159', 'W77005159', 'UT01', 'Smith, Bryson', 'Bryson', NULL, 'Smith', 'MD', 'Neurosurgery', NULL, NULL, NULL, 'O', '425 E 5350 S Ste 315', 'Ogden', 'Weber', 'UT', '84405', '8014799119', NULL, NULL, NULL, '', NULL, NULL, '', '', 'UOGDEN', NULL, NULL, '0.00', '35.00', NULL, 3, '1999-09-01', '2006-12-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1669507984', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870512254', 'W77005160', 'W77005160', 'UT01', 'Surgical Associates', 'Remington', NULL, 'Brooks', 'MD', 'General Surgery', NULL, NULL, NULL, 'O', '3570 W 9000 S Ste 110', 'West Jordan', 'Salt Lake', 'UT', '84088', '8015691260', NULL, NULL, NULL, '', NULL, NULL, '', '', 'USTDSURG', NULL, NULL, '0.00', '35.00', NULL, 3, '2002-04-01', '2006-01-01', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '833191', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870512790', 'W77005161', 'W77005161', 'UT01', 'Fankhanel, Kathryn J', 'Kathryn', NULL, 'Fankhanel', 'MD', 'Internal Medicine', NULL, NULL, NULL, 'B', '1220 E 3900 S Ste 4-A', 'Salt Lake City', 'Salt Lake', 'UT', '84124', '8012620640', NULL, NULL, NULL, '', NULL, NULL, '', '', 'USTDINT', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2002-04-01', '2006-07-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '831089', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870512790', 'W77005162', 'W77005162', 'UT01', 'Fankhanel, Kathryn J', 'Kathryn', NULL, 'Fankhanel', 'MD', 'Internal Medicine', NULL, NULL, NULL, 'O', '1220 E 3900 S Ste 4A', 'Salt Lake City', 'Salt Lake', 'UT', '84124', '8012620640', NULL, NULL, NULL, '', NULL, NULL, '', '', 'USTDINT', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2002-04-01', '2006-07-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '831089', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870525882', 'W77005163', 'W77005163', 'UT01', 'Mountain View Anesthesia', 'Janie', 'S', 'Christensen', 'CRNA', 'Anesthesiology', NULL, NULL, NULL, 'O', '1000 E 100 N', 'Payson', 'Utah', 'UT', '84651', '8019939555', NULL, NULL, NULL, '', NULL, NULL, '', '', '135', NULL, '1000', '47.25', NULL, NULL, 3, '2003-08-01', '2006-12-31', 1, 12, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '834373', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870525882', 'W77005164', 'W77005164', 'UT01', 'Mountain View Anesthesia', 'Janie', 'S', 'Christensen', 'CRNA', 'Anesthesiology', NULL, NULL, NULL, 'B', '1954 E Fort Union Blvd Ste 105', 'Salt Lake City', 'Salt Lake', 'UT', '84121', NULL, NULL, NULL, NULL, '', NULL, NULL, '', '', '135', NULL, '1000', '47.25', NULL, NULL, 3, '2003-08-01', '2006-12-31', 1, 12, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '834373', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870525882', 'W77005165', 'W77005165', 'UT01', 'Mountain View Anesthesia', 'Daren', 'J', 'Felix', 'CRNA', 'Anesthesiology', NULL, NULL, NULL, 'B', '1954 E Fort Union Blvd Ste 105', 'Salt Lake City', 'Salt Lake', 'UT', '84121', NULL, NULL, NULL, NULL, '', NULL, NULL, '', '', '135', NULL, '1000', '47.25', NULL, NULL, 3, '2002-03-01', '2006-12-31', 1, 12, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '832510', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870525882', 'W77005166', 'W77005166', 'UT01', 'Mountain View Anesthesia', 'Jerry', 'A', 'Matthiesen', 'MD', 'Anesthesiology', NULL, NULL, NULL, 'B', '1954 E Fort Union Blvd Ste 105', 'Salt Lake City', 'Salt Lake', 'UT', '84121', NULL, NULL, NULL, NULL, '', NULL, NULL, '', '', '135', NULL, '1000', '47.25', NULL, NULL, 3, '2001-07-01', '2006-12-31', 1, 12, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '834084', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870525882', 'W77005167', 'W77005167', 'UT01', 'Mountain View Anesthesia', 'Paul', 'B', 'Reichert', 'CRNA', 'Anesthesiology', NULL, NULL, NULL, 'B', '1954 E Fort Union Blvd Ste 105', 'Salt Lake City', 'Salt Lake', 'UT', '84121', NULL, NULL, NULL, NULL, '', NULL, NULL, '', '', '135', NULL, '1000', '44.10', NULL, NULL, 3, '2001-07-01', '2001-07-01', 1, 12, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1316042732', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870525882', 'W77005168', 'W77005168', 'UT01', 'Mountain View Anesthesia', 'Paul', 'B', 'Reichert', 'CRNA', 'Anesthesiology', NULL, NULL, NULL, 'O', '750 W 800 N', 'Orem', 'Utah', 'UT', '84057', '8017146000', NULL, NULL, NULL, '', NULL, NULL, '', '', '135', NULL, '1000', '47.25', NULL, NULL, 3, '2001-07-01', '2006-12-31', 1, 12, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1316042732', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870525882', 'W77005169', 'W77005169', 'UT01', 'Mountain View Anesthesia', 'Fred', NULL, 'Starr', 'CRNA', 'Anesthesiology', NULL, NULL, NULL, 'O', '1000 E 100 N', 'Payson', 'Utah', 'UT', '84651', '8007484868', NULL, NULL, NULL, '', NULL, NULL, '', '', '135', NULL, '1000', '47.25', NULL, NULL, 3, '2001-07-02', '2006-12-31', 1, 12, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '834017', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870525882', 'W77005170', 'W77005170', 'UT01', 'Mountain View Anesthesia', 'Richard', 'G', 'Watts', 'CRNA', 'Anesthesiology', NULL, NULL, NULL, 'B', '1954 E Fort Union Blvd Ste 105', 'Salt Lake City', 'Salt Lake', 'UT', '84121', NULL, NULL, NULL, NULL, '', NULL, NULL, '', '', '135', NULL, '1000', '47.25', NULL, NULL, 3, '2003-07-01', '2006-12-31', 1, 12, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1023113545', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870526286', 'W77005171', 'W77005171', 'UT01', 'Wasatch Internal Medicine', 'Zaneta', 'J', 'Bulaj', 'MD', 'Internal Medicine', NULL, NULL, NULL, 'O', '1160 E 3900 S Ste 1000', 'Salt Lake City', 'Salt Lake', 'UT', '84124', '8012621771', '8012889101', NULL, NULL, '', NULL, NULL, '', '', 'UWASIM', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2003-10-01', '2006-07-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1598869026', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870526286', 'W77005172', 'W77005172', 'UT01', 'Wasatch Internal Medicine', 'Todd', 'R', 'Nelson', 'MD', 'Family Practice', NULL, NULL, NULL, 'O', '1160 E 3900 S Ste 1000', 'Salt Lake City', 'Salt Lake', 'UT', '84124', '8012621771', '8012889101', NULL, NULL, '', NULL, NULL, '', '', 'UWASIM', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2002-04-01', '2006-07-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1902917495', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870526286', 'W77005173', 'W77005173', 'UT01', 'Wasatch Internal Medicine', 'Lynn', NULL, 'Price', 'MD', 'Family Practice', NULL, NULL, NULL, 'O', '1160 E 3900 S Ste 1000', 'Salt Lake City', 'Salt Lake', 'UT', '84124', '8012621771', '8012889101', NULL, NULL, '', NULL, NULL, '', '', 'UWASIM', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2002-10-01', '2006-07-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1669583134', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870526286', 'W77005174', 'W77005174', 'UT01', 'Wasatch Internal Medicine', 'David', 'J', 'Shaskey', 'MD', 'Sports Medicine', 'Rheumatology', 'Internal Medicine', NULL, 'O', '1160 E 3900 S Ste 1000', 'Salt Lake City', 'Salt Lake', 'UT', '84124', '8012621771', '8012889101', NULL, NULL, '', NULL, NULL, '', '', 'UWASIM', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2002-04-01', '2006-07-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1033220603', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
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('870526462', 'W77005176', 'W77005176', 'UT01', 'University Of Utah Plastic Surgery', 'Marga', 'F', 'Massey', 'MD', 'Plastic Surgery', NULL, NULL, NULL, 'B', 'PO Box 58049', 'Salt Lake City', 'Salt Lake', 'UT', '84158', '8015817719', NULL, NULL, NULL, '', NULL, NULL, '', '', 'UUUMG', NULL, NULL, '0.00', '25.00', NULL, 3, '2002-07-01', '2006-07-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '832213', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870280408', 'W77005177', 'W77005177', 'UT01', 'Pediatric Anesthesiologists', 'Kim', 'K', 'Hissong', 'MD', 'Anesthesiology', 'Anesthesiology', NULL, NULL, 'O', '1954 E Fort Union Blvd Ste 111', 'Salt Lake City', 'Salt Lake', 'UT', '84121', '8019939551', '8017335872', '1954 E Ft Union Blvd', 'Salt Lake City', '', 'UT', '84121', '', '', '135', NULL, '1000', '54.60', NULL, NULL, 3, '2001-06-01', '2006-08-10', 1, 12, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '833822', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870280408', 'W77005178', 'W77005178', 'UT01', 'Pediatric Anesthesiologists', 'Amy', 'N', 'Phelps', 'MD', 'Anesthesiology', NULL, NULL, NULL, 'O', '1954 E Fort Union Blvd Ste 111', 'Salt Lake City', 'Salt Lake', 'UT', '84121', '8019939551', '8017335872', '1954 E Ft Union Blvd', 'Salt Lake City', '', 'UT', '84121', '', '', '135', NULL, '1000', '54.60', NULL, NULL, 3, '2001-06-01', '2006-08-31', 1, 12, 0, 'Primary Childrens Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1518072818', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870280408', 'W77005179', 'W77005179', 'UT01', '*Pediatric Anesthesiologists', 'Charles', 'G', 'Pribble', 'MD', 'Pediatric Critical Care', 'Anesthesiology', NULL, NULL, 'O', '100 N Medical Dr', 'Salt Lake City', 'Salt Lake', 'UT', '84113', '8015883280', NULL, '1954 E Ft Union Blvd', 'Salt Lake City', '', 'UT', '84121', '', '', '135', NULL, '1000', '54.60', NULL, NULL, 3, '2000-01-01', '2004-05-08', 1, 12, 0, 'Primary Childrens Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1245349042', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870280408', 'W77005180', 'W77005180', 'UT01', '*Pediatric Anesthesiologists', 'Michael', 'B', 'Welch', 'MD', 'Anesthesiology', NULL, NULL, NULL, 'O', '50 N Medical Dr', 'Salt Lake City', 'Salt Lake', 'UT', '84132', '8015816393', NULL, '1954 E Ft Union Blvd', 'Salt Lake City', '', 'UT', '84121', '', '', '135', NULL, '1000', '54.60', NULL, NULL, 3, '2001-06-01', '2004-05-08', 1, 12, 0, 'Primary Childrens Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1558470518', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870280408', 'W77005181', 'W77005181', 'UT01', 'Pediatric Anesthesiologists', 'Michael', 'B', 'Welch', 'MD', 'Anesthesiology', NULL, NULL, NULL, 'B', '1954 E Fort Union Blvd Ste 111', 'Salt Lake City', 'Salt Lake', 'UT', '84121', NULL, NULL, '1954 E Ft Union Blvd', 'Salt Lake City', '', 'UT', '84121', '', '', '135', NULL, '1000', '54.60', NULL, NULL, 3, '2001-06-01', '2004-05-08', 1, 12, 0, 'Primary Childrens Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1558470518', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
