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
('204009858', 'W73004888', 'W73004888', 'UT01', 'Aspen Dermatology', 'Michael', 'P', 'Eyre', 'DO', 'Dermatology', 'Dermatology', '', NULL, 'O', '114 E 800 N', 'Spanish Fork', 'Utah', 'UT', '84660', '8017941490', NULL, '114 E 800 N', 'Spanish Fork', 'Utah', 'UT', '84660', '8017941490', '', 'WiseSTD', 'WUSTDHCPC5', NULL, '0.00', '35.00', '0.00', 3, '2007-03-01', NULL, 0, 0, 0, 'Mountain View Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1063481646', 0, 'N', 0, '2014-03-04', NULL, NULL, 40.1201, -111.653, NULL, NULL),
('204009858', 'W73004889', 'W73004889', 'UT01', 'Aspen Dermatology', 'Warren', 'A', 'Peterson', 'DO', 'Dermatology', NULL, NULL, NULL, 'O', '114 E 800 N', 'Spanish Fork', 'Utah', 'UT', '84660', '8017941490', NULL, '114 E 800 N', 'Spanish Fork', 'Utah', 'UT', '84660', '8017941490', '', 'WiseSTD', 'WUSTDHCPC5', NULL, '0.00', '35.00', '0.00', 3, '2007-03-01', NULL, 0, 0, 0, 'Mountain View Hospital', '', '', '', 'HCFA|UB|', '1134198807', 0, 'N', 0, '2013-12-02', NULL, NULL, 40.1201, -111.653, NULL, NULL),
('204009858', 'W73004890', 'W73004890', 'UT01', 'Aspen Dermatology', 'Warren', 'A', 'Peterson', 'DO', NULL, NULL, NULL, NULL, 'O', '1385 E 750 N', 'Orem', 'Utah', 'UT', '84097', '8012245200', NULL, '114 E 800 N', 'Spanish Fork', '', 'UT', '84660', '', '', 'WiseSTD', 'WUSTDHCPC5', NULL, '0.00', '35.00', NULL, 3, '2007-03-01', '2007-03-01', 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1134198807', 0, 'y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('204009858', 'W73004891', 'W73004891', 'UT01', 'Aspen Dermatology', 'Warren', 'A', 'Peterson', 'DO', 'Dermatology', NULL, NULL, NULL, 'B', '114 E 800 N', 'Spanish Fork', 'Utah', 'UT', '84660', '8017941490', NULL, '114 E 800 N', 'Spanish Fork', '', 'UT', '84660', '', '', 'WiseSTD', 'WUSTDHCPC5', NULL, '0.00', '35.00', NULL, 3, '2007-03-01', '2007-03-01', 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1134198807', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('204009858', 'W73004892', 'W73004892', 'UT01', 'Aspen Dermatology', 'Warren', 'A', 'Peterson', 'DO', 'Dermatology', NULL, NULL, NULL, 'O', '35 E Ctr St', 'Gunnison', 'Sanpete', 'UT', '84634', '8017941490', NULL, '35 E Ctr St', 'Gunnison', 'Sanpete', 'UT', '84634', '8017941490', '', 'WiseSTD', 'WUSTDHCPC5', NULL, '0.00', '35.00', '0.00', 3, '2007-03-01', NULL, 0, 0, 0, 'Mountain View Hospital', '', '', '', 'HCFA|UB|', '1134198807', 0, 'N', 0, '2013-12-02', NULL, NULL, 0, 0, NULL, NULL),
('204009858', 'W73004893', 'W73004893', 'UT01', 'Aspen Dermatology', 'Warren', 'A', 'Peterson', 'DO', 'Dermatology', NULL, NULL, NULL, 'O', '48 W 1500 N', 'Nephi', 'Juab', 'UT', '84648', '8017941490', NULL, '48 W 1500 N', 'Nephi', 'Juab', 'UT', '84648', '8017941490', '', 'WiseSTD', 'WUSTDHCPC5', NULL, '0.00', '35.00', '0.00', 3, '2007-03-01', NULL, 0, 0, 0, 'Mountain View Hospital', '', '', '', 'HCFA|UB|', '1134198807', 0, 'N', 0, '2013-12-02', NULL, NULL, 39.7306, -111.839, NULL, NULL),
('841411398', 'W73004894', 'W73004894', 'UT01', 'Foothill Family Clinic', 'Jamie', NULL, 'Longe', 'MD', 'Sports Medicine', NULL, NULL, NULL, 'O', '6360 S 3000 E Ste 100', 'Salt Lake City', 'Salt Lake', 'UT', '84121', '8013651032', NULL, NULL, NULL, '', NULL, '84109', '', '', 'WUFOOTHIL5', 'WUSTDHCPC5', NULL, '0.00', '35.00', NULL, 3, '2007-01-01', '2007-01-01', 0, NULL, 0, 'St Marks Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1093730129', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('841411398', 'W73004895', 'W73004895', 'UT01', 'Foothill Family Clinic', 'Wesley', NULL, 'Lewis', 'MD', 'Sports Medicine', NULL, NULL, NULL, 'O', '6360 S 3000 E Ste 100', 'Salt Lake City', 'Salt Lake', 'UT', '84121', '8013651032', NULL, NULL, NULL, '', NULL, '84109', '', '', 'WUFOOTHIL5', 'WUSTDHCPC5', NULL, '0.00', '35.00', NULL, 3, '2007-01-01', '2007-01-01', 0, NULL, 0, 'St Marks Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1013932144', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870526286', 'W73004896', 'W73004896', 'UT01', 'Wasatch Internal Medicine', 'Kay', '', 'Koellner', 'PHD', 'Mental Health', 'Psychology', '', NULL, 'O', '1160 E 3900 S Ste 1000', 'Salt Lake City', 'Salt Lake', 'UT', '84124', '8012621771', '8012889101', '1160 E 3900 S Ste 1000', 'Salt Lake City', 'Salt Lake', 'UT', '84124', '8012621771', '8012889101', 'WUWASIM5', 'WUSTDHCPC5', NULL, '0.00', '35.00', '0.00', 3, '2006-08-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1790896132', 0, 'y', 0, '2011-01-28', NULL, NULL, 40.6871, -111.858, NULL, NULL),
('870526286', 'W73004897', 'W73004897', 'UT01', 'Wasatch Internal Medicine', 'Margaret', 'E', 'Grogan', 'NP', 'Family Practice', '', '', NULL, 'O', '1160 E 3900 S Ste 1000', 'Salt Lake City', 'Salt Lake', 'UT', '84124', '8012621771', NULL, '1160 E 3900 S Ste 1000', 'Salt Lake City', 'Salt Lake', 'UT', '84124', '8012621771', '', 'WUWASIM5', 'WUSTDHCPC5', NULL, '0.00', '35.00', '0.00', 3, '2006-08-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1962669853', 0, 'N', 0, '2013-07-09', NULL, NULL, 40.6871, -111.858, NULL, NULL),
('870481685', 'W73004898', 'W73004898', 'UT01', NULL, 'Janet', NULL, 'Williams', 'PA-C', 'Family Practice', NULL, NULL, NULL, 'O', '3540 S 4000 W Ste 340', 'West Valley', 'Salt Lake', 'UT', '84120', '8019690200', NULL, '3540 S 4000 W', 'West Valley', '', ' UT', '84120', '', '', 'WiseSTD', 'WUSTDHCPC5', NULL, '0.00', '35.00', '0.00', 3, '2006-10-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '0000009629', 0, 'N', 0, '2007-01-06', NULL, NULL, 40.6955, -111.987, NULL, NULL),
('870680455', 'W73004899', 'W73004899', 'UT01', 'Ogden Ortho & Neurosurgical Specialists', 'Carl', 'A', 'Mattsson', 'MD', 'Sports Medicine', NULL, NULL, NULL, 'O', '4403 Harrison Blvd Ste 2600', 'Ogden', 'Weber', 'UT', '84403', '8013872600', NULL, NULL, NULL, '', NULL, NULL, '', '', 'WiseOGORTHO', 'WUSTDHCPC5', NULL, '0.00', '35.00', NULL, 3, '2007-01-01', '2007-01-01', 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1982696076', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870680455', 'W73004900', 'W73004900', 'UT01', 'Ogden Ortho & Neurosurgical Specialists', 'Donald', 'W', 'Bryan', 'MD', 'Sports Medicine', NULL, NULL, NULL, 'O', '4403 Harrison Blvd Ste 2600', 'Ogden', 'Weber', 'UT', '84403', '8013872600', NULL, NULL, NULL, '', NULL, NULL, '', '', 'WiseOGORTHO', 'WUSTDHCPC5', NULL, '0.00', '35.00', NULL, 3, '2007-01-01', '2007-01-01', 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1366434433', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('731714968', 'W73004901', 'W73004901', 'UT01', 'Rocky Mountain Anesthesiology Lc', 'Alan', 'B', 'Taylor', 'CRNA', 'Anesthesiology', NULL, NULL, NULL, 'B', '1954 E Fort Union Blvd Ste 106', 'Salt Lake City', 'Salt Lake', 'UT', '84121', '8019939508', NULL, '1954 E Fort Union Bvld', 'Salt Lake City', '', 'UT', '84121', '', '', '', NULL, NULL, '0.00', '19.00', '0.00', 3, '2007-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1275544520', 0, 'Y', 0, '2007-02-23', NULL, NULL, 0, 0, NULL, NULL),
('731714968', 'W73004902', 'W73004902', 'UT01', 'Rocky Mountain Anesthesiology Lc', 'Alan', 'B', 'Taylor', 'CRNA', 'Anesthesiology', NULL, NULL, NULL, 'O', '5475 S 500 E', 'Ogden', 'Weber', 'UT', '84405', '8014792535', NULL, '1954 E Fort Union Bvld', 'Salt Lake City', '', 'UT', '84121', '', '', NULL, NULL, NULL, '0.00', '19.00', NULL, 3, '2007-01-01', '2007-01-01', 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1275544520', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('731714968', 'W73004903', 'W73004903', 'UT01', 'Rocky Mountain Anesthesiology Lc', 'Art', NULL, 'Shimata', 'CRNA', 'Anesthesiology', NULL, NULL, NULL, 'O', '5475 S 500 E', 'Ogden', 'Weber', 'UT', '84405', '8014792535', NULL, '1954 E Fort Union Bvld', 'Salt Lake City', '', 'UT', '84121', '', '', NULL, NULL, NULL, '0.00', '19.00', NULL, 3, '2007-01-01', '2007-01-01', 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1720099542', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
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('731714968', 'W73004905', 'W73004905', 'UT01', 'Rocky Mountain Anesthesiology Lc', 'Brad', NULL, 'Bohman', 'MD', 'Anesthesiology', NULL, NULL, NULL, 'B', '1954 E Fort Union Blvd Ste 106', 'Salt Lake City', 'Salt Lake', 'UT', '84121', '8019939508', NULL, '1954 E Fort Union Bvld', 'Salt Lake City', '', 'UT', '84121', '', '', '', NULL, NULL, '0.00', '19.00', '0.00', 3, '2007-01-01', NULL, 0, 0, 0, 'Ogden Regional Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1326059403', 0, 'Y', 0, '2007-02-23', NULL, NULL, 0, 0, NULL, NULL),
