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
('320186101', 'W11002695', 'W11002695', 'UT01', 'University Health Care', 'Ernest', 'C', 'Norlin', 'MD', 'Pediatrics', '', '', NULL, 'O', '100 N Mario Capecchi Dr', 'Salt Lake City', 'Salt Lake', 'UT', '84113', '8016625400', NULL, '100 N Mario Capecchi Dr', 'Salt Lake City', 'Salt Lake', 'UT', '84113', '8016625400', '          ', 'WUUPEDS', 'WUSTDHCPC5', '', '0.00', '15.00', '0.00', 3, '2007-07-01', '2011-01-01', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1154411767', 0, 'N', 0, '2011-12-19', NULL, NULL, 0, 0, NULL, NULL),
('876000525', 'W11002696', 'W11002696', 'UT01', 'University of Utah Hospital', 'Tressa', 'J', 'Hidden Friend', 'SP', 'Speech Therapy', NULL, NULL, NULL, 'B', 'PO Box 581700', 'Salt Lake City', 'Salt Lake', 'UT', '84158', '8012386615', NULL, '50 N Medical Dr', 'Salt Lake City', '', 'UT', '84132', '', '', '', NULL, '1', '0.00', '0.00', '0.00', 6, '2007-12-01', NULL, 1, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|', '0000006710', 0, 'Y', 0, '2008-01-07', NULL, NULL, 0, 0, NULL, NULL),
('876000525', 'W11002697', 'W11002697', 'UT01', 'University of Utah Hospital', 'Tressa', 'J', 'Hidden Friend', 'SP', 'Speech Therapy', NULL, NULL, NULL, 'O', '50 N Medical Dr', 'Salt Lake City', 'Salt Lake', 'UT', '84132', '8015812121', NULL, '50 N Medical Dr', 'Salt Lake City', '', 'UT', '84132', '', '', '', NULL, '1', '0.00', '0.00', '0.00', 6, '2007-12-01', NULL, 1, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|', '0000006710', 0, 'N', 0, '2008-01-07', NULL, NULL, 40.7685, -111.837, NULL, NULL),
('320186101', 'W11002698', 'W11002698', 'UT01', 'U of U Pediatric Diagnostic Cardiology', 'Victoria', 'E', 'Judd', 'MD', 'Pediatric Cardiology', 'Pediatrics', '', NULL, 'B', 'PO Box 413021', 'Salt Lake City', 'Salt Lake', 'UT', '84141', '8012133800', NULL, 'PO Box 413021', 'Salt Lake City', 'Salt Lake', 'UT', '84141', '8012133800', '          ', 'WUUPEDS', 'WUSTDHCPC5', '', '0.00', '15.00', '0.00', 3, '2007-07-01', '2012-05-01', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1790864361', 0, 'Y', 0, '2012-07-06', NULL, NULL, 0, 0, NULL, NULL),
('320186101', 'W11002699', 'W11002699', 'UT01', 'University Health Care', 'Victoria', 'E', 'Judd', 'MD', 'Pediatric Cardiology', 'Pediatrics', '', NULL, 'O', '100 N Mario Capecchi Dr', 'Salt Lake City', 'Salt Lake', 'UT', '84113', '8016625400', NULL, '100 N Mario Capecchi Dr', 'Salt Lake City', 'Salt Lake', 'UT', '84113', '8016625400', '          ', 'WUUPEDS', 'WUSTDHCPC5', '', '0.00', '15.00', '0.00', 3, '2007-07-01', '2012-05-01', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1790864361', 0, 'N', 0, '2012-07-06', NULL, NULL, 0, 0, NULL, NULL),
('205529469', 'W11002700', 'W11002700', 'UT01', 'University Health Care', 'Scott', 'T', 'Roberts', 'MD', 'Physical Medicine and Rehabilitation', NULL, NULL, NULL, 'B', 'PO Box 58108', 'Salt Lake City', 'Salt Lake', 'UT', '84158', '8015883998', NULL, NULL, NULL, '', NULL, NULL, '', '', 'WUUUMG5', 'WUSTDHCPC5', NULL, '0.00', '25.00', '0.00', 3, '2007-11-01', '2008-08-01', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1457480535', 0, 'Y', 0, '2008-01-07', NULL, NULL, 0, 0, NULL, NULL),