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('870525682', 'W77005257', 'W77005257', 'UT01', 'Retina Associates Of Utah', 'Mano', NULL, 'Swartz', 'MD', 'Ophthalmology', NULL, NULL, NULL, 'O', '1660 W Antelope Dr', 'Layton', 'Davis', 'UT', '84041', '8008738462', '8017758223', NULL, NULL, '', NULL, NULL, '', '', 'UUVPN', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2002-01-01', '2006-05-31', 0, 0, 0, 'St Marks Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1801870670', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870525682', 'W77005258', 'W77005258', 'UT01', 'Retina Associates Of Utah', 'Mano', NULL, 'Swartz', 'MD', 'Ophthalmology', NULL, NULL, NULL, 'O', '272 1/2 N Main St', 'Logan', 'Cache', 'UT', '84321', '8008738462', NULL, NULL, NULL, '', NULL, NULL, '', '', 'UUVPN', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2002-01-01', '2006-05-31', 0, 0, 0, 'St Marks Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1801870670', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL);
INSERT INTO `providers_new` (`Provider_Tax_ID`, `Provider_Suffix`, `Provider_Network_ID`, `Provider_Region`, `Provider_Name`, `Provider_Doctor_First_Name`, `Provider_Doctor_Middle_Name`, `Provider_Doctor_Last_Name`, `Provider_Doctor_Degree`, `Provider_Specialty_1`, `Provider_Specialty_2`, `Provider_Specialty_3`, `Provider_Specialty_4`, `Provider_Address_Type`, `Provider_Address`, `Provider_City`, `Provider_County`, `Provider_State`, `Provider_Zip`, `Provider_Phone`, `Provider_Fax`, `Provider_Mailing_Address`, `Provider_Mailing_City`, `Provider_Mailing_County`, `Provider_Mailing_State`, `Provider_Mailing_Zip`, `Provider_Mailing_Phone`, `Provider_Mailing_Fax`, `Provider_Primary_Schedule`, `Provider_Secondary_Schedule`, `Provider_Rate_Sheet`, `Provider_Anes_Rate`, `Provider_Default_Rate`, `Provider_Max_DOS`, `Provider_Min_Match_Value`, `Provider_Effective_Date`, `Provider_Term_Date`, `Provider_Pend`, `Provider_Anes_Minutes`, `Provider_PPO`, `Provider_Hospital_1`, `Provider_Hospital_2`, `Provider_Hospital_3`, `Provider_Hospital_4`, `Provider_Type`, `Provider_NPI`, `Provider_Check_Override`, `Exclude_Dir`, `Audit_Status`, `Last_Change_Date`, `Medicare_ID`, `Provider_Lang`, `Provider_Latitude`, `Provider_Longitude`, `Provider_school`, `Provider_cert`) VALUES
('870515631', 'W77005261', 'W77005261', 'UT01', 'U Of U Rehabilitation Medicine', 'Richard', 'W', 'Parry', 'MD', 'Physical Medicine and Rehabilitation', NULL, NULL, NULL, 'B', 'PO Box 58609', 'Salt Lake City', 'Salt Lake', 'UT', '84158', '8015817267', NULL, NULL, NULL, '', NULL, NULL, '', '', 'UUUMG', NULL, NULL, '0.00', '25.00', NULL, 3, '2005-07-01', '2006-07-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1609955178', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870515631', 'W77005262', 'W77005262', 'UT01', 'U Of U Rehabilitation Medicine', 'Jeffrey', 'P', 'Rosenbluth', 'MD', 'Physical Medicine and Rehabilitation', NULL, NULL, NULL, 'O', '50 N Medical Dr', 'Salt Lake City', 'Salt Lake', 'UT', '84132', '8015812267', NULL, NULL, NULL, '', NULL, NULL, '', '', 'UUUMG', NULL, NULL, '0.00', '25.00', NULL, 3, '2001-08-06', '2006-07-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1578653192', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870515631', 'W77005263', 'W77005263', 'UT01', 'U Of U Rehabilitation Medicine', 'Theresa', 'L', 'Such-Neibar', 'DO', 'Physical Medicine and Rehabilitation', NULL, NULL, NULL, 'O', '247 N 100 E', 'Orem', 'Utah', 'UT', '84057', '8012280323', NULL, NULL, NULL, '', NULL, NULL, '', '', 'UUUMG', NULL, NULL, '0.00', '25.00', NULL, 3, '1999-09-01', '2006-07-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '834283', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870515631', 'W77005264', 'W77005264', 'UT01', 'U Of U Rehabilitation Medicine', 'Theresa', 'L', 'Such-Neibar', 'DO', 'Physical Medicine and Rehabilitation', NULL, NULL, NULL, 'O', '50 N Medical Dr', 'Salt Lake City', 'Salt Lake', 'UT', '84132', '8015856032', NULL, NULL, NULL, '', NULL, NULL, '', '', 'UUUMG', NULL, NULL, '0.00', '25.00', NULL, 3, '1999-09-01', '2006-07-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '834283', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870515631', 'W77005265', 'W77005265', 'UT01', 'U Of U Rehabilitation Medicine', 'Theresa', 'L', 'Such-Neibar', 'DO', 'Physical Medicine and Rehabilitation', NULL, NULL, NULL, 'B', 'PO Box 58609', 'Salt Lake City', 'Salt Lake', 'UT', '84158', '8015817267', NULL, NULL, NULL, '', NULL, NULL, '', '', 'UUUMG', NULL, NULL, '0.00', '25.00', NULL, 3, '1999-09-01', '2006-07-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '834283', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870515631', 'W77005266', 'W77005266', 'UT01', 'U Of U Rehabilitation Medicine', 'Katarina', 'L', 'Waters', 'NP', 'Physical Medicine and Rehabilitation', NULL, NULL, NULL, 'O', '50 N Medical Dr', 'Salt Lake City', 'Salt Lake', 'UT', '84132', '8015817267', NULL, NULL, NULL, '', NULL, NULL, '', '', 'UUUMG', NULL, NULL, '0.00', '25.00', NULL, 3, '2002-02-20', '2006-07-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1568552156', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870515631', 'W77005267', 'W77005267', 'UT01', 'U Of U Rehabilitation Medicine', 'Joseph', 'B', 'Webster', 'MD', 'Physical Medicine and Rehabilitation', NULL, NULL, NULL, 'O', '50 N Medical Dr', 'Salt Lake City', 'Salt Lake', 'UT', '84132', '8015812932', NULL, NULL, NULL, '', NULL, NULL, '', '', 'UUUMG', NULL, NULL, '0.00', '25.00', NULL, 3, '2003-03-17', '2006-07-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1386734978', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870515631', 'W77005268', 'W77005268', 'UT01', 'U Of U Rehabilitation Medicine', 'Stuart', 'E', 'Willick', 'MD', 'Physical Medicine and Rehabilitation', NULL, NULL, NULL, 'B', 'PO Box 58609', 'Salt Lake City', 'Salt Lake', 'UT', '84158', '8015817267', NULL, NULL, NULL, '', NULL, NULL, '', '', 'UUUMG', NULL, NULL, '0.00', '25.00', NULL, 3, '1999-09-01', '2006-07-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1720169915', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870516264', 'W77005270', 'W77005270', 'UT01', 'Utah County Surgical Associates', 'R Richard', NULL, 'Rasmussen', 'MD', 'General Surgery', NULL, NULL, NULL, 'O', '3550 N University Ave Ste 250', 'Provo', 'Utah', 'UT', '84604', '8013749625', NULL, NULL, NULL, '', NULL, NULL, '', '', 'UUVPN', NULL, NULL, '0.00', '35.00', NULL, 3, '2003-07-22', '2006-05-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1528008588', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870517201', 'W77005271', 'W77005271', 'UT01', 'Central Utah Radiology', 'Bevan', 'V', 'Bastian', 'MD', 'Radiologist', NULL, NULL, NULL, 'O', '64 E 100 N', 'Gunnison', 'Sanpete', 'UT', '84634', '4356231242', '4355287358', NULL, NULL, '', NULL, NULL, '', '', 'USTDRAD', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2003-04-01', '2006-12-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1821098088', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870517201', 'W77005272', 'W77005272', 'UT01', 'Central Utah Radiology', 'Bevan', 'V', 'Bastian', 'MD', 'Radiologist', NULL, NULL, NULL, 'B', 'PO Box 908', 'Bountiful', 'Davis', 'UT', '84011', '4356231242', '4355287358', NULL, NULL, '', NULL, NULL, '', '', 'USTDRAD', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2003-04-01', '2006-12-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1821098088', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