('731714968', 'W73004906', 'W73004906', 'UT01', 'Rocky Mountain Anesthesiology Lc', 'Brad', NULL, 'Bohman', 'MD', 'Anesthesiology', NULL, NULL, NULL, 'O', '5475 S 500 E', 'Ogden', 'Weber', 'UT', '84405', '8014792535', NULL, '1954 E Fort Union Bvld', 'Salt Lake City', '', 'UT', '84121', '', '', NULL, NULL, NULL, '0.00', '19.00', NULL, 3, '2007-01-01', '2007-01-01', 0, NULL, 0, 'Ogden Regional Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1326059403', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('731714968', 'W73004907', 'W73004907', 'UT01', 'Rocky Mountain Anesthesiology Lc', 'Bryan', 'J', 'Peterson', 'MD', 'Anesthesiology', NULL, NULL, NULL, 'B', '1954 E Fort Union Blvd Ste 106', 'Salt Lake City', 'Salt Lake', 'UT', '84121', '8019939508', NULL, '1954 E Fort Union Bvld', 'Salt Lake City', '', 'UT', '84121', '', '', '', NULL, NULL, '0.00', '19.00', '0.00', 3, '2007-01-01', NULL, 0, 0, 0, 'Ogden Regional Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1578574489', 0, 'Y', 0, '2007-02-23', NULL, NULL, 0, 0, NULL, NULL),
('731714968', 'W73004908', 'W73004908', 'UT01', 'Rocky Mountain Anesthesiology Lc', 'Bryan', 'J', 'Peterson', 'MD', 'Anesthesiology', NULL, NULL, NULL, 'O', '5475 S 500 E', 'Ogden', 'Weber', 'UT', '84405', '8014792535', NULL, '1954 E Fort Union Bvld', 'Salt Lake City', '', 'UT', '84121', '', '', NULL, NULL, NULL, '0.00', '19.00', NULL, 3, '2007-01-01', '2007-01-01', 0, NULL, 0, 'Ogden Regional Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1578574489', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('731714968', 'W73004909', 'W73004909', 'UT01', 'Rocky Mountain Anesthesiology Lc', 'Chris', NULL, 'Torman', 'CRNA', 'Anesthesiology', NULL, NULL, NULL, 'B', '1954 E Fort Union Blvd Ste 106', 'Salt Lake City', 'Salt Lake', 'UT', '84121', '8019939508', NULL, '1954 E Fort Union Bvld', 'Salt Lake City', '', 'UT', '84121', '', '', '', NULL, NULL, '0.00', '19.00', '0.00', 3, '2007-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1265442230', 0, 'Y', 0, '2007-02-23', NULL, NULL, 0, 0, NULL, NULL),
('731714968', 'W73004910', 'W73004910', 'UT01', 'Rocky Mountain Anesthesiology Lc', 'Chris', NULL, 'Torman', 'CRNA', 'Anesthesiology', NULL, NULL, NULL, 'O', '5475 S 500 E', 'Ogden', 'Weber', 'UT', '84405', '8014792535', NULL, '1954 E Fort Union Bvld', 'Salt Lake City', '', 'UT', '84121', '', '', NULL, NULL, NULL, '0.00', '19.00', NULL, 3, '2007-01-01', '2007-01-01', 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1265442230', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
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('522229954', 'W73005990', 'W73005990', 'UT01', 'Wasatch Peak Physical Therapy', 'Sheldon', NULL, 'Cox', 'PT', 'Physical Therapy', NULL, NULL, NULL, 'O', '1492 W Antelope Dr Ste 100', 'Layton', 'Davis', 'UT', '84041', '8018258091', NULL, '1492 W Antelope Dr', 'Layton', '', 'UT', '84041', '', '', 'WestRehab', 'WUSTDHCPC5', NULL, '0.00', '0.00', '58.00', 3, '2006-05-01', '2008-09-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1780709022', 0, 'N', 0, '2009-11-30', NULL, NULL, 0, 0, NULL, NULL);
INSERT INTO `providers_new` (`Provider_Tax_ID`, `Provider_Suffix`, `Provider_Network_ID`, `Provider_Region`, `Provider_Name`, `Provider_Doctor_First_Name`, `Provider_Doctor_Middle_Name`, `Provider_Doctor_Last_Name`, `Provider_Doctor_Degree`, `Provider_Specialty_1`, `Provider_Specialty_2`, `Provider_Specialty_3`, `Provider_Specialty_4`, `Provider_Address_Type`, `Provider_Address`, `Provider_City`, `Provider_County`, `Provider_State`, `Provider_Zip`, `Provider_Phone`, `Provider_Fax`, `Provider_Mailing_Address`, `Provider_Mailing_City`, `Provider_Mailing_County`, `Provider_Mailing_State`, `Provider_Mailing_Zip`, `Provider_Mailing_Phone`, `Provider_Mailing_Fax`, `Provider_Primary_Schedule`, `Provider_Secondary_Schedule`, `Provider_Rate_Sheet`, `Provider_Anes_Rate`, `Provider_Default_Rate`, `Provider_Max_DOS`, `Provider_Min_Match_Value`, `Provider_Effective_Date`, `Provider_Term_Date`, `Provider_Pend`, `Provider_Anes_Minutes`, `Provider_PPO`, `Provider_Hospital_1`, `Provider_Hospital_2`, `Provider_Hospital_3`, `Provider_Hospital_4`, `Provider_Type`, `Provider_NPI`, `Provider_Check_Override`, `Exclude_Dir`, `Audit_Status`, `Last_Change_Date`, `Medicare_ID`, `Provider_Lang`, `Provider_Latitude`, `Provider_Longitude`, `Provider_school`, `Provider_cert`) VALUES
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('522229954', 'W73005992', 'W73005992', 'UT01', 'Wasatch Peak Physical Therapy', 'Cinthia', 'Aleen W', 'Becker', 'OT', 'Occupational Therapy', NULL, NULL, NULL, 'O', '1492 W Antelope Dr Ste 100', 'Layton', 'Davis', 'UT', '84041', '8018258091', NULL, '1492 W Antelope Dr', 'Layton', '', 'UT', '84041', '', '', 'WestRehab', 'WUSTDHCPC5', NULL, '0.00', '0.00', '58.00', 3, '2006-05-01', '2008-08-01', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '0000005244', 0, 'N', 0, '2007-02-12', NULL, NULL, 0, 0, NULL, NULL),
('522229954', 'W73005993', 'W73005993', 'UT01', 'Wasatch Peak Physical Therapy', 'Eric', 'Michael', 'Hoffman', 'PT', 'Physical Therapy', NULL, NULL, NULL, 'O', '1492 W Antelope Dr Ste 100', 'Layton', 'Davis', 'UT', '84041', '8018258091', NULL, '1492 W Antelope Dr', 'Layton', '', 'UT', '84041', '', '', 'WestRehab', 'WUSTDHCPC5', NULL, '0.00', '0.00', '58.00', 3, '2006-05-01', '2008-09-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1891810131', 0, 'N', 0, '2008-10-03', NULL, NULL, 0, 0, NULL, NULL),
('522229954', 'W73005994', 'W73005994', 'UT01', 'Wasatch Peak Physical Therapy', 'Jared', 'Giles', 'Flint', 'PT', 'Physical Therapy', NULL, NULL, NULL, 'O', '1492 W Antelope Dr Ste 100', 'Layton', 'Davis', 'UT', '84041', '8018258091', NULL, '1492 W Antelope Dr', 'Layton', '', 'UT', '84041', '', '', 'WestRehab', 'WUSTDHCPC5', NULL, '0.00', '0.00', '58.00', 3, '2006-05-01', '2008-06-06', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '0000006268', 0, 'N', 0, '2007-02-12', NULL, NULL, 0, 0, NULL, NULL),
('522229954', 'W73005995', 'W73005995', 'UT01', 'Wasatch Peak Physical Therapy', 'Todd', 'K', 'Larson', 'PT', 'Physical Therapy', NULL, NULL, NULL, 'O', '1492 W Antelope Dr Ste 100', 'Layton', 'Davis', 'UT', '84041', '8018258091', NULL, '1492 W Antelope Dr', 'Layton', '', 'UT', '84041', '', '', 'WestRehab', 'WUSTDHCPC5', NULL, '0.00', '0.00', '58.00', 3, '2006-05-01', '2008-08-01', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '0000007208', 0, 'N', 0, '2007-02-12', NULL, NULL, 0, 0, NULL, NULL),
('522229954', 'W73005996', 'W73005996', 'UT01', 'Wasatch Peak Physical Therapy', 'Royce', '', 'Larsen', 'PT', 'Physical Therapy', '', '', NULL, 'O', '1492 W Antelope Dr Ste 100', 'Layton', 'Davis', 'UT', '84041', '8018258091', NULL, '1492 W Antelope Dr Ste 100', 'Layton', 'Davis', 'UT', '84041', '8018258091', '          ', 'WestRehab', 'WUSTDHCPC5', '', '0.00', '0.00', '58.00', 3, '2006-05-01', '2008-09-30', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1790800431', 0, 'N', 0, '2012-01-05', NULL, NULL, 0, 0, NULL, NULL),
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('522229954', 'W73005999', 'W73005999', 'UT01', 'Performance West Physical Therapy', 'Klementina', '', 'Buchheister', 'PT', 'Physical Therapy', '', '', NULL, 'O', '1551 Renaissance Town Dr Ste 350', 'Bountiful', 'Davis', 'UT', '84010', '8012953553', NULL, '1551 Renaissance Town Dr Ste 350', 'Bountiful', 'Davis', 'UT', '84010', '8012953553', '          ', 'WestRehab', 'WUSTDHCPC5', '', '0.00', '0.00', '58.00', 3, '2006-07-01', '2008-09-30', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1447242847', 0, 'N', 0, '2012-11-01', NULL, NULL, 0, 0, NULL, NULL),
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('522229954', 'W73006075', 'W73006075', 'UT01', 'Mountain Land Sports & Orthopedic', 'Jacqueline', 'Joanne', 'Corry', 'PT', 'Physical Therapy', NULL, NULL, NULL, 'B', 'PO Box 74125', 'Salt Lake City', 'Salt Lake', 'UT', '84171', '8019422729', NULL, NULL, NULL, '', NULL, NULL, '', '', 'WestRehab', 'WUSTDHCPC5', NULL, '0.00', NULL, '58.00', 3, '2006-05-01', '2007-04-01', 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', NULL, 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('522229954', 'W73003039', 'W73003039', 'UT01', 'Hand & Orthopedic Rehabilitation Specialists', 'Ryan', 'Russell', 'Fuhriman', 'PT', 'Physical Therapy', '', '', NULL, 'B', 'PO Box 74125', 'Salt Lake City', 'Salt Lake', 'UT', '84171', '8019422729', NULL, 'PO Box 74125', 'Salt Lake City', 'Salt Lake', 'UT', '84171', '8019422729', '          ', 'WestRehab', 'WUSTDHCPC5', '', '0.00', '0.00', '58.00', 3, '2006-05-01', '2008-09-30', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1609877372', 0, 'Y', 0, '2011-04-22', NULL, NULL, 0, 0, NULL, NULL),