('205529469', 'W11002701', 'W11002701', 'UT01', 'University Health Care', 'Scott', 'T', 'Roberts', 'MD', 'Physical Medicine and Rehabilitation', NULL, NULL, NULL, 'O', '1493 Lowell Ave', 'Park City', 'Summit', 'UT', '84060', '4356557970', NULL, NULL, NULL, '', NULL, NULL, '', '', 'WUUUMG5', 'WUSTDHCPC5', NULL, '0.00', '25.00', '0.00', 3, '2007-11-01', '2008-08-01', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1457480535', 0, 'N', 0, '2008-01-07', NULL, NULL, 0, 0, NULL, NULL),
('205529469', 'W11002702', 'W11002702', 'UT01', 'University Health Care', 'Michelle', 'J', 'Rowe', 'DO', 'Physical Medicine and Rehabilitation', NULL, NULL, NULL, 'B', 'PO Box 58108', 'Salt Lake City', 'Salt Lake', 'UT', '84158', '8015883998', NULL, NULL, NULL, '', NULL, NULL, '', '', 'WUUUMG5', 'WUSTDHCPC5', NULL, '0.00', '25.00', '0.00', 3, '2007-12-06', '2008-08-01', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1013199843', 0, 'Y', 0, '2008-01-07', NULL, NULL, 0, 0, NULL, NULL),
('205529469', 'W11002703', 'W11002703', 'UT01', 'University Health Care', 'Michelle', 'J', 'Rowe', 'DO', 'Physical Medicine and Rehabilitation', NULL, NULL, NULL, 'O', '1493 Lowell Ave', 'Park City', 'Summit', 'UT', '84060', '4356557970', NULL, NULL, NULL, '', NULL, NULL, '', '', 'WUUUMG5', 'WUSTDHCPC5', NULL, '0.00', '25.00', '0.00', 3, '2007-12-06', '2008-08-01', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1013199843', 0, 'N', 0, '2008-01-07', NULL, NULL, 0, 0, NULL, NULL),
('320186101', 'W11002704', 'W11002704', 'UT01', 'U of U Pediatric Diagnostic Cardiology', 'Elizabeth', 'Vickers', 'Saarel', 'MD', 'Pediatric Cardiology', 'Pediatrics', '', NULL, 'B', 'PO Box 413021', 'Salt Lake City', 'Salt Lake', 'UT', '84141', '8012133800', NULL, 'PO Box 413021', 'Salt Lake City', 'Salt Lake', 'UT', '84141', '8012133800', '          ', 'WUUPEDS', 'WUSTDHCPC5', '', '0.00', '15.00', '0.00', 3, '2007-07-01', '2012-05-01', 0, 0, 0, 'Primary Childrens Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1780763250', 0, 'Y', 0, '2012-05-03', NULL, NULL, 0, 0, NULL, NULL),
('320186101', 'W11002705', 'W11002705', 'UT01', 'University Health Care', 'Elizabeth', 'Vickers', 'Saarel', 'MD', 'Pediatric Cardiology', 'Pediatrics', '', NULL, 'O', '100 N Mario Capecchi Dr', 'Salt Lake City', 'Salt Lake', 'UT', '84113', '8016625400', NULL, '100 N Mario Capecchi Dr', 'Salt Lake City', 'Salt Lake', 'UT', '84113', '8016625400', '          ', 'WUUPEDS', 'WUSTDHCPC5', '', '0.00', '15.00', '0.00', 3, '2007-07-01', '2012-05-01', 0, 0, 0, 'Primary Childrens Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1780763250', 0, 'N', 0, '2012-05-03', NULL, NULL, 0, 0, NULL, NULL),