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('870519172', 'W77005370', 'W77005370', 'UT01', 'Utah Heart Clinic', 'Steven', 'Curtis', 'Horton', 'MD', 'Cardiovascular Disease', 'Internal Medicine', NULL, NULL, 'O', '324 10th Ave Ste 206', 'Salt Lake City', 'Salt Lake', 'UT', '84103', '8014083900', '8014083909', NULL, NULL, '', NULL, NULL, '', '', 'USTDCARD', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2005-04-29', '2006-05-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1043288640', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870519172', 'W77005372', 'W77005372', 'UT01', 'Utah Heart Clinic', 'Donald', 'Lewis', 'Lappe', 'MD', 'Cardiovascular Disease', 'Internal Medicine', NULL, NULL, 'B', '324 10th Ave Ste 206', 'Salt Lake City', 'Salt Lake', 'UT', '84103', '8014085868', NULL, NULL, NULL, '', NULL, NULL, '', '', 'USTDCARD', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2005-05-20', '2005-05-20', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1669440277', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870519172', 'W77005373', 'W77005373', 'UT01', 'Utah Heart Clinic', 'Sherman', 'G', 'Sorensen', 'MD', 'Cardiovascular Disease', NULL, NULL, NULL, 'O', '324 10th Ave Ste 206', 'Salt Lake City', 'Salt Lake', 'UT', '84103', '8014083900', '8014083909', NULL, NULL, '', NULL, NULL, '', '', 'USTDCARD', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2005-04-29', '2006-05-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '923760', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870519172', 'W77005374', 'W77005374', 'UT01', 'Utah Heart Clinic', 'J Peter', '', 'Weiss', 'MD', 'Cardiovascular Disease', NULL, NULL, NULL, 'O', '324 10th Ave Ste 206', 'Salt Lake City', 'Salt Lake', 'UT', '84103', '8014083900', '8014083909', NULL, NULL, '', NULL, NULL, '', '', 'USTDCARD', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2005-04-29', '2006-05-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1528036654', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870519172', 'W77005376', 'W77005376', 'UT01', 'Utah Heart Clinic', 'Brian', 'K', 'Whisenant', 'MD', 'Cardiovascular Disease', NULL, NULL, NULL, 'O', '324 10th Ave Ste 206', 'Salt Lake City', 'Salt Lake', 'UT', '84103', '8014083900', '8014083909', NULL, NULL, '', NULL, NULL, '', '', 'USTDCARD', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2000-07-10', '2006-05-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1750359253', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870519691', 'W77005378', 'W77005378', 'UT01', 'Utah Cancer Specialists', 'Kent', NULL, 'Difiore', 'MD', 'Hematology and Oncology', NULL, NULL, NULL, 'B', '1121 E 3900 S Bldg C Ste 240', 'Salt Lake City', 'Salt Lake', 'UT', '84124', '8012660878', '8012662074', NULL, NULL, '', NULL, NULL, '', '', 'USTDONC', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2003-04-01', '2006-10-31', 0, 0, 0, 'St Marks Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1649229618', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870519691', 'W77005382', 'W77005382', 'UT01', 'Utah Cancer Specialists', 'Ann', 'J', 'Eisenbraun', 'MD', 'Hematology and Oncology', NULL, NULL, NULL, 'O', '1250 E 3900 S Ste 30', 'Salt Lake City', 'Salt Lake', 'UT', '84124', '8012690231', NULL, NULL, NULL, '', NULL, NULL, '', '', 'USTDONC', NULL, NULL, '0.00', '35.00', NULL, 3, '2003-04-01', '2004-10-18', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '832028', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870542403', 'W77005383', 'W77005383', 'UT01', 'Intermountain Anesthesia', 'Spencer', 'J', 'Combe', 'CRNA', 'Anesthesiology', NULL, NULL, NULL, 'O', '3580 W 9000 S', 'West Jordan', 'Salt Lake', 'UT', '84088', '8019939506', NULL, NULL, NULL, '', NULL, NULL, '', '', '135', NULL, '1000', '31.50', NULL, NULL, 3, '2001-04-01', '2004-05-08', 1, 12, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '832225', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870542403', 'W77005384', 'W77005384', 'UT01', 'Intermountain Anesthesia', 'Nancy', NULL, 'Knape', 'CRNA', 'Anesthesiology', NULL, NULL, NULL, 'O', '3580 W 9000 S', 'West Jordan', 'Salt Lake', 'UT', '84088', '8019939506', NULL, NULL, NULL, '', NULL, NULL, '', '', '135', NULL, '1000', '43.05', NULL, NULL, 3, '2001-04-01', '2004-05-08', 1, 12, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1427050186', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870542403', 'W77005385', 'W77005385', 'UT01', 'Intermountain Anesthesia', 'Dale', 'E', 'Koford', 'CRNA', 'Anesthesiology', NULL, NULL, NULL, 'B', '1954 E Fort Union Blvd Ste 107', 'Salt Lake City', 'Salt Lake', 'UT', '84121', '8019939506', NULL, NULL, NULL, '', NULL, NULL, '', '', '135', NULL, '1000', '31.50', NULL, NULL, 3, '2001-04-01', '2004-05-08', 1, 12, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '834214', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870542403', 'W77005386', 'W77005386', 'UT01', 'Intermountain Anesthesia', 'Dale', 'E', 'Koford', 'CRNA', 'Anesthesiology', NULL, NULL, NULL, 'O', '3580 W 9000 S', 'West Jordan', 'Salt Lake', 'UT', '84088', '8019939506', NULL, NULL, NULL, '', NULL, NULL, '', '', '135', NULL, '1000', '31.50', NULL, NULL, 3, '2001-04-01', '2004-05-08', 1, 12, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '834214', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL);
INSERT INTO `providers_new` (`Provider_Tax_ID`, `Provider_Suffix`, `Provider_Network_ID`, `Provider_Region`, `Provider_Name`, `Provider_Doctor_First_Name`, `Provider_Doctor_Middle_Name`, `Provider_Doctor_Last_Name`, `Provider_Doctor_Degree`, `Provider_Specialty_1`, `Provider_Specialty_2`, `Provider_Specialty_3`, `Provider_Specialty_4`, `Provider_Address_Type`, `Provider_Address`, `Provider_City`, `Provider_County`, `Provider_State`, `Provider_Zip`, `Provider_Phone`, `Provider_Fax`, `Provider_Mailing_Address`, `Provider_Mailing_City`, `Provider_Mailing_County`, `Provider_Mailing_State`, `Provider_Mailing_Zip`, `Provider_Mailing_Phone`, `Provider_Mailing_Fax`, `Provider_Primary_Schedule`, `Provider_Secondary_Schedule`, `Provider_Rate_Sheet`, `Provider_Anes_Rate`, `Provider_Default_Rate`, `Provider_Max_DOS`, `Provider_Min_Match_Value`, `Provider_Effective_Date`, `Provider_Term_Date`, `Provider_Pend`, `Provider_Anes_Minutes`, `Provider_PPO`, `Provider_Hospital_1`, `Provider_Hospital_2`, `Provider_Hospital_3`, `Provider_Hospital_4`, `Provider_Type`, `Provider_NPI`, `Provider_Check_Override`, `Exclude_Dir`, `Audit_Status`, `Last_Change_Date`, `Medicare_ID`, `Provider_Lang`, `Provider_Latitude`, `Provider_Longitude`, `Provider_school`, `Provider_cert`) VALUES
('870542578', 'W77005387', 'W77005387', 'UT01', 'U Of U Dialysis Program', 'Srinivasan', NULL, 'Beddhu', 'MD', 'Nephrology', 'Internal Medicine', NULL, NULL, 'B', 'PO Box 27071', 'Salt Lake City', 'Salt Lake', 'UT', '84127', '8015818578', NULL, NULL, NULL, '', NULL, NULL, '', '', 'UUUMG', NULL, NULL, '0.00', '25.00', NULL, 3, '1999-09-02', '2006-07-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1124118757', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870542578', 'W77005388', 'W77005388', 'UT01', 'U Of U Dialysis Program', 'Alexander', 'S', 'Goldfarb', 'MD', 'Nephrology', NULL, NULL, NULL, 'B', 'PO Box 27071', 'Salt Lake City', 'Salt Lake', 'UT', '84127', '8015818578', NULL, NULL, NULL, '', NULL, NULL, '', '', 'UUUMG', NULL, NULL, '0.00', '25.00', NULL, 3, '2001-08-17', '2006-07-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1013007616', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870542578', 'W77005389', 'W77005389', 'UT01', 'U Of U Dialysis Program', 'Carl', NULL, 'Kablitz', 'MD', 'Nephrology', 'Internal Medicine', NULL, NULL, 'O', '85 Medical Dr Ste 201', 'Salt Lake City', 'Salt Lake', 'UT', '84112', '8015818578', NULL, NULL, NULL, '', NULL, NULL, '', '', 'UUUMG', NULL, NULL, '0.00', '25.00', NULL, 3, '1999-09-01', '2006-07-31', 0, 0, 0, 'University Health Care University Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1245320845', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870542578', 'W77005390', 'W77005390', 'UT01', 'U Of U Dialysis Program', 'Carl', NULL, 'Kablitz', 'MD', 'Nephrology', 'Internal Medicine', NULL, NULL, 'B', 'PO Box 27071', 'Salt Lake City', 'Salt Lake', 'UT', '84127', '8015818578', NULL, NULL, NULL, '', NULL, NULL, '', '', 'UUUMG', NULL, NULL, '0.00', '25.00', NULL, 3, '1999-09-01', '2006-07-31', 0, 0, 0, 'University Health Care University Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1245320845', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870542578', 'W77005391', 'W77005391', 'UT01', 'U Of U Dialysis Program', 'Barbara', NULL, 'Stark', 'NP', NULL, NULL, NULL, NULL, 'O', '85 Medical Dr Ste 201', 'Salt Lake City', 'Salt Lake', 'UT', '84112', '8015818578', NULL, NULL, NULL, '', NULL, NULL, '', '', 'UUUMG', NULL, NULL, '0.00', '25.00', NULL, 3, '2001-10-01', '2004-06-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1053401687', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870542578', 'W77005392', 'W77005392', 'UT01', 'U Of U Dialysis Program', 'Barbara', NULL, 'Stark', 'NP', NULL, NULL, NULL, NULL, 'B', 'PO Box 27071', 'Salt Lake City', 'Salt Lake', 'UT', '84127', '8015818578', NULL, NULL, NULL, '', NULL, NULL, '', '', 'UUUMG', NULL, NULL, '0.00', '25.00', NULL, 3, '2001-10-01', '2004-06-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1053401687', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870542578', 'W77005393', 'W77005393', 'UT01', 'U Of U Dialysis Program', 'Christof', NULL, 'Westenfelder', 'MD', 'Nephrology', NULL, NULL, NULL, 'B', 'PO Box 27071', 'Salt Lake City', 'Salt Lake', 'UT', '84127', '8015818578', NULL, NULL, NULL, '', NULL, NULL, '', '', 'UUUMG', NULL, NULL, '0.00', '25.00', NULL, 3, '1999-09-01', '2006-07-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1730279324', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870542586', 'W77005394', 'W77005394', 'UT01', 'University Of Utah Nephrology Dept', 'Srinivasan', NULL, 'Beddhu', 'MD', 'Nephrology', 'Internal Medicine', NULL, NULL, 