('522229954', 'W73006077', 'W73006077', 'UT01', 'Professional Physical Therapy & Sports Medicine', 'Jeramiah', NULL, 'DelLamas', 'PT', 'Physical Therapy', NULL, NULL, NULL, 'B', 'PO Box 74125', 'Salt Lake City', 'Salt Lake', 'UT', '84171', '8019422729', NULL, NULL, NULL, '', NULL, NULL, '', '', 'WestRehab', 'WUSTDHCPC5', NULL, '0.00', NULL, '58.00', 3, '2006-05-01', '2007-01-01', 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', NULL, 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('522229954', 'W73003115', 'W73003115', 'UT01', 'Mountain Land Sports & Orthopedic Physical Therapy', 'Josh', 'David', 'Fuhriman', 'PT', 'Physical Therapy', '', '', NULL, 'B', 'PO Box 74125', 'Salt Lake City', 'Salt Lake', 'UT', '84171', '8019422729', NULL, 'PO Box 74125', 'Salt Lake City', 'Salt Lake', 'UT', '84171', '8019422729', '          ', 'WestRehab', 'WUSTDHCPC5', '', '0.00', '0.00', '58.00', 3, '2006-05-01', '2008-09-30', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1376649400', 0, 'Y', 0, '2011-06-13', NULL, NULL, 0, 0, NULL, NULL),
('522229954', 'W73006079', 'W73006079', 'UT01', 'Wasatch Peak Physical Therapy', 'Jared', 'Giles', 'Flint', 'PT', 'Physical Therapy', NULL, NULL, NULL, 'B', 'PO Box 74125', 'Salt Lake City', 'Salt Lake', 'UT', '84171', '8019422729', NULL, NULL, NULL, '', NULL, NULL, '', '', 'WestRehab', 'WUSTDHCPC5', NULL, '0.00', '0.00', '58.00', 3, '2006-05-01', '2008-06-06', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '0000006268', 0, 'Y', 0, '2007-02-12', NULL, NULL, 0, 0, NULL, NULL),
('522229954', 'W73003096', 'W73003096', 'UT01', 'Mountain Land Rehabilitation Home Health', 'Douglas', NULL, 'Flint', 'PT', 'Physical Therapy', '', '', NULL, 'B', 'PO Box 74125', 'Salt Lake City', 'Salt Lake', 'UT', '84171', '8019422729', NULL, NULL, NULL, '', NULL, NULL, '', '', 'WestRehab', 'WUSTDHCPC5', NULL, '0.00', '0.00', '58.00', 3, '2006-05-01', '2008-09-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1588794374', 0, 'Y', 0, '2009-11-30', NULL, NULL, 0, 0, NULL, NULL),
('522229954', 'W73003063', 'W73003063', 'UT01', 'Mountain Land Orthopedic & Sports Physical Therapy', 'Mark', 'Alan', 'Flinders', 'PT', 'Physical Therapy', '', '', NULL, 'B', 'PO Box 74125', 'Salt Lake City', 'Salt Lake', 'UT', '84171', '8019422729', NULL, 'PO Box 74125', 'Salt Lake City', 'Salt Lake', 'UT', '84171', '8019422729', '          ', 'WestRehab', 'WUSTDHCPC5', '', '0.00', '0.00', '58.00', 3, '2006-05-01', '2008-09-30', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1184736951', 0, 'Y', 0, '2011-04-20', NULL, NULL, 0, 0, NULL, NULL),
('522229954', 'W73003157', 'W73003157', 'UT01', 'Rocky Mountain Therapy Services', 'Mitchell', '', 'Felix', 'PT', 'Physical Therapy', '', '', NULL, 'B', 'PO Box 74125', 'Salt Lake City', 'Salt Lake', 'UT', '84171', '8019422729', NULL, 'PO Box 74125', 'Salt Lake City', 'Salt Lake', 'UT', '84171', '8019422729', '          ', 'WestRehab', 'WUSTDHCPC5', '', '0.00', '0.00', '58.00', 3, '2006-05-01', '2008-09-30', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1144213216', 0, 'Y', 0, '2013-10-16', NULL, NULL, 0, 0, NULL, NULL),
('522229954', 'W73003038', 'W73003038', 'UT01', 'Hand & Orthopedic Rehabilitation Specialists', 'Cheryl', 'Ann', 'Farnsworth', 'PT', 'Physical Therapy', '', '', NULL, 'B', 'PO Box 74125', 'Salt Lake City', 'Salt Lake', 'UT', '84171', '8019422729', NULL, 'PO Box 74125', 'Salt Lake City', 'Salt Lake', 'UT', '84171', '8019422729', '          ', 'WestRehab', 'WUSTDHCPC5', '', '0.00', '0.00', '58.00', 3, '2006-05-01', '2008-07-03', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1720089485', 0, 'Y', 0, '2011-09-08', NULL, NULL, 0, 0, NULL, NULL),
('522229954', 'W73006084', 'W73006084', 'UT01', 'Mountain Land Rehabilitation Home Health', 'Rowdy', 'J', 'Hatch', 'PT', 'Physical Therapy', NULL, NULL, NULL, 'B', 'PO Box 74125', 'Salt Lake City', 'Salt Lake', 'UT', '84171', '8019422729', NULL, NULL, NULL, '', NULL, NULL, '', '', 'WestRehab', 'WUSTDHCPC5', NULL, '0.00', NULL, '58.00', 3, '2006-05-01', '2007-01-01', 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1982720579', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('522229954', 'W73003108', 'W73003108', 'UT01', 'Mountain Land Rehabiltation', 'John', 'Benson', 'Egan', 'PT', 'Physical Therapy', '', '', NULL, 'B', 'PO Box 74125', 'Salt Lake City', 'Salt Lake', 'UT', '84171', '8019422729', NULL, 'PO Box 74125', 'Salt Lake City', 'Salt Lake', 'UT', '84171', '8019422729', '          ', 'WestRehab', 'WUSTDHCPC5', '', '0.00', '0.00', '58.00', 3, '2006-05-01', '2008-09-30', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1821109026', 0, 'Y', 0, '2011-04-22', NULL, NULL, 0, 0, NULL, NULL),
('522229954', 'W73006078', 'W73006078', 'UT01', 'Advanced Motion Physical Therapy', 'Robert', 'Lance', 'Dougher', 'PT', 'Physical Therapy', NULL, NULL, NULL, 'B', 'PO Box 74125', 'Salt Lake City', 'Salt Lake', 'UT', '84171', '8019422729', NULL, NULL, NULL, '', NULL, NULL, '', '', 'WestRehab', 'WUSTDHCPC5', NULL, '0.00', '0.00', '58.00', 3, '2006-05-01', '2008-09-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1669458220', 0, 'Y', 0, '2010-03-12', NULL, NULL, 0, 0, NULL, NULL),
('522229954', 'W73003176', 'W73003176', 'UT01', 'Sports Medicine Clinic', 'Chris', 'H', 'Dahlberg', 'PT', 'Physical Therapy', '', '', NULL, 'B', 'PO Box 74125', 'Salt Lake City', 'Salt Lake', 'UT', '84171', '8019422729', NULL, 'PO Box 74125', 'Salt Lake City', 'Salt Lake', 'UT', '84171', '8019422729', '          ', 'WestRehab', 'WUSTDHCPC5', '', '0.00', '0.00', '58.00', 3, '2006-05-01', '2008-09-30', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1366553208', 0, 'Y', 0, '2012-01-10', NULL, NULL, 0, 0, NULL, NULL);
INSERT INTO `providers_new` (`Provider_Tax_ID`, `Provider_Suffix`, `Provider_Network_ID`, `Provider_Region`, `Provider_Name`, `Provider_Doctor_First_Name`, `Provider_Doctor_Middle_Name`, `Provider_Doctor_Last_Name`, `Provider_Doctor_Degree`, `Provider_Specialty_1`, `Provider_Specialty_2`, `Provider_Specialty_3`, `Provider_Specialty_4`, `Provider_Address_Type`, `Provider_Address`, `Provider_City`, `Provider_County`, `Provider_State`, `Provider_Zip`, `Provider_Phone`, `Provider_Fax`, `Provider_Mailing_Address`, `Provider_Mailing_City`, `Provider_Mailing_County`, `Provider_Mailing_State`, `Provider_Mailing_Zip`, `Provider_Mailing_Phone`, `Provider_Mailing_Fax`, `Provider_Primary_Schedule`, `Provider_Secondary_Schedule`, `Provider_Rate_Sheet`, `Provider_Anes_Rate`, `Provider_Default_Rate`, `Provider_Max_DOS`, `Provider_Min_Match_Value`, `Provider_Effective_Date`, `Provider_Term_Date`, `Provider_Pend`, `Provider_Anes_Minutes`, `Provider_PPO`, `Provider_Hospital_1`, `Provider_Hospital_2`, `Provider_Hospital_3`, `Provider_Hospital_4`, `Provider_Type`, `Provider_NPI`, `Provider_Check_Override`, `Exclude_Dir`, `Audit_Status`, `Last_Change_Date`, `Medicare_ID`, `Provider_Lang`, `Provider_Latitude`, `Provider_Longitude`, `Provider_school`, `Provider_cert`) VALUES
('522229954', 'W73003071', 'W73003071', 'UT01', 'Mountain Land Rehabilitation', 'Jed', 'L', 'Crowton', 'PT', 'Physical Therapy', NULL, NULL, NULL, 'B', 'PO Box 74125', 'Salt Lake City', 'Salt Lake', 'UT', '84171', '8019422729', NULL, NULL, NULL, '', NULL, NULL, '', '', 'WestRehab', 'WUSTDHCPC5', NULL, '0.00', '0.00', '58.00', 3, '2006-05-01', '2008-03-07', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1285736041', 0, 'Y', 0, '2007-02-12', NULL, NULL, 0, 0, NULL, NULL),
('522229954', 'W73003095', 'W73003095', 'UT01', 'Mountain Land Rehabilitation Home Health', 'Suzanne', 'Elizabeth', 'Critchley', 'PT', 'Physical Therapy', NULL, NULL, NULL, 'B', 'PO Box 74125', 'Salt Lake City', 'Salt Lake', 'UT', '84171', '8019422729', NULL, NULL, NULL, '', NULL, NULL, '', '', 'WestRehab', 'WUSTDHCPC5', NULL, '0.00', '0.00', '58.00', 3, '2006-05-01', '2008-09-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '0000005836', 0, 'Y', 0, '2008-10-03', NULL, NULL, 0, 0, NULL, NULL),
('522229954', 'W73003037', 'W73003037', 'UT01', 'Hand & Orthopedic Rehabilitation Specialists', 'Steven', '', 'Crandall', 'PT', 'Physical Therapy', NULL, NULL, NULL, 'B', 'PO Box 74125', 'Salt Lake City', 'Salt Lake', 'UT', '84171', '8019422729', NULL, 'PO Box 74125', 'Salt Lake City', 'Salt Lake', 'UT', '84171', '8019422729', '          ', 'WestRehab', 'WUSTDHCPC5', '', '0.00', '0.00', '58.00', 3, '2006-05-01', '2008-09-30', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1154322816', 0, 'Y', 0, '2011-04-19', NULL, NULL, 0, 0, NULL, NULL),
('522229954', 'W73003093', 'W73003093', 'UT01', 'Mountain Land Rehabilitation Home Health', 'Kimberly', 'Ann', 'Hoth', 'MPT', 'Physical Therapy', NULL, NULL, NULL, 'B', 'PO Box 74125', 'Salt Lake City', 'Salt Lake', 'UT', '84171', '8019422729', NULL, 'PO Box 74125', 'Salt Lake City', 'Salt Lake', 'UT', '84171', '8019422729', '          ', 'WestRehab', 'WUSTDHCPC5', '', '0.00', '0.00', '58.00', 3, '2006-05-01', '2008-09-30', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1790888394', 0, 'Y', 0, '2013-06-21', NULL, NULL, 0, 0, NULL, NULL),