('870616107', 'W11002706', 'W11002706', 'UT01', 'U of U Hospitals and Clinics', 'Stacey', 'T', 'Vroman', 'PA', 'Family Practice', NULL, NULL, NULL, 'b', 'PO Box 510708', 'Salt Lake City', 'Salt Lake', 'UT', '84151', '8015876303', NULL, NULL, NULL, '', NULL, NULL, '', '', 'WISESTDU', 'WUSTDHCPC5', NULL, '0.00', '35.00', NULL, 6, '2007-11-08', '2007-11-08', 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1144404757', 0, 'y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870616107', 'W11002707', 'W11002707', 'UT01', 'University Health Care', 'Stacey', 'T', 'Vroman', 'PA', 'Family Practice', NULL, NULL, NULL, 'O', '1525 W 2100 S', 'Salt Lake City', 'Salt Lake', 'UT', '84119', '8012139910', NULL, NULL, NULL, '', NULL, NULL, '', '', 'WISESTDU', 'WUSTDHCPC5', NULL, '0.00', '35.00', NULL, 6, '2007-11-08', '2007-11-08', 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1144404757', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870515631', 'W11002708', 'W11002708', 'UT01', 'U-U Rehabilitation Medicine', 'Gretchen', 'L', 'Alexander', 'APRN', 'Physical Medicine and Rehabilitation', '', '', NULL, 'B', 'PO Box 413032', 'Salt Lake City', 'Salt Lake', 'UT', '84141', '8017158238', NULL, 'PO Box 413032', 'Salt Lake City', 'Salt Lake', 'UT', '84141', '8017158238', '          ', 'WUUUMG5', 'WUSTDHCPC5', '', '0.00', '25.00', '0.00', 3, '2007-12-10', '2012-08-22', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1508054776', 0, 'N', 0, '2012-08-23', NULL, NULL, 0, 0, NULL, NULL),
('870515631', 'W11002709', 'W11002709', 'UT01', 'University Health Care', 'Gretchen', 'L', 'Alexander', 'APRN', 'Physical Medicine and Rehabilitation', '', '', NULL, 'O', '50 N Medical Dr', 'Salt Lake City', 'Salt Lake', 'UT', '84132', '8015812268', NULL, '50 N Medical Dr', 'Salt Lake City', 'Salt Lake', 'UT', '84132', '8015812268', '          ', 'WUUUMG5', 'WUSTDHCPC5', '', '0.00', '25.00', '0.00', 3, '2007-12-10', '2012-08-22', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1508054776', 0, 'N', 0, '2012-08-23', NULL, NULL, 0, 0, NULL, NULL),
('320186101', 'W11002710', 'W11002710', 'UT01', 'U of U Pediatric Diagnostic Cardiology', 'Ronald', 'W', 'Day', 'MD', 'Pediatric Cardiology', 'Pediatrics', '', NULL, 'B', 'PO Box 413021', 'Salt Lake City', 'Salt Lake', 'UT', '84141', '8012133800', NULL, 'PO Box 413021', 'Salt Lake City', 'Salt Lake', 'UT', '84141', '8012133800', '          ', 'WUUPEDS', 'WUSTDHCPC5', '', '0.00', '15.00', '0.00', 3, '2007-07-01', '2012-05-01', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1780763359', 0, 'Y', 0, '2013-07-08', NULL, NULL, 0, 0, NULL, NULL),
('320186101', 'W11002711', 'W11002711', 'UT01', 'University Health Care', 'Ronald', 'W', 'Day', 'MD', 'Pediatric Cardiology', 'Pediatrics', '', NULL, 'O', '100 N Mario Capecchi Dr', 'Salt Lake City', 'Salt Lake', 'UT', '84113', '8016625400', NULL, '100 N Mario Capecchi Dr', 'Salt Lake City', 'Salt Lake', 'UT', '84113', '8016625400', '          ', 'WUUPEDS', 'WUSTDHCPC5', '', '0.00', '15.00', '0.00', 3, '2007-07-01', '2012-05-01', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1780763359', 0, 'N', 0, '2013-07-08', NULL, NULL, 0, 0, NULL, NULL),
('205529469', 'W11002712', 'W11002712', 'UT01', 'University Health Care', 'Arthur', 'J', 'DeLuigi', 'DO', 'Physical Medicine and Rehabilitation', NULL, NULL, NULL, 'B', 'PO Box 58108', 'Salt Lake City', 'Salt Lake', 'UT', '84158', '8015883998', NULL, NULL, NULL, '', NULL, NULL, '', '', 'WUUUMG5', 'WUSTDHCPC5', NULL, '0.00', '25.00', '0.00', 3, '2007-11-01', '2008-08-01', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1497861363', 0, 'Y', 0, '2008-01-07', NULL, NULL, 0, 0, NULL, NULL),