'B', 'PO Box 581700', 'Salt Lake City', 'Salt Lake', 'UT', '84158', '8015816709', NULL, NULL, NULL, '', NULL, NULL, '', '', 'UUUMG', NULL, NULL, '0.00', '25.00', NULL, 3, '1999-09-02', '2006-07-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1124118757', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870542586', 'W77005395', 'W77005395', 'UT01', 'University Of Utah Nephrology Dept', 'Irel', 'S', 'Eppich', 'MD', 'Internal Medicine', 'Nephrology', NULL, NULL, 'B', 'PO Box 581700', 'Salt Lake City', 'Salt Lake', 'UT', '84158', '8015816709', NULL, NULL, NULL, '', NULL, NULL, '', '', 'UUUMG', NULL, NULL, '0.00', '25.00', NULL, 3, '2003-11-03', '2006-07-31', 0, 0, 0, 'University Health Care University Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1689764276', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870542586', 'W77005396', 'W77005396', 'UT01', 'University of Utah Nephrology Dept', 'Martin', 'C', 'Gregory', 'MD PHD', 'Nephrology', 'Pediatric Nephrology', NULL, NULL, 'O', '50 N Medical Dr', 'Salt Lake City', 'Salt Lake', 'UT', '84132', '8015816709', NULL, NULL, NULL, '', NULL, NULL, '', '', 'UUUMG', NULL, NULL, '0.00', '25.00', NULL, 3, '2002-08-05', '2006-07-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1912926049', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870281028', 'W77005397', 'W77005397', 'UT01', 'Central Utah Clinic', 'David', 'H', 'Watters', 'MD', 'Radiologist', NULL, NULL, NULL, 'B', '1055 N 500 W', 'Provo', 'Utah', 'UT', '84604', '8013742362', '8013742615', NULL, NULL, '', NULL, NULL, '', '', 'UUVPN', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '1999-09-01', '2005-12-31', 0, 0, 0, 'Mountain View Hospital', 'Timpanogos Regional Hospital', NULL, NULL, 'HCFA|UB|', '1558397570', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870281299', 'W77005398', 'W77005398', 'UT01', 'American Fork Clinic', 'Timo', NULL, 'Hoggard', 'MD', 'Family Practice', NULL, NULL, NULL, 'O', '226 N 1100 E Ste A', 'American Fork', 'Utah', 'UT', '84003', '8018553841', '8018553847', NULL, NULL, '', NULL, NULL, '', '', 'UUVPN', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '1999-09-01', '2005-12-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1639288798', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870281299', 'W77005399', 'W77005399', 'UT01', 'American Fork Clinic', 'Douglas', 'R', 'Jones', 'MD', 'Family Practice', NULL, NULL, NULL, 'O', '680 E Main St Ste 100', 'Lehi', 'Utah', 'UT', '84043', '8017681699', '8017684526', NULL, NULL, '', NULL, NULL, '', '', 'UUVPN', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2002-04-01', '2006-05-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '831575', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870281299', 'W77005400', 'W77005400', 'UT01', 'American Fork Clinic', 'Toran', 'J', 'MacArthur', 'MD', 'Family Practice', NULL, NULL, NULL, 'O', '226 N 1100 E Ste A', 'American Fork', 'Utah', 'UT', '84003', '8018553850', '8018553847', NULL, NULL, '', NULL, NULL, '', '', 'UUVPN', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2002-12-20', '2005-12-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1063521177', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870281299', 'W77005401', 'W77005401', 'UT01', 'American Fork Clinic', 'Douglas', 'R', 'Mower', 'MD', 'Family Practice', NULL, NULL, NULL, 'O', '226 N 1100 E Ste A', 'American Fork', 'Utah', 'UT', '84003', '8018553841', '8018553847', NULL, NULL, '', NULL, NULL, '', '', 'UUVPN', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '1999-09-01', '2005-12-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1033228283', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870281707', 'W77005402', 'W77005402', 'UT01', 'Cache Valley Eye Associates', 'Jon', 'A', 'Siler', 'MD', 'Ophthalmology', NULL, NULL, NULL, 'O', '1300 N 500 E Ste 350', 'Logan', 'Cache', 'UT', '84341', '4357527445', '4357533059', NULL, NULL, '', NULL, NULL, '', '', 'USTDOPHT', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '1999-09-01', '2006-09-30', 0, 0, 0, 'Logan Regional Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1407885007', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870282100', 'W77005403', 'W77005403', 'UT01', 'Medical Arts Center Clinic', 'Jeffrey', 'Ray', 'Lish', 'MD', 'Family Practice', NULL, NULL, NULL, 'O', '984 Medical Dr Ste 1', 'Brigham City', 'Box Elder', 'UT', '84302', '4357235248', NULL, NULL, NULL, '', NULL, NULL, '', '', 'USTDFAM', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2003-04-01', '2006-08-31', 0, 0, 0, 'Brigham City Community Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1003848797', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870283576', 'W77005404', 'W77005404', 'UT01', 'Excel Eye Center', 'Todd', 'B', 'Engen', 'MD', 'Ophthalmology', NULL, NULL, NULL, 'O', '1735 N State St', 'Provo', 'Utah', 'UT', '84604', '8013792900', '8013740163', NULL, NULL, '', NULL, NULL, '', '', 'UUVPN', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2000-09-01', '2006-05-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1295705697', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870283576', 'W77005405', 'W77005405', 'UT01', 'Excel Eye Center', 'Jesse', 'N', 'Hunsaker', 'MD', 'Ophthalmology', NULL, NULL, NULL, 'B', '1735 N State St', 'Provo', 'Utah', 'UT', '84604', NULL, NULL, NULL, NULL, '', NULL, NULL, '', '', 'UUVPN', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2003-01-01', '2006-05-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1104895507', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870283576', 'W77005406', 'W77005406', 'UT01', 'Excel Eye Center', 'N Kent', NULL, 'Linton', 'MD', 'Ophthalmology', NULL, NULL, NULL, 'O', '1172 E 100 N Ste 4', 'Payson', 'Utah', 'UT', '84651', '8014652575', NULL, NULL, NULL, '', NULL, NULL, '', '', 'UUVPN', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2001-06-01', '2006-05-31', 0, 0, 0, 'Mountain View Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1114991429', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870283576', 'W77005407', 'W77005407', 'UT01', 'Excel Eye Center', 'W Scott', NULL, 'Lohner', 'MD', 'Ophthalmology', NULL, NULL, NULL, 'O', '700 W 800 N Ste 160', 'Orem', 'Utah', 'UT', '84057', '8014269800', NULL, NULL, NULL, '', NULL, NULL, '', '', 'UUVPN', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2001-11-02', '2006-05-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1992764187', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870283576', 'W77005408', 'W77005408', 'UT01', 'Excel Eye Center', 'Steven', 'J', 'Weaver', 'OD', 'Optometry', NULL, NULL, NULL, 'O', '700 W 800 N Ste 160', 'Orem', 'Utah', 'UT', '84057', '8014269800', NULL, NULL, NULL, '', NULL, NULL, '', '', 'UUVPN', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2005-09-30', '2006-05-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '937244', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870283830', 'W77005409', 'W77005409', 'UT01', 'Intermountain Allergy', 'Joseph', 'R', 'Anderson', 'MD', 'Allergy', NULL, NULL, NULL, 'O', '1682 E 5600 S', 'Ogden', 'Weber', 'UT', '84403', '8014760052', NULL, NULL, NULL, '', NULL, NULL, '', '', 'USTDALLE', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2003-04-01', '2006-08-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1720080062', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870533611', 'W77005410', 'W77005410', 'UT01', 'North Davis Anesthesiology', 'Brian', 'C', 'Hales', 'MD', 'Anesthesiology', NULL, NULL, NULL, 'O', '1600 W Antelope Dr', 'Layton', 'Davis', 'UT', '84041', '8017748992', NULL, NULL, NULL, '', NULL, NULL, '', '', '135', NULL, '1000', '47.25', NULL, NULL, 3, '2003-04-01', '2006-05-31', 1, 12, 0, 'Davis Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1053396770', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870533854', 'W77005411', 'W77005411', 'UT01', 'West Jordan Medical Center', 'Joan', 'N', 'Bentley', 'NP', 'Family Practice', NULL, NULL, NULL, 'O', '3570 W 9000 S Ste 200', 'West Jordan', 'Salt Lake', 'UT', '84088', '8015669211', NULL, NULL, NULL, '', NULL, NULL, '', '', 'USTDFAM', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2003-04-01', '2006-05-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1467485342', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
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('870533854', 'W77005413', 'W77005413', 'UT01', 'West Jordan Medical Center', 'Maria', 'A', 'Oneida', 'MD', 'Family Practice', NULL, NULL, NULL, 'O', '3570 W 9000 S Ste 200', 'West Jordan', 'Salt Lake', 'UT', '84088', '8015669211', NULL, NULL, NULL, '', NULL, NULL, '', '', 'USTDFAM', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2002-04-01', '2006-05-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1154350239', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
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('870543677', 'W77005482', 'W77005482', 'UT01', 'Rehabilitation Source', 'e, LLC', NULL, 'Rehabilitation Sourc', 'GROUP', 'Physical Therapy', NULL, NULL, NULL, 'O', '3303 N University Ave', 'Provo', 'Utah', 'UT', '84604', '8013731037', NULL, NULL, NULL, '', NULL, NULL, '', '', 'UUVPN', NULL, NULL, '0.00', '35.00', NULL, 3, '2004-05-01', '2005-01-01', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '833011', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