('522229954', 'W73006076', 'W73006076', 'UT01', 'Wasatch Peak Physical Therapy', 'Sheldon', NULL, 'Cox', 'PT', 'Physical Therapy', NULL, NULL, NULL, 'B', 'PO Box 74125', 'Salt Lake City', 'Salt Lake', 'UT', '84171', '8019422729', NULL, NULL, NULL, '', NULL, NULL, '', '', 'WestRehab', 'WUSTDHCPC5', NULL, '0.00', '0.00', '58.00', 3, '2006-05-01', '2008-09-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1780709022', 0, 'Y', 0, '2009-11-30', NULL, NULL, 0, 0, NULL, NULL),
('522229954', 'W73006093', 'W73006093', 'UT01', 'Ashley Creek Physical Therapy', 'Jerry', 'D', 'Kulland', 'PT', 'Physical Therapy', NULL, NULL, NULL, 'B', 'PO Box 74125', 'Salt Lake City', 'Salt Lake', 'UT', '84171', '8019422729', NULL, NULL, NULL, '', NULL, NULL, '', '', 'WestRehab', 'WUSTDHCPC5', NULL, '0.00', NULL, '58.00', 3, '2006-05-01', '2006-05-01', 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1194721704', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('522229954', 'W73003061', 'W73003061', 'UT01', 'Mountain Land Orthopedic & Sports Physical Therapy', 'Brett', 'Harding', 'Cook', 'PT', 'Physical Therapy', NULL, NULL, NULL, 'B', 'PO Box 74125', 'Salt Lake City', 'Salt Lake', 'UT', '84171', '8019422729', NULL, NULL, NULL, '', NULL, NULL, '', '', 'WestRehab', 'WUSTDHCPC5', NULL, '0.00', '0.00', '58.00', 3, '2006-05-01', '2008-08-01', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1457462657', 0, 'Y', 0, '2007-02-12', NULL, NULL, 0, 0, NULL, NULL),
('522229954', 'W73003175', 'W73003175', 'UT01', 'Sports Medicine Clinic', 'Roger', 'L', 'Colvin', 'PT', 'Physical Therapy', '', '', NULL, 'B', 'PO Box 74125', 'Salt Lake City', 'Salt Lake', 'UT', '84171', '8019422729', NULL, 'PO Box 74125', 'Salt Lake City', 'Salt Lake', 'UT', '84171', '8019422729', '          ', 'WestRehab', 'WUSTDHCPC5', '', '0.00', '0.00', '58.00', 3, '2006-05-01', '2008-09-30', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1740390988', 0, 'Y', 0, '2011-04-20', NULL, NULL, 0, 0, NULL, NULL),
('522229954', 'W73003193', 'W73003193', 'UT01', 'Wasatch Therapy', 'Ernest', 'Casias', 'Chavez', 'PT', 'Physical Therapy', '', '', NULL, 'B', 'PO Box 74125', 'Salt Lake City', 'Salt Lake', 'UT', '84171', '8019422729', NULL, 'PO Box 74125', 'Salt Lake City', 'Salt Lake', 'UT', '84171', '8019422729', '          ', 'WestRehab', 'WUSTDHCPC5', '', '0.00', '0.00', '58.00', 3, '2006-05-01', '2008-09-30', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1013016559', 0, 'Y', 0, '2011-04-21', NULL, NULL, 0, 0, NULL, NULL),
('522229954', 'W73006074', 'W73006074', 'UT01', 'Mountain Land Rehabilitation', 'Jennifer', 'Michelle', 'Carter', 'PT', 'Physical Therapy', NULL, NULL, NULL, 'B', 'PO Box 74125', 'Salt Lake City', 'Salt Lake', 'UT', '84171', '8019422729', NULL, NULL, NULL, '', NULL, NULL, '', '', 'WestRehab', 'WUSTDHCPC5', NULL, '0.00', '0.00', '58.00', 3, '2006-05-01', '2008-08-01', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '0000005592', 0, 'Y', 0, '2007-02-12', NULL, NULL, 0, 0, NULL, NULL),
('522229954', 'W73003122', 'W73003122', 'UT01', 'Orem Sports Medicine', 'Ned', 'B', 'Bushnell', 'PT', 'Physical Therapy', '', '', NULL, 'B', 'PO Box 74125', 'Salt Lake City', 'Salt Lake', 'UT', '84171', '8019422729', NULL, 'PO Box 74125', 'Salt Lake City', 'Salt Lake', 'UT', '84171', '8019422729', '          ', 'WestRehab', 'WUSTDHCPC5', '', '0.00', '0.00', '58.00', 3, '2006-05-01', '2008-09-30', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1528050861', 0, 'Y', 0, '2012-06-21', NULL, NULL, 0, 0, NULL, NULL),
('522229954', 'W73003124', 'W73003124', 'UT01', 'Performance West Physical Therapy', 'Klementina', '', 'Buchheister', 'PT', 'Physical Therapy', '', '', NULL, 'B', 'PO Box 74125', 'Salt Lake City', 'Salt Lake', 'UT', '84171', '8019422729', NULL, 'PO Box 74125', 'Salt Lake City', 'Salt Lake', 'UT', '84171', '8019422729', '          ', 'WestRehab', 'WUSTDHCPC5', '', '0.00', '0.00', '58.00', 3, '2006-05-01', '2008-09-30', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1447242847', 0, 'Y', 0, '2012-11-01', NULL, NULL, 0, 0, NULL, NULL),
('522229954', 'W73003156', 'W73003156', 'UT01', 'Rocky Mountain Therapy Services', 'Todd', 'Elliot', 'Brown', 'PT', 'Physical Therapy', '', '', NULL, 'B', 'PO Box 74125', 'Salt Lake City', 'Salt Lake', 'UT', '84171', '8019422729', NULL, 'PO Box 74125', 'Salt Lake City', 'Salt Lake', 'UT', '84171', '8019422729', '          ', 'WestRehab', 'WUSTDHCPC5', '', '0.00', '0.00', '58.00', 3, '2006-05-01', '2008-09-30', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1093708166', 0, 'Y', 0, '2011-11-01', NULL, NULL, 0, 0, NULL, NULL),
('522229954', 'W73003034', 'W73003034', 'UT01', 'Hand & Orthopedic Rehabilitation Specialists', 'Margo', 'Jones', 'Brady', 'PT', 'Physical Therapy', NULL, NULL, NULL, 'B', 'PO Box 74125', 'Salt Lake City', 'Salt Lake', 'UT', '84171', '8019422729', NULL, 'PO Box 74125', 'Salt Lake City', 'Salt Lake', 'UT', '84171', '8019422729', '          ', 'WestRehab', 'WUSTDHCPC5', '', '0.00', '0.00', '58.00', 3, '2006-05-01', '2008-09-30', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1104827849', 0, 'Y', 0, '2011-04-20', NULL, NULL, 0, 0, NULL, NULL),
('522229954', 'W73003143', 'W73003143', 'UT01', 'Registered Physical Therapists', 'Josh', 'Douglas', 'Boulton', 'PT', 'Physical Therapy', NULL, NULL, NULL, 'B', 'PO Box 74125', 'Salt Lake City', 'Salt Lake', 'UT', '84171', '8019422729', NULL, NULL, NULL, '', NULL, NULL, '', '', 'WestRehab', 'WUSTDHCPC5', NULL, '0.00', '0.00', '58.00', 3, '2006-05-01', '2008-09-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1457338550', 0, 'Y', 0, '2008-10-03', NULL, NULL, 0, 0, NULL, NULL),
('522229954', 'W73003138', 'W73003138', 'UT01', 'Physical Therapy @ The Crossroads', 'Michael', 'R', 'Bond', 'PT', 'Physical Therapy', NULL, NULL, NULL, 'B', 'PO Box 74125', 'Salt Lake City', 'Salt Lake', 'UT', '84171', '8019422729', NULL, NULL, NULL, '', NULL, NULL, '', '', 'WestRehab', 'WUSTDHCPC5', NULL, '0.00', '0.00', '58.00', 3, '2006-05-01', '2008-09-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1518990183', 0, 'Y', 0, '2008-10-03', NULL, NULL, 0, 0, NULL, NULL),
('522229954', 'W73003118', 'W73003118', 'UT01', 'Neuroworx', 'Jan', 'R', 'Black', 'PT', 'Physical Therapy', '', '', NULL, 'B', 'PO Box 74125', 'Salt Lake City', 'Salt Lake', 'UT', '84171', '8019422729', NULL, 'PO Box 74125', 'Salt Lake City', 'Salt Lake', 'UT', '84171', '8019422729', '          ', 'WestRehab', 'WUSTDHCPC5', '', '0.00', '0.00', '58.00', 3, '2006-05-01', '2008-09-30', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1568429967', 0, 'Y', 0, '2014-01-31', NULL, NULL, 0, 0, NULL, NULL),
('522229954', 'W73006105', 'W73006105', 'UT01', 'Prorehab', 'Jeffrey', 'Nathan', 'Ohlwiler', 'PT', 'Physical Therapy', NULL, NULL, NULL, 'B', 'PO Box 74125', 'Salt Lake City', 'Salt Lake', 'UT', '84171', '8019422729', NULL, NULL, NULL, '', NULL, NULL, '', '', 'WestRehab', 'WUSTDHCPC5', NULL, '0.00', NULL, '58.00', 3, '2006-05-01', '2006-05-01', 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1669464939', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('522229954', 'W73006106', 'W73006106', 'UT01', 'Professional Physical Therapy & Sports Medicine', 'Steven', 'J', 'Orrock', 'PT', 'Physical Therapy', NULL, NULL, NULL, 'B', 'PO Box 74125', 'Salt Lake City', 'Salt Lake', 'UT', '84171', '8019422729', NULL, NULL, NULL, '', NULL, NULL, '', '', 'WestRehab', 'WUSTDHCPC5', NULL, '0.00', NULL, '58.00', 3, '2006-05-01', '2007-01-01', 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1629125174', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('522229954', 'W73006107', 'W73006107', 'UT01', 'Professional Physical Therapy & Sports Medicine', 'Steven', 'J', 'Orrock', 'PT', 'Physical Therapy', NULL, NULL, NULL, 'B', 'PO Box 74125', 'Salt Lake City', 'Salt Lake', 'UT', '84171', '8019422729', NULL, NULL, NULL, '', NULL, NULL, '', '', 'WestRehab', 'WUSTDHCPC5', NULL, '0.00', NULL, '58.00', 3, '2006-05-01', '2007-01-01', 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1629125174', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('522229954', 'W73003141', 'W73003141', 'UT01', 'Registered Physical Therapists', 'Scott', 'C', 'Benson', 'PT', 'Physical Therapy', '', '', NULL, 'B', 'PO Box 74125', 'Salt Lake City', 'Salt Lake', 'UT', '84171', '8019422729', NULL, 'PO Box 74125', 'Salt Lake City', 'Salt Lake', 'UT', '84171', '8019422729', '          ', 'WestRehab', '', '', '0.00', '0.00', '58.00', 3, '2006-05-01', '2008-09-30', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1447237490', 0, 'Y', 0, '2011-10-20', NULL, NULL, 0, 0, NULL, NULL),