('205529469', 'W11002713', 'W11002713', 'UT01', 'University Health Care', 'Arthur', 'J', 'DeLuigi', 'DO', 'Physical Medicine and Rehabilitation', NULL, NULL, NULL, 'O', '1493 Lowell Ave', 'Park City', 'Summit', 'UT', '84060', '4356557970', NULL, NULL, NULL, '', NULL, NULL, '', '', 'WUUUMG5', 'WUSTDHCPC5', NULL, '0.00', '25.00', '0.00', 3, '2007-11-01', '2008-08-01', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1497861363', 0, 'N', 0, '2008-01-07', NULL, NULL, 0, 0, NULL, NULL),
('320186101', 'W11002714', 'W11002714', 'UT01', 'U of U Pediatric Diagnostic Cardiology', 'Collin', 'G', 'Cowley', 'MD', 'Pediatric Cardiology', 'Pediatrics', '', NULL, 'B', 'PO Box 413021', 'Salt Lake City', 'Salt Lake', 'UT', '84141', '8012133800', NULL, 'PO Box 413021', 'Salt Lake City', 'Salt Lake', 'UT', '84141', '8012133800', '          ', 'WUUPEDS', 'WUSTDHCPC5', '', '0.00', '15.00', '0.00', 3, '2007-07-01', '2012-05-01', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1598844169', 0, 'Y', 0, '2012-10-04', NULL, NULL, 0, 0, NULL, NULL),
('320186101', 'W11002715', 'W11002715', 'UT01', 'University Health Care', 'Collin', 'G', 'Cowley', 'MD', 'Pediatric Cardiology', 'Pediatrics', '', NULL, 'O', '100 N Mario Capecchi Dr', 'Salt Lake City', 'Salt Lake', 'UT', '84113', '8016625400', NULL, '100 N Mario Capecchi Dr', 'Salt Lake City', 'Salt Lake', 'UT', '84113', '8016625400', '          ', 'WUUPEDS', 'WUSTDHCPC5', '', '0.00', '15.00', '0.00', 3, '2007-07-01', '2012-05-01', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1598844169', 0, 'N', 0, '2012-10-04', NULL, NULL, 0, 0, NULL, NULL),
('320186101', 'W11002716', 'W11002716', 'UT01', 'U of U Pediatric Diagnostic Cardiology', 'Angela', 'T', 'Yetman', 'MD', 'Pediatric Cardiology', 'Pediatrics', '', NULL, 'B', 'PO Box 413021', 'Salt Lake City', 'Salt Lake', 'UT', '84141', '8012133800', NULL, 'PO Box 413021', 'Salt Lake City', 'Salt Lake', 'UT', '84141', '8012133800', '          ', 'WUUPEDS', 'WUSTDHCPC5', '', '0.00', '15.00', '0.00', 3, '2007-07-01', '2012-05-01', 0, 0, 0, 'Primary Childrens Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1891885471', 0, 'Y', 0, '2012-10-05', NULL, NULL, 0, 0, NULL, NULL),
('320186101', 'W11002717', 'W11002717', 'UT01', 'University Health Care', 'Angela', 'T', 'Yetman', 'MD', 'Pediatric Cardiology', 'Pediatrics', '', NULL, 'O', '100 N Mario Capecchi Dr', 'Salt Lake City', 'Salt Lake', 'UT', '84113', '8016625400', NULL, '100 N Mario Capecchi Dr', 'Salt Lake City', 'Salt Lake', 'UT', '84113', '8016625400', '          ', 'WUUPEDS', 'WUSTDHCPC5', '', '0.00', '15.00', '0.00', 3, '2007-07-01', '2012-05-01', 0, 0, 0, 'Primary Childrens Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1891885471', 0, 'N', 0, '2012-10-05', NULL, NULL, 0, 0, NULL, NULL),