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('870543678', 'W77005484', 'W77005484', 'UT01', 'Spine Orthopedics & Sports Physical Therapy', 'Sports Physical', ' Therapy', 'Spine Orthopedics &', 'GROUP', 'Physical Therapy', NULL, NULL, NULL, 'O', '3303 N University Ave', 'Provo', 'Utah', 'UT', '84604', '8013731037', '8013754382', NULL, NULL, '', NULL, NULL, '', '', NULL, NULL, NULL, '0.00', '0.00', '57.75', 3, '2004-05-01', '2006-12-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '833005', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
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('870284475', 'W77005489', 'W77005489', 'UT01', 'Granger Medical Clinic', 'Scott', 'L', 'Carpenter', 'PA', 'Orthopedic Surgery', NULL, NULL, NULL, 'O', '3725 W 4100 S', 'West Valley', 'Salt Lake', 'UT', '84120', '8019653600', '8019683605', NULL, NULL, '', NULL, NULL, '', '', 'UGRANGER', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2003-10-03', '2006-07-31', 0, 0, 0, 'Pioneer Valley Hospital', 'Riverton Childrens Unit Operated by Primary Childrens Medical Center', NULL, NULL, 'HCFA|UB|', '1346271715', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870284475', 'W77005490', 'W77005490', 'UT01', 'Granger Medical Clinic', 'Scott', 'L', 'Carpenter', 'PA', 'Orthopedic Surgery', NULL, NULL, NULL, 'B', 'PO Box 70658', 'West Valley', 'Salt Lake', 'UT', '84170', NULL, NULL, NULL, NULL, '', NULL, NULL, '', '', 'UGRANGER', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2003-10-03', '2006-07-31', 0, 0, 0, 'Pioneer Valley Hospital', 'Riverton Childrens Unit Operated by Primary Childrens Medical Center', NULL, NULL, 'HCFA|UB|', '1346271715', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL);
INSERT INTO `providers_new` (`Provider_Tax_ID`, `Provider_Suffix`, `Provider_Network_ID`, `Provider_Region`, `Provider_Name`, `Provider_Doctor_First_Name`, `Provider_Doctor_Middle_Name`, `Provider_Doctor_Last_Name`, `Provider_Doctor_Degree`, `Provider_Specialty_1`, `Provider_Specialty_2`, `Provider_Specialty_3`, `Provider_Specialty_4`, `Provider_Address_Type`, `Provider_Address`, `Provider_City`, `Provider_County`, `Provider_State`, `Provider_Zip`, `Provider_Phone`, `Provider_Fax`, `Provider_Mailing_Address`, `Provider_Mailing_City`, `Provider_Mailing_County`, `Provider_Mailing_State`, `Provider_Mailing_Zip`, `Provider_Mailing_Phone`, `Provider_Mailing_Fax`, `Provider_Primary_Schedule`, `Provider_Secondary_Schedule`, `Provider_Rate_Sheet`, `Provider_Anes_Rate`, `Provider_Default_Rate`, `Provider_Max_DOS`, `Provider_Min_Match_Value`, `Provider_Effective_Date`, `Provider_Term_Date`, `Provider_Pend`, `Provider_Anes_Minutes`, `Provider_PPO`, `Provider_Hospital_1`, `Provider_Hospital_2`, `Provider_Hospital_3`, `Provider_Hospital_4`, `Provider_Type`, `Provider_NPI`, `Provider_Check_Override`, `Exclude_Dir`, `Audit_Status`, `Last_Change_Date`, `Medicare_ID`, `Provider_Lang`, `Provider_Latitude`, `Provider_Longitude`, `Provider_school`, `Provider_cert`) VALUES
('870284475', 'W77005491', 'W77005491', 'UT01', 'Granger Medical Clinic', 'Peter', 'L', 'Christensen', 'MD', 'Family Practice', NULL, NULL, NULL, 'B', 'PO Box 70658', 'West Valley', 'Salt Lake', 'UT', '84170', NULL, NULL, NULL, NULL, '', NULL, NULL, '', '', 'UGRANGER', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2003-01-01', '2006-07-31', 0, 0, 0, 'Jordan Valley Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1992737159', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870284475', 'W77005492', 'W77005492', 'UT01', 'Granger Medical Clinic', 'Eugene', 'P', 'Christian', 'MD', 'Orthopedic Surgery', NULL, NULL, NULL, 'O', '3725 W 4100 S', 'West Valley', 'Salt Lake', 'UT', '84120', '8019653424', '8019683605', NULL, NULL, '', NULL, NULL, '', '', 'UGRANGER', NULL, NULL, '0.00', '35.00', NULL, 3, '2003-01-01', '2005-08-01', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '832258', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870284475', 'W77005493', 'W77005493', 'UT01', 'Granger Medical Clinic', 'James', 'S', 'Coy', 'MD', 'Family Practice', 'Urgent Care', NULL, NULL, 'O', '2751 W 9000 S', 'West Jordan', 'Salt Lake', 'UT', '84088', '8013525900', NULL, NULL, NULL, '', NULL, NULL, '', '', 'UGRANGER', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2003-07-17', '2006-07-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1174555320', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870284475', 'W77005494', 'W77005494', 'UT01', 'Granger Medical Clinic', 'Jennifer', 'E', 'DenBleyker', 'MD', 'Family Practice', NULL, NULL, NULL, 'O', '3725 W 4100 S', 'West Valley', 'Salt Lake', 'UT', '84120', '8019653419', '8019683605', NULL, NULL, '', NULL, NULL, '', '', 'UGRANGER', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2002-04-01', '2006-07-31', 0, 0, 0, 'Pioneer Valley Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1033141270', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870284475', 'W77005495', 'W77005495', 'UT01', 'Granger Medical Clinic', 'Alyson', NULL, 'Eyre', 'MD', 'Pediatrics', NULL, NULL, NULL, 'B', 'PO Box 70658', 'West Valley', 'Salt Lake', 'UT', '84170', NULL, NULL, NULL, NULL, '', NULL, NULL, '', '', 'UGRANGER', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2003-01-01', '2006-07-31', 0, 0, 0, 'Pioneer Valley Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1508897927', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870284475', 'W77005496', 'W77005496', 'UT01', 'Granger Medical Clinic', 'Randall', 'R', 'Fillmore', 'MD', 'Family Practice', NULL, NULL, NULL, 'O', '2751 W 9000 S', 'West Jordan', 'Salt Lake', 'UT', '84088', '8013525900', NULL, NULL, NULL, '', NULL, NULL, '', '', 'UGRANGER', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2003-01-01', '2006-07-31', 0, 0, 0, 'Jordan Valley Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1386675627', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870284475', 'W77005497', 'W77005497', 'UT01', 'Granger Medical Clinic', 'Mary', 'L', 'Freeman', 'FNP', 'Pediatrics', NULL, NULL, NULL, 'B', 'PO Box 70658', 'West Valley', 'Salt Lake', 'UT', '84170', NULL, NULL, NULL, NULL, '', NULL, NULL, '', '', 'UGRANGER', NULL, NULL, '0.00', '35.00', NULL, 3, '2003-01-01', '2006-09-11', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '831645', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870284475', 'W77005498', 'W77005498', 'UT01', 'Granger Medical Clinic', 'Elizabeth', 'M', 'Harmer', 'CNM', 'Obstetrics and Gynecology', NULL, NULL, NULL, 'O', '3725 W 4100 S', 'West Valley', 'Salt Lake', 'UT', '84120', '8019653720', '8019683605', NULL, NULL, '', NULL, NULL, '', '', 'UGRANGER', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2003-06-13', '2006-07-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1992736342', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870284475', 'W77005499', 'W77005499', 'UT01', 'Granger Medical Clinic', 'David', 'A', 'Harris', 'MD', 'Pediatrics', NULL, NULL, NULL, 'B', 'PO Box 70658', 'West Valley', 'Salt Lake', 'UT', '84170', NULL, NULL, NULL, NULL, '', NULL, NULL, '', '', 'UGRANGER', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2003-01-01', '2006-07-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1922023324', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870284475', 'W77005500', 'W77005500', 'UT01', 'Granger Medical Clinic', 'Christopher', NULL, 'Hutchison', 'MD', 'Obstetrics and Gynecology', NULL, NULL, NULL, 'B', 'PO Box 70658', 'West Valley', 'Salt Lake', 'UT', '84170', NULL, NULL, NULL, NULL, '', NULL, NULL, '', '', 'UGRANGER', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2003-01-01', '2006-07-31', 0, 0, 0, 'Pioneer Valley Hospital', 'Riverton Childrens Unit Operated by Primary Childrens Medical Center', NULL, NULL, 'HCFA|UB|', '1134151384', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870284475', 'W77005501', 'W77005501', 'UT01', 'Granger Medical Clinic', 'Pinky', NULL, 'Kotwal', 'MD', 'Internal Medicine', NULL, NULL, NULL, 'O', '3725 W 4100 S', 'West Valley', 'Salt Lake', 'UT', '84120', '8019653600', '8019683605', NULL, NULL, '', NULL, NULL, '', '', 'UGRANGER', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2003-01-01', '2006-07-31', 0, 0, 0, 'Pioneer Valley Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1083645444', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870284475', 'W77005502', 'W77005502', 'UT01', 'Granger Medical Clinic', 'Diane', 'M', 'Mattocks', 'PA', 'Family Practice', NULL, NULL, NULL, 'O', '3725 W 4100 S', 'West Valley', 'Salt Lake', 'UT', '84120', '8019653600', '8019683605', NULL, NULL, '', NULL, NULL, '', '', 'UGRANGER', NULL, NULL, '0.00', '35.00', NULL, 3, '2003-11-01', '2004-01-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '834745', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870542586', 'W77005503', 'W77005503', 'UT01', 'University Of Utah Nephrology Dept', 'Donald', 'E', 'Kohan', 'MD', 'Nephrology', NULL, NULL, NULL, 'O', '85 Medical Dr Ste 201', 'Salt Lake City', 'Salt Lake', 'UT', '84112', '8015816709', NULL, NULL, NULL, '', NULL, NULL, '', '', 'UUUMG', NULL, NULL, '0.00', '25.00', NULL, 3, '1999-09-01', '2006-07-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1235229840', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870542586', 'W77005504', 'W77005504', 'UT01', 'University of Utah Nephrology Dept', 'Abinash', 'C', 'Roy', 'MD', 'Nephrology', NULL, NULL, NULL, 'O', '50 N Medical Dr', 'Salt Lake City', 'Salt Lake', 