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INSERT INTO `providers_new` (`Provider_Tax_ID`, `Provider_Suffix`, `Provider_Network_ID`, `Provider_Region`, `Provider_Name`, `Provider_Doctor_First_Name`, `Provider_Doctor_Middle_Name`, `Provider_Doctor_Last_Name`, `Provider_Doctor_Degree`, `Provider_Specialty_1`, `Provider_Specialty_2`, `Provider_Specialty_3`, `Provider_Specialty_4`, `Provider_Address_Type`, `Provider_Address`, `Provider_City`, `Provider_County`, `Provider_State`, `Provider_Zip`, `Provider_Phone`, `Provider_Fax`, `Provider_Mailing_Address`, `Provider_Mailing_City`, `Provider_Mailing_County`, `Provider_Mailing_State`, `Provider_Mailing_Zip`, `Provider_Mailing_Phone`, `Provider_Mailing_Fax`, `Provider_Primary_Schedule`, `Provider_Secondary_Schedule`, `Provider_Rate_Sheet`, `Provider_Anes_Rate`, `Provider_Default_Rate`, `Provider_Max_DOS`, `Provider_Min_Match_Value`, `Provider_Effective_Date`, `Provider_Term_Date`, `Provider_Pend`, `Provider_Anes_Minutes`, `Provider_PPO`, `Provider_Hospital_1`, `Provider_Hospital_2`, `Provider_Hospital_3`, `Provider_Hospital_4`, `Provider_Type`, `Provider_NPI`, `Provider_Check_Override`, `Exclude_Dir`, `Audit_Status`, `Last_Change_Date`, `Medicare_ID`, `Provider_Lang`, `Provider_Latitude`, `Provider_Longitude`, `Provider_school`, `Provider_cert`) VALUES
('621801973', 'W73006182', 'W73006182', 'UT01', 'Pioneer Valley Hospital Physicians', 'Dennis', 'H', 'Gordon', 'MD', 'Orthopedic Surgery', NULL, NULL, NULL, 'B', '3336 S Pioneer Parkway Ste 101', 'Salt Lake City', 'Salt Lake', 'UT', '84120', '8013529500', NULL, 'PO Box 95970', 'South Jordan', '', 'UT', '84095', '', '', 'WUSTDSURG5', 'WUSTDHCPC5', NULL, '0.00', '35.00', NULL, 3, '2007-02-01', '2007-08-01', 0, NULL, 0, 'Pioneer Valley Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1558301366', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('621801973', 'W73006183', 'W73006183', 'UT01', 'Pioneer Valley Orthopaedic Clinic', 'Hanafy', NULL, 'Hanafy', 'MD', 'General Surgery', NULL, NULL, NULL, 'O', '3336 S 4155 W Ste 306', 'Salt Lake City', 'Salt Lake', 'UT', '84120', '8018409474', NULL, 'PO Box 95970', 'South Jordan', '', 'UT', '84095', '', '', 'WUSTDSURG5', 'WUSTDHCPC5', NULL, '0.00', '35.00', NULL, 3, '2007-02-01', '2007-04-11', 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', NULL, 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('621801973', 'W73006184', 'W73006184', 'UT01', 'Pioneer Valley Hospital Physicians', 'Hanafy', NULL, 'Hanafy', 'MD', 'General Surgery', NULL, NULL, NULL, 'B', 'PO Box 95970', 'South Jordan', 'Salt Lake', 'UT', '84095', '8013529500', NULL, 'PO Box 95970', 'South Jordan', '', 'UT', '84095', '', '', 'WUSTDSURG5', 'WUSTDHCPC5', NULL, '0.00', '35.00', NULL, 3, '2007-02-01', '2007-04-11', 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', NULL, 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('621801973', 'W73006185', 'W73006185', 'UT01', 'Pioneer Valley Hospital Physicians', 'Reid', 'C', 'Harrison', 'MD', 'Internal Medicine', '', '', NULL, 'B', '406 W South Jordan Pkwy Ste 500', 'South Jordan', 'Salt Lake', 'UT', '84095', '8013529500', NULL, '406 W South Jordan Pkwy Ste 500', 'South Jordan', 'Salt Lake', 'UT', '84095', '8013529500', '', 'WUSTDINT5', 'WUSTDHCPC5', NULL, '0.00', '35.00', '0.00', 6, '2007-02-01', '2014-04-30', 0, 0, 0, 'Riverton Childrens Unit Operated by Primary Childrens Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1356373500', 0, 'Y', 0, '2011-07-05', NULL, NULL, 0, 0, NULL, NULL),
('621801973', 'W73006186', 'W73006186', 'UT01', 'Internal Medicine Specialist - Hospitalists', 'Reid', 'C', 'Harrison', 'MD', 'Internal Medicine', '', '', NULL, 'O', '3460 Pioneer Pkwy', 'Salt Lake City', 'Salt Lake', 'UT', '84120', '8019643101', NULL, '3460 Pioneer Pkwy', 'Salt Lake City', 'Salt Lake', 'UT', '84120', '8019643101', '', 'WUSTDINT5', 'WUSTDHCPC5', NULL, '0.00', '35.00', '0.00', 6, '2007-02-01', '2014-04-30', 0, 0, 0, 'Riverton Childrens Unit Operated by Primary Childrens Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1356373500', 0, 'y', 0, '2011-07-05', NULL, NULL, 40.6972, -111.99, NULL, NULL),
('621801973', 'W73006187', 'W73006187', 'UT01', 'Pioneer Valley Orthopaedic Clinic', 'Ross', 'M', 'Jarrett', 'PA', 'Orthopedic Surgery', NULL, NULL, NULL, 'O', '3336 S 4155 W Ste 203', 'Salt Lake City', 'Salt Lake', 'UT', '84120', '8019643925', NULL, '3336 S 4155 W Ste 203', 'Salt Lake City', 'Salt Lake', 'UT', '84120', '8019643925', '          ', 'WUSTDSURG5', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 6, '2007-02-01', '2011-10-09', 0, 0, 0, 'Pioneer Valley Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1396789558', 0, 'N', 0, '2013-11-14', NULL, NULL, 0, 0, NULL, NULL),
('621801973', 'W73006188', 'W73006188', 'UT01', 'Pioneer Valley Hospital Physicians', 'Ross', 'M', 'Jarrett', 'PA', 'Orthopedic Surgery', NULL, NULL, NULL, 'B', '3336 S Pioneer Parkway Ste 101', 'Salt Lake City', 'Salt Lake', 'UT', '84120', '8013529500', NULL, 'PO Box 95970', 'South Jordan', '', 'UT', '84095', '', '', 'WUSTDSURG5', 'WUSTDHCPC5', NULL, '0.00', '35.00', NULL, 3, '2007-02-01', '2007-08-01', 0, NULL, 0, 'Pioneer Valley Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1396789558', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('621801973', 'W73006189', 'W73006189', 'UT01', 'Internal Medicine Specialist - Hospitalists', 'Pinky', '', 'Kotwal', 'MD', 'Internal Medicine', NULL, NULL, NULL, 'O', '3460 Pioneer Pkwy', 'Salt Lake City', 'Salt Lake', 'UT', '84120', '8019643101', NULL, '3460 Pioneer Pkwy', 'Salt Lake City', 'Salt Lake', 'UT', '84120', '8019643101', '', 'WUSTDINT5', 'WUSTDHCPC5', NULL, '0.00', '35.00', '0.00', 6, '2007-02-01', '2014-04-30', 0, 0, 0, 'Pioneer Valley Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1083645444', 0, 'y', 0, '2012-04-23', NULL, NULL, 40.6972, -111.99, NULL, NULL),
('621801973', 'W73006190', 'W73006190', 'UT01', 'Pioneer Valley Hospital Physicians', 'Pinky', '', 'Kotwal', 'MD', 'Internal Medicine', NULL, NULL, NULL, 'B', '406 W South Jordan Pkwy Ste 500', 'South Jordan', 'Salt Lake', 'UT', '84095', '8013529500', NULL, '406 W South Jordan Pkwy Ste 500', 'South Jordan', 'Salt Lake', 'UT', '84095', '8013529500', '', 'WUSTDINT5', 'WUSTDHCPC5', NULL, '0.00', '35.00', '0.00', 6, '2007-02-01', '2014-04-30', 0, 0, 0, 'Pioneer Valley Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1083645444', 0, 'Y', 0, '2012-04-23', NULL, NULL, 0, 0, NULL, NULL),
('621801973', 'W73006191', 'W73006191', 'UT01', 'Salt Lake Senior Clinic', 'Mandi', 'J', 'McKay', 'MD', 'Internal Medicine', NULL, NULL, NULL, 'O', '24 S 1100 E Ste 209', 'Salt Lake City', 'Salt Lake', 'UT', '84102', '8013504602', NULL, 'PO Box 95970', 'South Jordan', '', 'UT', '84095', '', '', 'WUSTDINT5', 'WUSTDHCPC5', NULL, '0.00', '35.00', NULL, 3, '2007-02-01', '2007-03-01', 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1699716373', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('621801973', 'W73006192', 'W73006192', 'UT01', 'Internal Medicine Specialist - Hospitalists', 'Mandi', 'J', 'McKay', 'MD', 'Internal Medicine', NULL, NULL, NULL, 'O', '2530 W 4700 S Ste B8', 'Salt Lake City', 'Salt Lake', 'UT', '84118', '8019675866', NULL, 'PO Box 95970', 'South Jordan', '', 'UT', '84095', '', '', 'WUSTDINT5', 'WUSTDHCPC5', NULL, '0.00', '35.00', NULL, 3, '2007-02-01', '2007-06-04', 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1699716373', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('621801973', 'W73006193', 'W73006193', 'UT01', 'Pioneer Valley Hospital Physicians', 'Mandi', 'J', 'McKay', 'MD', 'Internal Medicine', NULL, NULL, NULL, 'B', '3336 S Pioneer Parkway Ste 101', 'Salt Lake City', 'Salt Lake', 'UT', '84120', '8013529500', NULL, 'PO Box 95970', 'South Jordan', '', 'UT', '84095', '', '', 'WUSTDINT5', 'WUSTDHCPC5', NULL, '0.00', '35.00', NULL, 3, '2007-02-01', '2007-06-04', 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1699716373', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('621801973', 'W73006194', 'W73006194', 'UT01', 'Urology Specialists of Utah', 'Justin', 'P', 'Parkinson', 'MD', 'Urology', '', '', NULL, 'O', '4052 W 3390 S Ste 202', 'Salt Lake City', 'Salt Lake', 'UT', '84120', '8019554685', NULL, '4052 W 3390 S Ste 202', 'Salt Lake City', 'Salt Lake', 'UT', '84120', '8019554685', '', 'WUSTDSURG5', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 6, '2007-02-01', '2010-06-16', 0, 0, 0, 'Jordan Valley Medical Center', 'Salt Lake Regional Medical Center', 'Pioneer Valley Hospital', '', 'HCFA|UB|', '1851314066', 0, 'N', 0, '2014-06-17', NULL, NULL, 0, 0, NULL, NULL),