('870645895', 'W11002718', 'W11002718', 'UT01', 'U of U Pediatric Orthopedics', 'Erik', 'N', 'Kubiak', 'MD', 'Orthopedic Surgery', 'Pediatric Orthopedic Surgery', NULL, NULL, 'B', 'PO Box 58886', 'Salt Lake City', 'Salt Lake', 'UT', '84158', '8012133800', NULL, NULL, NULL, '', NULL, NULL, '', '', 'WUUPEDS', 'WUSTDHCPC5', NULL, '0.00', '15.00', '0.00', 3, '2007-12-01', '2008-01-01', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1003825753', 0, 'y', 0, '2008-01-07', NULL, NULL, 0, 0, NULL, NULL),
('870645895', 'W11002719', 'W11002719', 'UT01', 'University Health Care', 'Erik', 'N', 'Kubiak', 'MD', 'Orthopedic Surgery', 'Pediatric Orthopedic Surgery', NULL, NULL, 'O', '100 N Mario Capecchi Dr', 'Salt Lake City', 'Salt Lake', 'UT', '84113', '8016625600', NULL, NULL, NULL, '', NULL, NULL, '', '', 'WUUPEDS', 'WUSTDHCPC5', NULL, '0.00', '15.00', '0.00', 3, '2007-12-01', '2008-01-01', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1003825753', 0, 'N', 0, '2008-01-07', NULL, NULL, 0, 0, NULL, NULL),
('870645895', 'W11002720', 'W11002720', 'UT01', 'U of U Pediatric Orthopedics', 'Michael', 'D', 'Daubs', 'MD', 'Orthopedic Surgery', 'Pediatric Orthopedic Surgery', '', NULL, 'B', 'PO Box 413026', 'Salt Lake City', 'Salt Lake', 'UT', '84141', '8012133800', NULL, 'PO Box 413026', 'Salt Lake City', 'Salt Lake', 'UT', '84141', '8012133800', '          ', 'WUUPEDS', 'WUSTDHCPC5', '', '0.00', '15.00', '0.00', 3, '2007-12-01', '2012-08-01', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1275528416', 0, 'N', 0, '2012-08-22', NULL, NULL, 0, 0, NULL, NULL),
('870645895', 'W11002721', 'W11002721', 'UT01', 'University Health Care', 'Michael', 'D', 'Daubs', 'MD', 'Orthopedic Surgery', 'Pediatric Orthopedic Surgery', '', NULL, 'O', '100 N Mario Capecchi Dr Ste 4550', 'Salt Lake City', 'Salt Lake', 'UT', '84113', '8016625600', NULL, '100 N Mario Capecchi Dr Ste 4550', 'Salt Lake City', 'Salt Lake', 'UT', '84113', '8016625600', '          ', 'WUUPEDS', 'WUSTDHCPC5', '', '0.00', '15.00', '0.00', 3, '2007-12-01', '2012-08-01', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1275528416', 0, 'N', 0, '2012-08-22', NULL, NULL, 0, 0, NULL, NULL),
('870619420', 'W11002722', 'W11002722', 'UT01', 'College of Nursing, University of Utah', 'Susanna', 'R', 'Cohen', 'CNM', 'Obstetrics and Gynecology', 'Certified Nurse Midwife', '', NULL, 'B', 'PO Box 413036', 'Salt Lake City', 'Salt Lake', 'UT', '84141', '8012133800', NULL, 'PO Box 413036', 'Salt Lake City', 'Salt Lake', 'UT', '84141', '8012133800', '          ', 'WUUUMG5', 'WUSTDHCPC5', '', '0.00', '25.00', '0.00', 3, '2007-12-21', '2012-09-18', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1033391552', 0, 'N', 0, '2012-09-19', NULL, NULL, 0, 0, NULL, NULL),
('870619420', 'W11002723', 'W11002723', 'UT01', 'University Health Care', 'Susanna', 'R', 'Cohen', 'CNM', 'Obstetrics and Gynecology', 'Certified Nurse Midwife', '', NULL, 'O', '50 N Medical Dr', 'Salt Lake City', 'Salt Lake', 'UT', '84132', '8015812121', NULL, '50 N Medical Dr', 'Salt Lake City', 'Salt Lake', 'UT', '84132', '8015812121', '          ', 'WUUUMG5', 'WUSTDHCPC5', '', '0.00', '25.00', '0.00', 3, '2007-12-21', '2012-09-18', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1033391552', 0, 'N', 0, '2012-09-19', NULL, NULL, 0, 0, NULL, NULL),