'UT', '84132', '8015816709', NULL, NULL, NULL, '', NULL, NULL, '', '', 'UUUMG', NULL, NULL, '0.00', '25.00', NULL, 3, '2001-07-01', '2006-07-31', 0, 0, 0, 'Dixie Regional Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1295825818', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870542586', 'W77005505', 'W77005505', 'UT01', 'University Of Utah Nephrology Dept', 'Fuad', 'S', 'Shihab', 'MD', 'Nephrology', NULL, NULL, NULL, 'B', 'PO Box 581700', 'Salt Lake City', 'Salt Lake', 'UT', '84158', '8015816709', NULL, NULL, NULL, '', NULL, NULL, '', '', 'UUUMG', NULL, NULL, '0.00', '25.00', NULL, 3, '1999-09-01', '2006-07-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1700976321', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870542586', 'W77005506', 'W77005506', 'UT01', 'University Of Utah Nephrology Dept', 'Barbara', NULL, 'Stark', 'NP', NULL, NULL, NULL, NULL, 'B', 'PO Box 581700', 'Salt Lake City', 'Salt Lake', 'UT', '84158', '8015816709', NULL, NULL, NULL, '', NULL, NULL, '', '', 'UUUMG', NULL, NULL, '0.00', '25.00', NULL, 3, '2001-10-01', '2004-06-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1053401687', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870542586', 'W77005507', 'W77005507', 'UT01', 'University of Utah Nephrology Dept', 'Christof', NULL, 'Westenfelder', 'MD', 'Nephrology', NULL, NULL, NULL, 'O', '50 N Medical Dr', 'Salt Lake City', 'Salt Lake', 'UT', '84132', '8015816709', NULL, NULL, NULL, '', NULL, NULL, '', '', 'UUUMG', NULL, NULL, '0.00', '25.00', NULL, 3, '1999-09-01', '2006-07-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1730279324', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870542605', 'W77005508', 'W77005508', 'UT01', 'Alley, Robert J', 'Robert', 'J', 'Alley', 'MD', 'General Surgery', NULL, NULL, NULL, 'B', '1652 Wildcat Ln Ste 1', 'Ogden', 'Weber', 'UT', '84403', '8013932249', '8013939909', NULL, NULL, '', NULL, NULL, '', '', 'USTDSURG', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2003-07-25', '2006-10-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1255343117', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870542605', 'W77005509', 'W77005509', 'UT01', 'Alley, Robert J', 'Robert', 'J', 'Alley', 'MD', 'General Surgery', NULL, NULL, NULL, 'O', '5475 S 500 E', 'Ogden', 'Weber', 'UT', '84405', '8013932249', NULL, NULL, NULL, '', NULL, NULL, '', '', 'USTDSURG', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2003-07-25', '2006-10-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1255343117', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870543074', 'W77005510', 'W77005510', 'UT01', 'Park City Vision Center', 'Robert', 'S', 'Briggs', 'OD', 'Optometry', NULL, NULL, NULL, 'O', '1920 Prospector Ave', 'Park City', 'Summit', 'UT', '84060', '4356495200', NULL, NULL, NULL, '', NULL, NULL, '', '', 'UTALBERT', NULL, NULL, '0.00', '25.00', NULL, 3, '2001-01-09', '2006-08-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1063472538', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870543318', 'W77005511', 'W77005511', 'UT01', 'Mountain West Gastroenterology', 'Mark', 'E', 'Boschert', 'MD', 'Gastroenterology', NULL, NULL, NULL, 'B', '6360 S 3000 E Ste 300', 'Salt Lake City', 'Salt Lake', 'UT', '84121', '8019443188', '8019443180', NULL, NULL, '', NULL, NULL, '', '', 'USTDGSTR', 'USTDHCPC', '12180', '0.00', NULL, NULL, 3, '2003-04-01', '2006-05-31', 1, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1346252236', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870543318', 'W77005512', 'W77005512', 'UT01', 'Mountain West Gastroenterology', 'John', 'H', 'Bowers', 'MD', 'Gastroenterology', NULL, NULL, NULL, 'B', '6360 S 3000 E Ste 300', 'Salt Lake City', 'Salt Lake', 'UT', '84121', '8019443188', '8019443180', NULL, NULL, '', NULL, NULL, '', '', 'USTDGSTR', 'USTDHCPC', '12180', '0.00', NULL, NULL, 3, '2003-04-01', '2006-05-31', 1, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1649283318', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870543318', 'W77005513', 'W77005513', 'UT01', 'Mountain West Gastroenterology', 'Terry', 'D', 'Box', 'MD', 'Gastroenterology', 'Internal Medicine', 'Transplant Heptol', NULL, 'O', '6360 S 3000 E Ste 310', 'Salt Lake City', 'Salt Lake', 'UT', '84121', '8019443144', '8019443186', NULL, NULL, '', NULL, NULL, '', '', 'USTDGSTR', 'USTDHCPC', '12180', '0.00', NULL, NULL, 3, '2003-04-01', '2006-05-31', 1, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1235142985', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870543318', 'W77005514', 'W77005514', 'UT01', 'Mountain West Gastroenterology', 'Deborah', 'D', 'Cobb', 'FNP', NULL, NULL, NULL, NULL, 'O', '520 Medical Dr Ste 200', 'Bountiful', 'Davis', 'UT', '84010', '8012980057', '8019443186', NULL, NULL, '', NULL, NULL, '', '', 'USTDGSTR', 'USTDHCPC', '12180', '0.00', NULL, NULL, 3, '2003-04-01', '2006-05-31', 1, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1912013632', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870519691', 'W77005516', 'W77005516', 'UT01', 'Utah Cancer Specialists', 'Nancy', NULL, 'Weber', 'PA', 'Hematology and Oncology', NULL, NULL, NULL, 'O', '520 Medical Dr Ste 340', 'Bountiful', 'Davis', 'UT', '84010', '8012966665', NULL, NULL, NULL, '', NULL, NULL, '', '', 'USTDONC', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2003-04-01', '2006-10-31', 0, 0, 0, 'Davis Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1194774554', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870520042', 'W77005517', 'W77005517', 'UT01', 'Nephrology Associates', 'Phyllis', 'T', 'Aseltine', 'NP', 'Nephrology', NULL, NULL, NULL, 'B', '650 E 4500 S Ste 210', 'Murray', 'Salt Lake', 'UT', '84107', '8012882634', NULL, NULL, NULL, '', NULL, NULL, '', '', 'USTDNEPH', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2004-09-24', '2006-10-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1376545251', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870520042', 'W77005518', 'W77005518', 'UT01', 'Nephrology Associates', 'Richard', 'C', 'Cline', 'MD', 'Nephrology', NULL, NULL, NULL, 'B', '650 E 4500 S Ste 210', 'Murray', 'Salt Lake', 'UT', '84107', '8012882634', NULL, NULL, NULL, '', NULL, NULL, '', '', 'USTDNEPH', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2003-04-01', '2006-10-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1245237080', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870520042', 'W77005519', 'W77005519', 'UT01', 'Nephrology Associates', 'Richard', 'C', 'Cline', 'MD', 'Nephrology', NULL, NULL, NULL, 'O', '650 E 4500 S Ste 210', 'Salt Lake City', 'Salt Lake', 'UT', '84107', '8012882634', NULL, NULL, NULL, '', NULL, NULL, '', '', 'USTDNEPH', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2003-04-01', '2006-10-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1245237080', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870520042', 'W77005520', 'W77005520', 'UT01', 'Nephrology Associates', 'Melinda', 'J', 'McAnulty', 'MD', 'Nephrology', NULL, NULL, NULL, 'B', '650 E 4500 S Ste 210', 'Murray', 'Salt Lake', 'UT', '84107', '8012882634', NULL, NULL, NULL, '', NULL, NULL, '', '', 'USTDNEPH', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2003-04-01', '2006-10-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1902803661', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870520042', 'W77005521', 'W77005521', 'UT01', 'Nephrology Associates', 'James', 'B', 'Stinson', 'MD', 'Nephrology', NULL, NULL, NULL, 'B', '650 E 4500 S Ste 210', 'Murray', 'Salt Lake', 'UT', '84107', '8012882634', NULL, NULL, NULL, '', NULL, NULL, '', '', 'USTDNEPH', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2003-04-01', '2006-10-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1023015260', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870520042', 'W77005522', 'W77005522', 'UT01', 'Nephrology Associates', 'James', 'B', 'Stinson', 'MD', 'Nephrology', NULL, NULL, NULL, 'O', '650 E 4500 S Ste 210', 'Salt Lake City', 'Salt Lake', 'UT', '84107', '8012882634', NULL, NULL, NULL, '', NULL, NULL, '', '', 'USTDNEPH', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2003-04-01', '2006-10-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1023015260', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870520042', 'W77005523', 'W77005523', 'UT01', 'Nephrology Associates', 'Dave', NULL, 'Tien', 'MD', 'Nephrology', NULL, NULL, NULL, 'O', '650 E 4500 S Ste 210', 'Salt Lake City', 'Salt Lake', 'UT', '84107', '8012882634', NULL, NULL, NULL, '', NULL, NULL, '', '', 'USTDNEPH', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2003-04-01', '2006-10-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1053319657', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870521827', 'W77005524', 'W77005524', 'UT01', 'Remittance Processing', 'Michael', 'R', 'Lowry', 'MD', 'Mental Health', NULL, NULL, NULL, 'O', '501 Chipeta Way', 'Salt Lake City', 'Salt Lake', 'UT', '84108', '8015832500', NULL, NULL, NULL, '', NULL, NULL, '', '', 'UUUMG', NULL, NULL, '0.00', '25.00', NULL, 3, '2001-02-23', '2005-12-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1932116662', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870525237', 'W77005525', 'W77005525', 'UT01', 'U Of U Immunology', 'Harry', 'R', 'Hill', 'MD', 'Pediatric Immunology and Rheumatology', 'Immunology', 'Pathology', NULL, 'B', 'PO Box 581700', 'Salt Lake City', 'Salt Lake', 