('621801973', 'W73006195', 'W73006195', 'UT01', 'Urology Specialists of Utah', 'Justin', 'P', 'Parkinson', 'MD', 'Urology', '', '', NULL, 'B', '406 W South Jordan Pkwy Ste 500', 'South Jordan', 'Salt Lake', 'UT', '84095', '8019554685', NULL, '406 W South Jordan Pkwy Ste 500', 'South Jordan', 'Salt Lake', 'UT', '84095', '8019554685', '', 'WUSTDSURG5', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 6, '2007-02-01', NULL, 0, 0, 0, 'Jordan Valley Medical Center', 'Salt Lake Regional Medical Center', 'Pioneer Valley Hospital', '', 'HCFA|UB|', '1851314066', 0, 'Y', 0, '2014-06-17', NULL, NULL, 0, 0, NULL, NULL),
('621801973', 'W73006196', 'W73006196', 'UT01', 'Internal Medicine Specialist - Hospitalists', 'Abdul', 'F', 'Saidi', 'MD', 'Internal Medicine', 'Hospitalist', '', NULL, 'O', '3460  Pioneer Pkwy', 'West Valley', 'Salt Lake', 'UT', '84120', '8019643100', NULL, '3460  Pioneer Pkwy', 'West Valley', 'Salt Lake', 'UT', '84120', '8019643100', '          ', 'WUSTDINT5', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 6, '2007-02-01', '2010-10-31', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1336246230', 0, 'Y', 0, '2014-02-04', NULL, NULL, 0, 0, NULL, NULL),
('621801973', 'W73006197', 'W73006197', 'UT01', 'Pioneer Valley Hospital Physicians', 'Abdul', 'F', 'Saidi', 'MD', 'Internal Medicine', 'Hospitalist', '', NULL, 'B', '406 W South Jordan Pkwy Ste 500', 'South Jordan', 'Salt Lake', 'UT', '84095', '8013529500', NULL, '406 W South Jordan Pkwy Ste 500', 'South Jordan', 'Salt Lake', 'UT', '84095', '8013529500', '          ', 'WUSTDINT5', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 6, '2007-02-01', '2010-10-31', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1336246230', 0, 'Y', 0, '2014-02-04', NULL, NULL, 0, 0, NULL, NULL),
('621801973', 'W73006198', 'W73006198', 'UT01', 'Internal Medicine Specialist - Hospitalists', 'Kenneth', 'L', 'Schaecher', 'MD', 'Internal Medicine', '', '', NULL, 'O', '3460 Pioneer Pkwy', 'Salt Lake City', 'Salt Lake', 'UT', '84120', '8019643101', NULL, '3460 Pioneer Pkwy', 'Salt Lake City', 'Salt Lake', 'UT', '84120', '8019643101', '', 'WUSTDINT5', 'WUSTDHCPC5', NULL, '0.00', '35.00', '0.00', 6, '2007-02-01', '2014-04-30', 0, 0, 0, 'Pioneer Valley Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1245262492', 0, 'y', 0, '2011-07-21', NULL, NULL, 40.6972, -111.99, NULL, NULL),
('621801973', 'W73006199', 'W73006199', 'UT01', 'Pioneer Valley Hospital Physicians', 'Kenneth', 'L', 'Schaecher', 'MD', 'Internal Medicine', '', '', NULL, 'B', '406 W South Jordan Pkwy Ste 500', 'South Jordan', 'Salt Lake', 'UT', '84095', '8013529500', NULL, '406 W South Jordan Pkwy Ste 500', 'South Jordan', 'Salt Lake', 'UT', '84095', '8013529500', '', 'WUSTDINT5', 'WUSTDHCPC5', NULL, '0.00', '35.00', '0.00', 6, '2007-02-01', '2014-04-30', 0, 0, 0, 'Pioneer Valley Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1245262492', 0, 'Y', 0, '2011-07-21', NULL, NULL, 0, 0, NULL, NULL),
('621801973', 'W73006200', 'W73006200', 'UT01', 'Pioneer Valley Hospital Physicians', 'J', 'Lynn', 'Smith', 'MD', 'Orthopedic Surgery', NULL, NULL, NULL, 'B', '3336 S Pioneer Parkway Ste 101', 'Salt Lake City', 'Salt Lake', 'UT', '84120', '8013529500', NULL, 'PO Box 95970', 'South Jordan', '', 'UT', '84095', '', '', 'WUSTDSURG5', 'WUSTDHCPC5', NULL, '0.00', '35.00', NULL, 3, '2007-02-01', '2007-08-01', 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1548293400', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
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('621801973', 'W73006202', 'W73006202', 'UT01', NULL, 'Bireen', 'L', 'Whitten', 'MD', 'Internal Medicine', NULL, NULL, NULL, 'O', '2530 W 4700 S Ste B8', 'Salt Lake City', 'Salt Lake', 'UT', '84123', '8019675866', NULL, 'PO Box 95970', 'South Jordan', '', 'UT', '84095', '', '', 'WUSTDINT5', 'WUSTDHCPC5', NULL, '0.00', '35.00', NULL, 3, '2007-02-01', '2007-06-04', 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1831162882', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('621801973', 'W73006203', 'W73006203', 'UT01', 'Pioneer Valley Hospital Physicians', 'Bireen', 'L', 'Whitten', 'MD', 'Internal Medicine', NULL, NULL, NULL, 'B', '3336 S Pioneer Parkway Ste 101', 'Salt Lake City', 'Salt Lake', 'UT', '84120', '8013529500', NULL, 'PO Box 95970', 'South Jordan', '', 'UT', '84095', '', '', 'WUSTDINT5', 'WUSTDHCPC5', NULL, '0.00', '35.00', NULL, 3, '2007-02-01', '2007-06-04', 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1831162882', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('621801973', 'W73006204', 'W73006204', 'UT01', 'Pioneer Valley Hospital Physicians', 'James', 'A', 'Wilcox', 'MD', 'Internal Medicine', NULL, NULL, NULL, 'B', '3336 S Pioneer Parkway Ste 101', 'Salt Lake City', 'Salt Lake', 'UT', '84120', '8013529500', NULL, 'PO Box 95970', 'South Jordan', '', 'UT', '84095', '', '', 'WUSTDINT5', 'WUSTDHCPC5', NULL, '0.00', '35.00', NULL, 3, '2007-02-01', '2007-08-01', 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1031121078', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('621801973', 'W73006205', 'W73006205', 'UT01', 'Internal Medicine Specialist - Hospitalists', 'James', 'A', 'Wilcox', 'MD', NULL, NULL, NULL, NULL, 'O', '3460 Pioneer Pkwy', 'Salt Lake City', 'Salt Lake', 'UT', '84120', '8019643101', NULL, 'PO Box 95970', 'South Jordan', '', 'UT', '84095', '', '', 'WUSTDINT5', 'WUSTDHCPC5', NULL, '0.00', '35.00', '0.00', 6, '2007-02-01', '2014-04-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1831121078', 0, 'y', 0, '2007-02-28', NULL, NULL, 40.6972, -111.99, NULL, NULL),
('621795214', 'W73006206', 'W73006206', 'UT01', 'Salt Lake Senior Clinic', 'Carole', 'A', 'Baraldi', 'MD', 'Geriatrics', NULL, NULL, NULL, 'O', '24 S 1100 E Ste 209', 'Salt Lake City', 'Salt Lake', 'UT', '84102', '8013504602', NULL, 'PO Box 95970', 'South Jordan', '', 'UT', '84095', '', '', 'WUSTDINT5', 'WUSTDHCPC5', NULL, '0.00', '35.00', '0.00', 6, '2007-02-01', '2008-07-20', 1, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|', '1891704698', 0, 'N', 0, '2007-02-28', NULL, NULL, 0, 0, NULL, NULL),
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INSERT INTO `providers_new` (`Provider_Tax_ID`, `Provider_Suffix`, `Provider_Network_ID`, `Provider_Region`, `Provider_Name`, `Provider_Doctor_First_Name`, `Provider_Doctor_Middle_Name`, `Provider_Doctor_Last_Name`, `Provider_Doctor_Degree`, `Provider_Specialty_1`, `Provider_Specialty_2`, `Provider_Specialty_3`, `Provider_Specialty_4`, `Provider_Address_Type`, `Provider_Address`, `Provider_City`, `Provider_County`, `Provider_State`, `Provider_Zip`, `Provider_Phone`, `Provider_Fax`, `Provider_Mailing_Address`, `Provider_Mailing_City`, `Provider_Mailing_County`, `Provider_Mailing_State`, `Provider_Mailing_Zip`, `Provider_Mailing_Phone`, `Provider_Mailing_Fax`, `Provider_Primary_Schedule`, `Provider_Secondary_Schedule`, `Provider_Rate_Sheet`, `Provider_Anes_Rate`, `Provider_Default_Rate`, `Provider_Max_DOS`, `Provider_Min_Match_Value`, `Provider_Effective_Date`, `Provider_Term_Date`, `Provider_Pend`, `Provider_Anes_Minutes`, `Provider_PPO`, `Provider_Hospital_1`, `Provider_Hospital_2`, `Provider_Hospital_3`, `Provider_Hospital_4`, `Provider_Type`, `Provider_NPI`, `Provider_Check_Override`, `Exclude_Dir`, `Audit_Status`, `Last_Change_Date`, `Medicare_ID`, `Provider_Lang`, `Provider_Latitude`, `Provider_Longitude`, `Provider_school`, `Provider_cert`) VALUES
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('200832807', 'W77000136', 'W77000136', 'UT01', 'Brigham City Community Hospital Physician Services', 'ty Hospital Phy', 'sician Services', 'Brigham City Communi', 'GROUP', 'Multi Specialty (Clinic)', NULL, NULL, NULL, 'O', '950 Medical Dr', 'Brigham City', 'Box Elder', 'UT', '84302', '4357344352', NULL, NULL, NULL, '', NULL, NULL, '', '', '135', NULL, NULL, '0.00', '35.00', NULL, 3, '1999-09-01', '2005-03-07', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '833911', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
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('202641960', 'W77000220', 'W77000220', 'UT01', 'Davis Center for Oral and Maxillofacial Surgery', 'Paul', 'D', 'Benson', 'DMD, MD', 'Oral/Maxillofacial Surgery', NULL, NULL, NULL, 'O', '890 Heritage Park Blvd Ste 103', 'Layton', 'Davis', 'UT', '84041', '8016140999', NULL, NULL, NULL, '', NULL, NULL, '', '', 'USTDOSRG', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 6, '2005-08-26', '2006-12-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '931668', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('202781181', 'W77000221', 'W77000221', 'UT01', 'Cole PC, Danny L', 'Danny', 'L', 'Cole', 'CRNA', 'Nurse Anesthetist', NULL, NULL, NULL, 'O', 'PO Box 210', 'Roy', 'Weber', 'UT', '84067', '8018254700', NULL, NULL, NULL, '', NULL, NULL, '', '', 'USTDMULT', NULL, '2459', '0.00', NULL, NULL, 3, '2005-06-24', '2006-12-31', 1, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1376553065', 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