('870515631', 'W11002724', 'W11002724', 'UT01', 'U-U Rehabilitation Medicine', 'Trenaisa', 'M', 'Nay', 'APRN', 'Physical Medicine and Rehabilitation', NULL, NULL, NULL, 'B', 'PO Box 58609', 'Salt Lake City', 'Salt Lake', 'UT', '84158', '8017158238', NULL, NULL, NULL, '', NULL, NULL, '', '', 'WUUUMG5', 'WUSTDHCPC5', NULL, '0.00', '25.00', '0.00', 3, '2007-12-11', '2008-08-08', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1447373451', 0, 'y', 0, '2008-01-07', NULL, NULL, 0, 0, NULL, NULL),
('870515631', 'W11002725', 'W11002725', 'UT01', 'University Health Care', 'Trenaisa', 'M', 'Nay', 'APRN', 'Physical Medicine and Rehabilitation', NULL, NULL, NULL, 'O', '50 N Medical Dr', 'Salt Lake City', 'Salt Lake', 'UT', '84132', '8015812268', NULL, NULL, NULL, '', NULL, NULL, '', '', 'WUUUMG5', 'WUSTDHCPC5', NULL, '0.00', '25.00', '0.00', 3, '2007-12-11', '2008-08-08', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1447373451', 0, 'N', 0, '2008-01-07', NULL, NULL, 0, 0, NULL, NULL),
('870645895', 'W11002726', 'W11002726', 'UT01', 'U of U Pediatric Orthopedics', 'Alpesh', 'A', 'Patel', 'MD', 'Orthopedic Surgery', 'Pediatric Orthopedic Surgery', '', NULL, 'B', 'PO Box 413026', 'Salt Lake City', 'Salt Lake', 'UT', '84141', '8012133800', NULL, 'PO Box 413026', 'Salt Lake City', 'Salt Lake', 'UT', '84141', '8012133800', '          ', 'WUUPEDS', 'WUSTDHCPC5', '', '0.00', '15.00', '0.00', 3, '2007-12-01', '2012-08-01', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1639192164', 0, 'N', 0, '2012-08-02', NULL, NULL, 0, 0, NULL, NULL),
('870645895', 'W11002727', 'W11002727', 'UT01', 'University Health Care', 'Alpesh', 'A', 'Patel', 'MD', 'Orthopedic Surgery', 'Pediatric Orthopedic Surgery', '', NULL, 'O', '100 N Mario Capecchi Dr Ste 4550', 'Salt Lake City', 'Salt Lake', 'UT', '84113', '8016625600', NULL, '100 N Mario Capecchi Dr Ste 4550', 'Salt Lake City', 'Salt Lake', 'UT', '84113', '8016625600', '          ', 'WUUPEDS', 'WUSTDHCPC5', '', '0.00', '15.00', '0.00', 3, '2007-12-01', '2012-08-01', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1639192164', 0, 'N', 0, '2012-08-02', NULL, NULL, 0, 0, NULL, NULL),
('205529469', 'W11002728', 'W11002728', 'UT01', 'University Health Care Park City Mountain Resort Urgent Care', 'Alpesh', 'A', 'Patel', 'MD', 'Orthopedic Surgery', 'Pediatric Orthopedic Surgery', NULL, NULL, 'b', 'Po Box 58108 ', 'Salt Lake City', 'Salt Lake', 'UT', '84158', '8015813998', NULL, NULL, NULL, '', NULL, NULL, '', '', 'WUUUMG5', 'WUSTDHCPC5', NULL, '0.00', '25.00', NULL, 3, '2006-09-12', '2007-07-31', 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1639192164', 0, 'y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('205529469', 'W11002729', 'W11002729', 'UT01', 'University Health Care', 'Alpesh', 'A', 'Patel', 'MD', 'Orthopedic Surgery', 'Pediatric Orthopedic Surgery', NULL, NULL, 'O', '1493 Lowell Ave ', 'Park City', 'Summit', 'UT', '84060', '4356557970', NULL, NULL, NULL, '', NULL, NULL, '', '', 'WUUUMG5', 'WUSTDHCPC5', NULL, '0.00', '25.00', NULL, 3, '2006-09-12', '2007-07-31', 