'UT', '84158', '8012386615', '8012367733', NULL, NULL, '', NULL, NULL, '', '', 'UUUMG', NULL, NULL, '0.00', '25.00', NULL, 3, '1999-09-01', '2006-07-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1366532962', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870525567', 'W77005526', 'W77005526', 'UT01', 'Mcfadden, Michael R', 'Michael', 'R', 'McFadden', 'MD', 'Urology', NULL, NULL, NULL, 'O', '3590 W 9000 S Ste 330', 'West Jordan', 'Salt Lake', 'UT', '84088', '8012558633', NULL, NULL, NULL, '', NULL, NULL, '', '', 'USTDURO', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2002-04-01', '2006-10-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1811067283', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870525567', 'W77005527', 'W77005527', 'UT01', 'Mcfadden, Michael R', 'Michael', 'R', 'McFadden', 'MD', 'Urology', NULL, NULL, NULL, 'B', 'PO Box 680290', 'Park City', 'Summit', 'UT', '84068', '8013221181', NULL, NULL, NULL, '', NULL, NULL, '', '', 'USTDURO', NULL, NULL, '0.00', '35.00', NULL, 3, '2002-04-01', '2004-09-01', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1811067283', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870525567', 'W77005528', 'W77005528', 'UT01', 'Mcfadden, Michael R', 'Michael', 'R', 'McFadden', 'MD', 'Urology', NULL, NULL, NULL, 'B', 'PO Box 680290', 'Park City', 'Summit', 'UT', '84068', '8013221181', NULL, NULL, NULL, '', NULL, NULL, '', '', 'USTDURO', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2002-04-01', '2006-10-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1811067283', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870543678', 'W77005529', 'W77005529', 'UT01', 'Spine Orthopedics & Sports Physical Therapy', 'Rogan', NULL, 'Taylor', 'PT', 'Physical Therapy', NULL, NULL, NULL, 'B', 'PO Box 307', 'Bountiful', 'Davis', 'UT', '84011', '8012946907', '8012946917', NULL, NULL, '', NULL, NULL, '', '', NULL, NULL, NULL, '0.00', '0.00', '57.75', 3, '1999-09-01', '2006-12-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '833493', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
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('870546501', 'W77005586', 'W77005586', 'UT01', 'Alpine Pediatrics', 'David', 'S', 'Johnson', 'MD', 'Pediatrics', NULL, NULL, NULL, 'O', '3688 Campus Dr Ste 120', 'Eagle Mountain', 'Utah', 'UT', '84043', '8017898999', '8014921991', NULL, NULL, '', NULL, NULL, '', '', 'UUVPN', NULL, NULL, '0.00', '35.00', NULL, 3, '1999-09-01', '2004-11-02', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1316985542', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
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('870546501', 'W77005589', 'W77005589', 'UT01', 'Alpine Pediatrics', 'Greg', 'M', 'Pavich', 'MD', 'Pediatrics', NULL, NULL, NULL, 'B', '1912 W 930 N', 'Pleasant Grove', 'Utah', 'UT', '84062', '8014921999', '8014921991', NULL, NULL, '', NULL, NULL, '', '', 'UUVPN', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2002-06-24', '2002-06-24', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1053359216', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870546501', 'W77005590', 'W77005590', 'UT01', 'Alpine Pediatrics', 'Greg', 'M', 'Pavich', 'MD', 'Pediatrics', NULL, NULL, NULL, 'O', '3688 Campus Dr Ste 120', 'Eagle Mountain', 'Utah', 'UT', '84043', '8017898999', '8014921991', NULL, NULL, '', NULL, NULL, '', '', 'UUVPN', NULL, NULL, '0.00', '35.00', NULL, 3, '2002-06-24', '2004-11-02', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1053359216', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870546501', 'W77005591', 'W77005591', 'UT01', 'Alpine Pediatrics', 'Carol', 'S', 'Tanner', 'PA', 'Pediatrics', NULL, NULL, NULL, 'B', '1912 W 930 N', 'Pleasant Grove', 'Utah', 'UT', '84062', '8014921999', '8014921991', NULL, NULL, '', NULL, NULL, '', '', 'UUVPN', NULL, NULL, '0.00', '35.00', NULL, 3, '2002-12-11', '2002-12-11', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '831791', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870546501', 'W77005592', 'W77005592', 'UT01', 'Alpine Pediatrics', 'Beverly', 'L', 'Vargo', 'MD', 'Pediatrics', NULL, NULL, NULL, 'O', '3688 Campus Dr Ste 120', 'Eagle Mountain', 'Utah', 'UT', '84043', '8017898999', '8014921991', NULL, NULL, '', NULL, NULL, '', '', 'UUVPN', NULL, NULL, '0.00', '35.00', NULL, 3, '2001-04-08', '2004-11-02', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1316991565', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870546501', 'W77005593', 'W77005593', 'UT01', 'Alpine Pediatrics', 'David', 'T', 'Whiting', 'MD', 'Pediatrics', NULL, NULL, NULL, 'O', '1912 W 930 N', 'Pleasant Grove', 'Utah', 'UT', '84062', '8014921999', '8014921991', NULL, NULL, '', NULL, NULL, '', '', 'UUVPN', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2000-07-28', '2006-05-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1023056298', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870547025', 'W77005594', 'W77005594', 'UT01', NULL, 'Kimberly', 'E', 'Beck', 'MD', 'Family Practice', NULL, NULL, NULL, 'O', '76 E Ctr', 'Gunnison', 'Sanpete', 'UT', '84634', '4355287935', '4355287936', NULL, NULL, '', NULL, NULL, '', '', 'URURAL', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2005-11-18', '2006-09-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1700814803', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870284475', 'W77005595', 'W77005595', 'UT01', 'Granger Medical Clinic', 'Susan', 'M', 'Zimmerman', 'MD', 'Neurology', NULL, NULL, NULL, 'B', 'PO Box 70658', 'West Valley', 'Salt Lake', 'UT', '84170', '8019653720', '8019653740', NULL, NULL, '', NULL, NULL, '', '', 'UGRANGER', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2005-07-19', '2006-07-31', 0, 0, 0, 'Pioneer Valley Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1063444214', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870285509', 'W77005596', 'W77005596', 'UT01', 'Provo Ob/Gyn Clinic', 'Kent', 'R', 'Gamette', 'MD', 'Obstetrics and Gynecology', NULL, NULL, NULL, 'O', '3550 N University Ave Ste 275', 'Provo', 'Utah', 'UT', '84604', '8013748600', NULL, NULL, NULL, '', NULL, NULL, '', '', 'UUVPN', NULL, NULL, '0.00', '35.00', NULL, 3, '2001-07-01', '2004-08-13', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1538284120', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870285509', 'W77005597', 'W77005597', 'UT01', 'Provo Ob/Gyn Clinic', 'Kent', 'R', 'Gamette', 'MD', 'Obstetrics and Gynecology', NULL, NULL, NULL, 'O', '920 N 500 W', 'Provo', 'Utah', 'UT', '84604', '8013741801', '8013750369', NULL, NULL, '', NULL, NULL, '', '', 'UUVPN', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2001-07-01', '2005-12-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1538284120', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870285547', 'W77005598', 'W77005598', 'UT01', 'Registered Physical Therapists', 'Therapists Inc', NULL, 'Registered Physical', 'GROUP', 'Physical Therapy', NULL, NULL, NULL, 'O', '389 W 10000 S', 'South Jordan', 'Salt Lake', 'UT', '84095', '8016762210', '8016762212', NULL, NULL, '', NULL, NULL, '', '', NULL, NULL, NULL, '0.00', '0.00', '57.75', 3, '2004-10-29', '2006-12-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '911310', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870286381', 'W77005599', 'W77005599', 'UT01', 'Ogden Clinic', 'Jon', 'W', 'Ahlstrom', 'MD', 'Obstetrics and Gynecology', NULL, NULL, NULL, 'O', '1159 12th St', 'Ogden', 'Weber', 'UT', '84404', '8013343000', '8014762670', NULL, NULL, '', NULL, NULL, '', '', 'UOGDCLIN', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2003-04-01', '2006-07-31', 0, 0, 0, 'Logan Regional Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1437146065', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870286381', 'W77005600', 'W77005600', 'UT01', 'Ogden Clinic', 'Jon', 'W', 'Ahlstrom', 'MD', 'Obstetrics and Gynecology', NULL, NULL, NULL, 'O', '5430 S 1900 W Ste G1', 'Roy', 'Weber', 'UT', '84067', '8017799975', NULL, NULL, NULL, '', NULL, NULL, '', '', 'UOGDCLIN', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2003-04-01', '2006-07-31', 0, 0, 0, 'Logan Regional Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1437146065', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870286381', 'W77005601', 'W77005601', 'UT01', 'Ogden Clinic', 'Kelly', 'R', 'Amann', 'DO', 'Family Practice', NULL, NULL, NULL, 'O', '2595 N Highway 162', 'Eden', 'Weber', 'UT', '84310', '8014794621', NULL, NULL, NULL, '', NULL, NULL, '', '', 'UOGDCLIN', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2003-04-01', '2006-07-31', 0, 0, 0, 'Ogden Regional Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1134116783', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870286381', 'W77005602', 'W77005602', 'UT01', 'Ogden Clinic', 'Kelly', 'R', 'Amann', 'DO', 'Family Practice', NULL, NULL, NULL, 'O', '5430 S 1900 W Ste G1', 'Roy', 'Weber', 'UT', '84067', '8017799975', NULL, NULL, NULL, '', NULL, NULL, '', '', 'UOGDCLIN', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2003-04-01', '2006-07-31', 0, 0, 0, 'Ogden Regional Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1134116783', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870286381', 'W77005603', 'W77005603', 'UT01', 'Ogden Clinic', 'Elisabeth', 'G', 'Anderson', 'PA', 'Family Practice', NULL, NULL, NULL, 'O', '4650 Harrison Blvd', 'Ogden', 'Weber', 'UT', '84403', '8014794621', '8014762670', NULL, NULL, '', NULL, NULL, '', '', 'UOGDCLIN', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2003-10-03', '2006-07-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1518955624', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870286381', 'W77005604', 'W77005604', 'UT01', 'Ogden Clinic', 'Brent', 'M', 'Baranko', 'MD', 'Orthopedic Surgery', NULL, NULL, NULL, 'O', '4350 Washington Blvd', 'Ogden', 'Weber', 'UT', '84403', '8014765100', NULL, NULL, NULL, '', NULL, NULL, '', '', 'UOGDCLIN', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2003-04-01', '2006-07-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1306833967', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL);