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('202965326', 'W77000223', 'W77000223', 'UT01', 'Wasatch Neonatal LC', 'Dale', NULL, 'Gerstmann', 'MD', 'Hospitalist', NULL, NULL, NULL, 'O', '750 W 800 N', 'Orem', 'Utah', 'UT', '84057', '8013696129', NULL, NULL, NULL, '', NULL, NULL, '', '', 'USTDNEON', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2005-08-01', '2006-10-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1205834843', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('203072591', 'W77000224', 'W77000224', 'UT01', 'Gasser FNP, Brian D', 'Brian', 'D', 'Gasser', 'APRN', NULL, NULL, NULL, NULL, 'O', '772 E 100 N Ste 6', 'Payson', 'Utah', 'UT', '84651', '8014657758', NULL, NULL, NULL, '', NULL, NULL, '', '', 'URURAL', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2005-08-26', '2006-10-31', 0, 0, 0, 'Mountain View Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1194744615', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('203132781', 'W77000225', 'W77000225', 'UT01', 'West Valley Infectious Disease', 'David', 'H', 'Matthews', 'MD', 'Internal Medicine', 'Infectious Disease', NULL, NULL, 'O', '3590 W 9000 S Ste 240', 'West Jordan', 'Salt Lake', 'UT', '84088', '8015692384', '8015698643', NULL, NULL, '', NULL, NULL, '', '', 'USTDINT', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2005-06-24', '2006-10-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '928792', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('203269756', 'W77000226', 'W77000226', 'UT01', NULL, 'Michael', 'T', 'Swinyard', 'MD', 'Pediatric Endocrinology', NULL, NULL, NULL, 'O', '5495 S 500 E Ste 120', 'Ogden', 'Weber', 'UT', '84405', '8014790174', '8014798888', NULL, NULL, '', NULL, NULL, '', '', 'USTDENDO', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2002-04-02', '2006-10-31', 0, 0, 0, 'Primary Childrens Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1245222819', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('203350494', 'W77000227', 'W77000227', 'UT01', 'Spector, Jay M', 'Jay', 'M', 'Spector', 'MD', 'Family Practice', NULL, NULL, NULL, 'B', '196 E 2000 N Set 100', 'Tooele', 'Tooele', 'UT', '84074', '8015539568', '8015539562', NULL, NULL, '', NULL, NULL, '', '', 'USTDFAM', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2005-10-28', '2006-08-31', 0, 0, 0, 'Mountain West Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1386630259', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('203373192', 'W77000228', 'W77000228', 'UT01', 'Ashley Valley Family Practice', 'Shaun', 'C', 'Shurtliff', 'DO', 'Family Practice', NULL, NULL, NULL, 'B', 'PO Box 150610', 'Ogden', 'Weber', 'UT', '84415', '8015609313', '4357818898', NULL, NULL, '', NULL, NULL, '', '', 'USTDFAM', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2005-09-30', '2006-12-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1285719294', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('202994901', 'W77000229', 'W77000229', 'UT01', 'Warby DPM, David H', 'David', 'H', 'Warby', 'DPM', 'Podiatry', NULL, NULL, NULL, 'O', '934 S Main St', 'Kaysville', 'Davis', 'UT', '84037', '8015444227', '8015443724', NULL, NULL, '', NULL, NULL, '', '', 'USTDPOD', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2005-08-20', '2006-12-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1912949421', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('223887117', 'W77000230', 'W77000230', 'UT01', 'Mountain Valley Eye Institute', 'Scott', 'A', 'Czarnecki', 'MD', 'Ophthalmology', NULL, NULL, NULL, 'B', 'PO Box 27688', 'Salt Lake City', 'Salt Lake', 'UT', '84127', '8015341360', '8013669883', NULL, NULL, '', NULL, NULL, '', '', 'USTDOPHT', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2005-07-15', '2006-10-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '923445', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('223897585', 'W77000231', 'W77000231', 'UT01', NULL, 'Joshua', 'M', 'Hickman', 'MD', 'Orthopedic Surgery', NULL, NULL, NULL, 'O', '214 W 1500 S', 'Bountiful', 'Davis', 'UT', '84010', '8012957200', NULL, NULL, NULL, '', NULL, NULL, '', '', 'UMTNORTH', NULL, NULL, '0.00', '35.00', NULL, 3, '2003-08-21', '2004-07-31', 0, 0, 0, 'Lakeview Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1821139619', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('237268471', 'W77000232', 'W77000232', 'UT01', 'University Radiology Associates', 'Associates', NULL, 'University Radiology', 'GROUP', 'Radiologist', NULL, NULL, NULL, 'B', 'PO Box 581200', 'Salt Lake City', 'Salt Lake', 'UT', '84158', '8012367725', NULL, NULL, NULL, '', NULL, NULL, '', '', 'UUUMG', NULL, NULL, '0.00', '25.00', NULL, 3, '2002-01-01', '2006-07-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '902305', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
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('237268471', 'W77000235', 'W77000235', 'UT01', 'U Of U Radiology Associates', 'Perry', 'P', 'Ng', 'MD', 'Radiologist', NULL, NULL, NULL, 'O', '50 N Medical Dr', 'Salt Lake City', 'Salt Lake', 'UT', '84132', '8012367725', NULL, NULL, NULL, '', NULL, NULL, '', '', 'UUUMG', NULL, NULL, '0.00', '25.00', NULL, 3, '2005-11-08', '2006-07-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1336239946', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('237268471', 'W77000236', 'W77000236', 'UT01', 'U Of U Radiology Associates', 'Kathleen', 'A', 'O''Neil', 'MD', 'Radiologist', NULL, NULL, NULL, 'B', 'PO Box 581200', 'Salt Lake City', 'Salt Lake', 'UT', '84158', NULL, NULL, NULL, NULL, '', NULL, NULL, '', '', 'UUUMG', NULL, '1000', '37.71', NULL, NULL, 3, '1999-09-01', '2004-11-08', 1, 12, 0, 'Lakeview Hospital', 'St Marks Hospital', NULL, NULL, 'HCFA|UB|', '1881693950', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('237268471', 'W77000237', 'W77000237', 'UT01', 'U Of U Radiology Associates', 'Karen', 'Y', 'Oh', 'MD', 'Radiologist', NULL, NULL, NULL, 'O', '50 N Medical Dr', 'Salt Lake City', 'Salt Lake', 'UT', '84132', '8015817840', NULL, NULL, NULL, '', NULL, NULL, '', '', 'UUUMG', NULL, '1000', '37.71', NULL, NULL, 3, '2003-07-01', '2006-07-31', 1, 12, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '832594', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('203093502', 'W77000239', 'W77000239', 'UT01', NULL, 'Richard', 'E', 'Lambert', 'MD', 'Anesthesiology', NULL, NULL, NULL, 'B', '1954 Fort Union Blvd Ste 107', 'Salt Lake City', 'Salt Lake', 'UT', '84121', '8019939506', NULL, NULL, NULL, '', NULL, NULL, '', '', '135', NULL, '1000', '47.25', NULL, NULL, 3, '2001-07-02', '2006-11-30', 1, 12, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1154435485', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('203093502', 'W77000240', 'W77000240', 'UT01', NULL, 'Richard', 'E', 'Lambert', 'MD', 'Anesthesiology', NULL, NULL, NULL, 'O', '3580 W 9000 S', 'West Jordan', 'Salt Lake', 'UT', '84088', '8019939506', NULL, NULL, NULL, '', NULL, NULL, '', '', '135', NULL, '1000', '47.25', NULL, NULL, 3, '2001-07-02', '2006-11-30', 1, 12, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1154435485', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('203101289', 'W77000241', 'W77000241', 'UT01', NULL, 'Mark', 'A', 'Rosen', 'MD', 'Orthopedic Surgery', NULL, NULL, NULL, 'O', '5911 Fashion Blvd Ste 100', 'Salt Lake City', 'Salt Lake', 'UT', '84107', '8012691333', '8012612288', NULL, NULL, '', NULL, NULL, '', '', 'USTDORTH', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2002-04-01', '2006-12-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1609823426', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('203153914', 'W77000242', 'W77000242', 'UT01', 'Peachtree Family Medicine', 'Vera', 'B', 'Carlson', 'MD', 'Family Practice', NULL, NULL, NULL, 'O', '169 Springcreek Pkwy Ste 170', 'Providence', 'Cache', 'UT', '84332', '4357525553', NULL, NULL, NULL, '', NULL, NULL, '', '', 'URURAL', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2005-10-28', '2006-08-31', 0, 0, 0, 'Logan Regional Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1023095585', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('203373192', 'W77000243', 'W77000243', 'UT01', 'Ashley Valley Family Practice', 'Shaun', 'C', 'Shurtliff', 'DO', 'Family Practice', NULL, NULL, NULL, 'O', '175 N 100 W Ste 104', 'Vernal', 'Uintah', 'UT', '84078', '4357818899', '4357818898', NULL, NULL, '', NULL, NULL, '', '', 'USTDFAM', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2005-09-30', '2006-12-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1285719294', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('203457743', 'W77000244', 'W77000244', 