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1639192164', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('876000525', 'W11002730', 'W11002730', 'UT01', 'University of Utah Hospital', 'Catherine', 'N', 'Tibbs', 'PT', 'Physical Therapy', NULL, NULL, NULL, 'O', '50 N Medical Dr', 'Salt Lake City', 'Salt Lake', 'UT', '84132', '8015812121', NULL, '50 N Medical Dr', 'Salt Lake City', '', 'UT', '84132', '', '', '', NULL, '1', '0.00', '0.00', '0.00', 6, '2007-12-27', NULL, 1, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|', '1053585000', 0, 'N', 0, '2008-01-07', NULL, NULL, 40.7685, -111.837, NULL, NULL),
('876000525', 'W11002731', 'W11002731', 'UT01', 'University of Utah Hospital', 'Catherine', 'N', 'Tibbs', 'PT', 'Physical Therapy', NULL, NULL, NULL, 'B', 'PO Box 510721 ', 'Salt Lake City', 'Salt Lake', 'UT', '84151', '8015812121', NULL, '50 N Medical Dr', 'Salt Lake City', '', 'UT', '84132', '', '', NULL, NULL, '1', '0.00', NULL, NULL, 6, '2007-12-27', '2006-01-01', 1, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1053585000', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870567427', 'W11002732', 'W11002732', 'UT01', 'U of U Emergency Physicians', 'Shane', 'L', 'Graham', 'PA', 'Emergency Medicine', '', '', NULL, 'B', 'PO Box 510726', 'Salt Lake City', 'Salt Lake', 'UT', '84151', '8015876303', NULL, 'PO Box 510726', 'Salt Lake City', 'Salt Lake', 'UT', '84151', '8015876303', '          ', 'WUUUMG5', 'WUSTDHCPC5', '', '0.00', '25.00', '0.00', 3, '2007-12-31', '2012-09-19', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1376762104', 0, 'Y', 0, '2012-09-19', NULL, NULL, 0, 0, NULL, NULL),
('870567427', 'W11002733', 'W11002733', 'UT01', 'University Health Care', 'Shane', 'L', 'Graham', 'PA', 'Emergency Medicine', '', '', NULL, 'O', '50 N Medical Dr', 'Salt Lake City', 'Salt Lake', 'UT', '84132', '8015812292', NULL, '50 N Medical Dr', 'Salt Lake City', 'Salt Lake', 'UT', '84132', '8015812292', '          ', 'WUUUMG5', 'WUSTDHCPC5', '', '0.00', '25.00', '0.00', 3, '2007-12-31', '2012-09-19', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1376762104', 0, 'N', 0, '2012-09-19', NULL, NULL, 0, 0, NULL, NULL),
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('870395551', 'W11002735', 'W11002735', 'UT01', 'UofU Neursurgery', 'Jeffrey', 'J', 'Hebert', 'DC', 'Chiropractic', NULL, NULL, NULL, 'O', '175 N Medical Dr E 5th Floor', 'Salt Lake City', 'Salt Lake', 'UT', '84132', '8016426000', '8019420879', '867 E 9400 S', 'Sandy', '', 'UT', '84094', '', '', 'WLABRAD', 'WUSTDHCPC5', NULL, '0.00', '0.00', '55.46', 3, '2007-11-01', '2010-10-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1457449290', 0, 'N', 0, '2008-01-07', NULL, NULL, 0, 0, NULL, NULL),