INSERT INTO `providers_new` (`Provider_Tax_ID`, `Provider_Suffix`, `Provider_Network_ID`, `Provider_Region`, `Provider_Name`, `Provider_Doctor_First_Name`, `Provider_Doctor_Middle_Name`, `Provider_Doctor_Last_Name`, `Provider_Doctor_Degree`, `Provider_Specialty_1`, `Provider_Specialty_2`, `Provider_Specialty_3`, `Provider_Specialty_4`, `Provider_Address_Type`, `Provider_Address`, `Provider_City`, `Provider_County`, `Provider_State`, `Provider_Zip`, `Provider_Phone`, `Provider_Fax`, `Provider_Mailing_Address`, `Provider_Mailing_City`, `Provider_Mailing_County`, `Provider_Mailing_State`, `Provider_Mailing_Zip`, `Provider_Mailing_Phone`, `Provider_Mailing_Fax`, `Provider_Primary_Schedule`, `Provider_Secondary_Schedule`, `Provider_Rate_Sheet`, `Provider_Anes_Rate`, `Provider_Default_Rate`, `Provider_Max_DOS`, `Provider_Min_Match_Value`, `Provider_Effective_Date`, `Provider_Term_Date`, `Provider_Pend`, `Provider_Anes_Minutes`, `Provider_PPO`, `Provider_Hospital_1`, `Provider_Hospital_2`, `Provider_Hospital_3`, `Provider_Hospital_4`, `Provider_Type`, `Provider_NPI`, `Provider_Check_Override`, `Exclude_Dir`, `Audit_Status`, `Last_Change_Date`, `Medicare_ID`, `Provider_Lang`, `Provider_Latitude`, `Provider_Longitude`, `Provider_school`, `Provider_cert`) VALUES
('870286381', 'W77005605', 'W77005605', 'UT01', 'Ogden Clinic', 'Brent', 'M', 'Baranko', 'MD', 'Orthopedic Surgery', NULL, NULL, NULL, 'B', '4650 Harrison Blvd', 'Ogden', 'Weber', 'UT', '84403', '8014794621', '8014762670', NULL, NULL, '', NULL, NULL, '', '', 'UOGDCLIN', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2003-04-01', '2003-04-01', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1306833967', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870286381', 'W77005606', 'W77005606', 'UT01', 'Ogden Clinic', 'Carolyn', NULL, 'Belfry', 'MD', 'Family Practice', NULL, NULL, NULL, 'O', '4350 Washington Blvd', 'Ogden', 'Weber', 'UT', '84403', '8014765100', NULL, NULL, NULL, '', NULL, NULL, '', '', 'UOGDCLIN', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2003-04-01', '2006-07-31', 0, 0, 0, 'Ogden Regional Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1417944083', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870286381', 'W77005607', 'W77005607', 'UT01', 'Ogden Clinic', 'Carolyn', NULL, 'Belfry', 'MD', 'Family Practice', NULL, NULL, NULL, 'O', '5430 S 1900 W Ste G1', 'Roy', 'Weber', 'UT', '84067', '8017799975', NULL, NULL, NULL, '', NULL, NULL, '', '', 'UOGDCLIN', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2003-04-01', '2006-07-31', 0, 0, 0, 'Ogden Regional Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1417944083', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870286381', 'W77005608', 'W77005608', 'UT01', 'Ogden Clinic', 'Joseph', 'W', 'Bell', 'DO', 'Obstetrics and Gynecology', NULL, NULL, NULL, 'O', '5495 S 500 E Ste 350', 'Ogden', 'Weber', 'UT', '84405', '8014755397', NULL, NULL, NULL, '', NULL, NULL, '', '', 'USTDOBG', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2003-04-01', '2005-01-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1851471767', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870543342', 'W77005610', 'W77005610', 'UT01', 'Allen Memorial Physician Services', 'John', 'R', 'Hudgins', 'MD', 'Internal Medicine', NULL, NULL, NULL, 'B', '233 W 1st St', 'Waconia', 'Carver', 'MN', '55387', '8004331439', '8003311579', NULL, NULL, '', NULL, NULL, '', '', '110', NULL, NULL, '0.00', '10.00', NULL, 3, '2004-02-27', '2006-10-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '831907', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870543342', 'W77005611', 'W77005611', 'UT01', 'Moab Regional Medical Clinic', 'John', 'R', 'Hudgins', 'MD', 'Internal Medicine', NULL, NULL, NULL, 'O', '380 N 500 W Ste 2', 'Moab', 'Grand', 'UT', '84532', '4352597425', NULL, NULL, NULL, '', NULL, NULL, '', '', '110', NULL, NULL, '0.00', '10.00', NULL, 3, '2004-02-27', '2006-10-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '831907', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870543342', 'W77005612', 'W77005612', 'UT01', 'Allen Memorial Physician Services', 'Robert', 'G', 'Kloepper', 'MD', 'Orthopedic Surgery', NULL, NULL, NULL, 'B', '233 W 1st St', 'Waconia', 'Carver', 'MN', '55387', '8004331439', '8003311579', NULL, NULL, '', NULL, NULL, '', '', '110', NULL, NULL, '0.00', '10.00', NULL, 3, '2004-02-27', '2004-02-27', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1295705481', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870543342', 'W77005614', 'W77005614', 'UT01', 'Blanding Family Practice Clinic', 'Robert', 'G', 'Kloepper', 'MD', 'Orthopedic Surgery', NULL, NULL, NULL, 'O', '799 S 200 W', 'Blanding', 'San Juan', 'UT', '84511', '4356783601', NULL, NULL, NULL, '', NULL, NULL, '', '', '110', NULL, NULL, '0.00', '10.00', NULL, 3, '2004-02-27', '2006-10-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1295705481', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870543342', 'W77005615', 'W77005615', 'UT01', 'Moab Regional Medical Clinic', 'Robert', 'G', 'Kloepper', 'MD', 'Orthopedic Surgery', NULL, NULL, NULL, 'O', '380 N 500 W Ste 2', 'Moab', 'Grand', 'UT', '84532', '4352597425', NULL, NULL, NULL, '', NULL, NULL, '', '', '110', NULL, NULL, '0.00', '10.00', NULL, 3, '2004-02-27', '2005-09-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1295705481', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870543342', 'W77005616', 'W77005616', 'UT01', 'Moab Regional Medical Clinic', 'Jon', 'L', 'Landeen', 'MD', 'Obstetrics and Gynecology', NULL, NULL, NULL, 'O', '380 N 500 W Ste 2', 'Moab', 'Grand', 'UT', '84532', '4352597425', NULL, NULL, NULL, '', NULL, NULL, '', '', '110', NULL, NULL, '0.00', '10.00', NULL, 3, '1999-09-01', '2006-10-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1205890928', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
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('870286381', 'W77005716', 'W77005716', 'UT01', 'Ogden Clinic', 'Travis', 'Kay', 'Schelling', 'PA', 'Family Practice', NULL, NULL, NULL, 'O', '5430 S 1900 W Ste G1', 'Roy', 'Weber', 'UT', '84067', '8017799975', NULL, NULL, NULL, '', NULL, NULL, '', '', 'UOGDCLIN', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2003-04-01', '2006-07-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1225027857', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870286381', 'W77005717', 'W77005717', 'UT01', 'Ogden Clinic', 'J David', NULL, 'Schmitz', 'MD', 'Family Practice', NULL, NULL, NULL, 'O', '5430 S 1900 W Ste G1', 'Roy', 'Weber', 'UT', '84067', '8017799975', NULL, NULL, NULL, '', NULL, NULL, '', '', 'UOGDCLIN', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2003-04-01', '2006-07-31', 0, 0, 0, 'Ogden Regional Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1891782819', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870286381', 'W77005718', 'W77005718', 'UT01', 'Ogden Clinic', 'John', 'R', 'Siddoway', 'MD', 'Ear, Nose and Throat', NULL, NULL, NULL, 'B', '4650 Harrison Blvd', 'Ogden', 'Weber', 'UT', '84403', '8014799870', NULL, NULL, NULL, '', NULL, NULL, '', '', 'UOGDCLIN', NULL, NULL, '0.00', '35.00', NULL, 3, '2003-04-01', '2006-01-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1356338388', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
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('870547016', 'W77005720', 'W77005720', 'UT01', 'Ogden, Jeffrey G', 'Jeffrey', NULL, 'Ogden', 'MD', 'Internal Medicine', NULL, NULL, NULL, 'O', '421 N Orem Blvd', 'Orem', 'Utah', 'UT', '84057', '8017640200', NULL, NULL, NULL, '', NULL, NULL, '', '', 'USTDINT', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2002-04-01', '2006-10-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1801953518', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870547025', 'W77005721', 'W77005721', 'UT01', NULL, 'Kimberly', 'E', 'Beck', 'MD', 'Family Practice', NULL, NULL, NULL, 'B', 'PO Box 640', 'Gunnison', 'Sanpete', 'UT', '84634', '4355287935', '4355287936', NULL, NULL, '', NULL, NULL, '', '', 'URURAL', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2005-11-18', '2006-09-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1700814803', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870548726', 'W77005722', 'W77005722', 'UT01', 'Snow Creek Emergency Center (Mtn Family Health)', 'John', 'A', 'Silverman', 'MD', 'Emergency Medicine', NULL, NULL, NULL, 'B', 'PO Box 95970', 'South Jordan', 'Salt Lake', 'UT', '84095', '4356550055', NULL, NULL, NULL, '', NULL, NULL, '', '', 'USTDER', NULL, NULL, '0.00', '35.00', NULL, 3, '2003-04-01', '2004-05-08', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1114974359', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL);