'UT01', 'Wasatch Foot and Ankle', 'Donald', 'R', 'Curtis', 'DPM', 'Podiatry', NULL, NULL, NULL, 'O', '1250 E 3900 S Ste 420', 'Salt Lake City', 'Salt Lake', 'UT', '84124', '8012699939', '8012699949', NULL, NULL, '', NULL, NULL, '', '', 'USTDPOD', NULL, NULL, '0.00', '35.00', NULL, 3, '2004-09-24', '2005-10-04', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1902847577', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('222274030', 'W77000245', 'W77000245', 'UT01', 'Monahan, Daniel', 'Daniel', NULL, 'Monahan', 'MD', 'Internal Medicine', NULL, NULL, NULL, 'O', '230 N Hospital Dr Ste 3', 'Price', 'Carbon', 'UT', '84501', '4356377960', '4356377336', NULL, NULL, '', NULL, NULL, '', '', 'UEASTUT', 'USTDHCPC', NULL, '0.00', '20.00', NULL, 3, '2001-01-01', '2006-12-31', 0, 0, 0, 'Castleview Hospital', 'Castleview Hospital-Pro Fees', NULL, NULL, 'HCFA|UB|', '1225030661', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('223887117', 'W77000246', 'W77000246', 'UT01', 'Mountain Valley Eye Institute', 'John', 'B', 'Fassio', 'MD', 'Ophthalmology', NULL, NULL, NULL, 'O', '1471 S Highway 40', 'Heber City', 'Wasatch', 'UT', '84032', '4356543090', NULL, NULL, NULL, '', NULL, NULL, '', '', 'USTDOPHT', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '1999-08-01', '2006-10-31', 0, 0, 0, 'Evanston Regional Hospital', 'Heber Valley Medical Center', NULL, NULL, 'HCFA|UB|', '1689671638', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
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('223897585', 'W77000248', 'W77000248', 'UT01', NULL, 'Joshua', 'M', 'Hickman', 'MD', 'Orthopedic Surgery', NULL, NULL, NULL, 'O', '2102 Robins Dr', 'Layton', 'Davis', 'UT', '84041', '8012957200', NULL, NULL, NULL, '', NULL, NULL, '', '', 'UMTNORTH', NULL, NULL, '0.00', '35.00', NULL, 3, '2003-08-21', '2005-01-01', 0, 0, 0, 'Lakeview Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1821139619', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
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('237268471', 'W77000250', 'W77000250', 'UT01', 'U Of U Radiology Associates', 'John', NULL, 'Arias', 'MD', 'Radiologist', NULL, NULL, NULL, 'O', '50 N Medical Dr', 'Salt Lake City', 'Salt Lake', 'UT', '84132', '8015817840', NULL, NULL, NULL, '', NULL, NULL, '', '', 'UUUMG', NULL, '1000', '37.71', NULL, NULL, 3, '2002-10-01', '2004-05-01', 1, 12, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '833119', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
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('223887117', 'W77000252', 'W77000252', 'UT01', 'Mountain Valley Eye Institute', 'Scott', 'A', 'Czarnecki', 'MD', 'Ophthalmology', NULL, NULL, NULL, 'O', '4568 Highland Dr Ste 160', 'Salt Lake City', 'Salt Lake', 'UT', '84117', '8014243090', NULL, NULL, NULL, '', NULL, NULL, '', '', 'USTDOPHT', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2005-07-15', '2006-10-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '923445', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
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('223889298', 'W77000254', 'W77000254', 'UT01', 'Belnap Surgical Associates', 'Willem', 'J', 'Vanderwerf', 'MD', 'General Surgery', NULL, NULL, NULL, 'O', '1250 E 3900 S Ste 220', 'Salt Lake City', 'Salt Lake', 'UT', '84124', '8012629782', NULL, NULL, NULL, '', NULL, NULL, '', '', 'WCSTLPB5', NULL, NULL, '0.00', '0.00', NULL, 3, '2003-04-15', '2006-07-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '832504', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
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('364288180', 'W77000327', 'W77000327', 'UT01', 'Cache Valley Specialty Hospital', 'al Therapy', NULL, 'Mountain West Physic', 'GROUP', 'Physical Therapy', 'Occupational Therapy', 'Speech Therapy', NULL, 'B', 'PO Box 6220', 'Logan', 'Cache', 'UT', '84341', '4357139700', NULL, NULL, NULL, '', NULL, NULL, '', '', NULL, NULL, NULL, '0.00', '0.00', '57.75', 3, '2002-11-01', '2006-12-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '836100', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('371474869', 'W77000329', 'W77000329', 'UT01', 'Summit Physical Therapy & Sports Medicine', 'apy & Sports Me', 'dicine, Inc', 'Summit Physical Ther', 'GROUP', 'Physical Therapy', NULL, NULL, NULL, 'O', '155 N Main St Ste A', 'Kamas', 'Summit', 'UT', '84036', '4357832659', 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|', '832976', 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
('411536255', 'W77000330', 'W77000330', 'UT01', 'Gary A Green, DPM', 'Gary', NULL, 'Green', 'DPM', 'Podiatry', NULL, NULL, NULL, 'O', '75 N 200 W', 'Vernal', 'Uintah', 'UT', '84078', '4357895500', NULL, NULL, NULL, '', NULL, NULL, '', '', 'USTDPOD', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '1999-09-01', '2006-08-31', 0, 0, 0, 'Lakeview Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1801896816', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('450470447', 'W77000331', 'W77000331', 'UT01', 'Layton Physical Therapy And Sports Medicine', 'apy And Sports', 'Medicine', 'Layton Physical Ther', 'GROUP', 'Physical Therapy', NULL, NULL, NULL, 'O', '2179 Robins Dr Ste 4', 'Layton', 'Davis', 'UT', '84041', '8017284624', '8017284630', 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|', '832974', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('470897660', 'W77000332', 'W77000332', 'UT01', 'South Valley Ear Nose And Throat Associates', 'Janis', 'K', 'Cline', 'PA', NULL, 'Ear, Nose & Throat', NULL, NULL, 'O', '3584 W 9000 S Ste 311', 'West Jordan', 'Salt Lake', 'UT', '84088', '8015668304', '8015668330', NULL, NULL, '', NULL, NULL, '', '', 'USTDENT', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2003-01-17', '2006-09-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1053327312', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('470905811', 'W77000333', 'W77000333', 'UT01', 'Asthma & Allergy Clinic of Utah', 'Cathy', 'J', 'Gonzales', 'NP', NULL, NULL, NULL, NULL, 'O', '1121 E 3900 S Bldg C Ste 130', 'Salt Lake City', 'Salt Lake', 'UT', '84124', '8012811300', '8012815973', NULL, NULL, '', NULL, NULL, '', '', 'USTDALLE', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2005-10-28', '2006-09-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '945526', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('481272647', 'W77000334', 'W77000334', 'UT01', 'Utah Imaging Associates', 'John', NULL, 'Arias', 'MD', 'Radiologist', NULL, NULL, NULL, 'O', '3715 W 4100 S Ste 150', 'West Valley', 'Salt Lake', 'UT', '84120', '8019240029', NULL, NULL, NULL, '', NULL, NULL, '', '', 'UUTIMAGE', NULL, NULL, '0.00', '35.00', NULL, 3, '2002-10-01', '2004-05-01', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '833119', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('481272647', 'W77000335', 'W77000335', 'UT01', 'Utah Imaging Associates', 'John', NULL, 'Arias', 'MD', 'Radiologist', NULL, NULL, NULL, 'B', 'PO Box 1288', 'Bountiful', 'Davis', 'UT', '84011', '8019512323', NULL, NULL, NULL, '', NULL, NULL, '', '', 'UUTIMAGE', NULL, NULL, '0.00', '35.00', NULL, 3, '2002-10-01', '2004-05-01', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '833119', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('481293994', 'W77000336', 'W77000336', 'UT01', NULL, 'Bradford', 'Kelly', 'Ence', 'MD', 'Ear, Nose and Throat', NULL, NULL, NULL, 'O', '39 Professional Way', 'Payson', 'Utah', 'UT', '84651', '8014654805', '8014654354', NULL, NULL, '', NULL, NULL, '', '', 'UUVPN', NULL, NULL, '0.00', '35.00', NULL, 3, '1999-09-01', '2005-03-31', 0, 0, 0, 'Mountain View Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1588766299', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('481297403', 'W77000337', 'W77000337', 'UT01', 'Mountain West Family Practice', 'Sergio', 'O', 'Abarca', 'MD', 'Family Practice', NULL, NULL, NULL, 'O', '1929 Aaron Dr Ste I', 'Tooele', 'Tooele', 'UT', '84074', '4358822350', NULL, NULL, NULL, '', NULL, NULL, '', '', 'USTDFAM', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2003-07-01', '2006-09-30', 0, 0, 0, 'Mountain West Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1245238617', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('481297403', 'W77000338', 'W77000338', 'UT01', 'Mountain West Family Practice', 'Chad', 'S', 'Jarvis', 'PA', NULL, NULL, NULL, NULL, 'O', '1929 Aaron Dr Ste I', 'Tooele', 'Tooele', 'UT', '84074', '4358822350', NULL, NULL, NULL, '', NULL, NULL, '', '', 'USTDFAM', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2005-01-28', '2006-09-30', 0, 0, 0, 'Mountain West Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1619974664', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
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