('870395551', 'W11002736', 'W11002736', 'UT01', NULL, 'Richard', 'K', 'Madsen', 'DC', 'Chiropractic', NULL, NULL, NULL, 'B', '9135 S Monroe St Ste B', 'Sandy', 'Salt Lake', 'UT', '84070', '8013527270', '8013527024', '9135 S Monroe', 'Sandy', '', 'UT', '84070', '', '', 'WLABRAD', 'WUSTDHCPC5', NULL, '0.00', NULL, '55.46', 3, '2007-11-12', '2007-12-31', 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1609856558', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870395551', 'W11002737', 'W11002737', 'UT01', NULL, 'Richard', 'K', 'Madsen', 'DC', 'Chiropractic', NULL, NULL, NULL, 'O', '291 E 4500 S Ste C', 'Murray', 'Salt Lake', 'UT', '84107', '8012641235', '8012641805', '867 E 9400 S', 'Sandy', '', 'UT', '84094', '', '', 'WLABRAD', 'WUSTDHCPC5', NULL, '0.00', '0.00', '55.46', 3, '2007-11-12', '2010-10-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1609856558', 0, 'N', 0, '2008-01-07', NULL, NULL, 0, 0, NULL, NULL),
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('592852900', 'W11002738', 'W11002738', 'WY01', 'Lincare', '', '', 'Lincare', 'GROUP', 'Durable Medical Equipment', '', '', NULL, 'B', 'PO Box 4598', 'Casper', 'NATRONA', 'WY', '82606', '8003590240', NULL, 'PO Box 4598', 'Casper', 'NATRONA', 'WY', '82606', '8003590240', '          ', 'LINCAREWY', '', '', '0.00', '20.00', '0.00', 8, '2007-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '0000007285', 0, 'Y', 0, '2013-06-18', NULL, NULL, 0, 0, NULL, NULL),
('592852900', 'W11002739', 'W11002739', 'UT01', 'Lincare', '', '', 'Lincare', 'GROUP', 'Durable Medical Equipment', '', '', NULL, 'B', 'PO Box 3907', 'Spokane', 'Spokane', 'WA', '99220', '8002180777', NULL, 'PO Box 3907', 'Spokane', 'Spokane', 'WA', '99220', '8002180777', '          ', 'WLINCARE', '', '', '0.00', '20.00', '0.00', 8, '2007-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '0000007285', 0, 'Y', 0, '2013-06-18', NULL, NULL, 0, 0, NULL, NULL),
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('592852900', 'W11002744', 'W11002744', 'UT01', 'Lincare Inc', '', '', 'Lincare', 'GROUP', 'Durable Medical Equipment', '', '', NULL, 'O', '255 N 950 W Ste 18', 'Logan', 'Cache', 'UT', '84321', '4357192090', NULL, '255 N 950 W Ste 18', 'Logan', 'Cache', 'UT', '84321', '4357192090', '          ', 'WLINCARE', '', '', '0.00', '20.00', '0.00', 8, '2007-01-01', '2011-02-22', 1, 0, 0, '', '', '', '', 'HCFA|UB|', '1215945399', 0, 'N', 0, '2013-06-18', NULL, NULL, 0, 0, NULL, NULL),
('592852900', 'W11002745', 'W11002745', 'UT01', 'Lincare', '', '', 'Lincare', 'GROUP', 'Durable Medical Equipment', '', '', NULL, 'O', '1181 S Hwy 191 Bldg 3', 'Moab', 'Grand', 'UT', '84532', '4357192090', NULL, '1181 S Hwy 191 Bldg 3', 'Moab', 'Grand', 'UT', '84532', '4357192090', '          ', 'WLINCARE', '', '', '0.00', '20.00', '0.00', 8, '2007-01-01', NULL, 1, 0, 0, '', '', '', '', 'HCFA|UB|', '1538238001', 0, 'N', 0, '2013-06-18', NULL, NULL, 0, 0, NULL, NULL),
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('592852900', 'W11002748', 'W11002748', 'UT01', 'Lincare', '', '', 'Lincare', 'GROUP', 'Durable Medical Equipment', '', '', NULL, 'O', '551 E Ctr', 'Panguitch', 'Garfield', 'UT', '84759', '4356768686', NULL, '551 E Ctr', 'Panguitch', 'Garfield', 'UT', '84759', '4356768686', '          ', 'WLINCARE', '', '', '0.00', '20.00', '0.00', 8, '2007-01-01', NULL, 1, 0, 0, '', '', '', '', 'HCFA|UB|', '1316017387', 0, 'N', 0, '2013-06-18', NULL, NULL, 0, 0, NULL, NULL),
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('592852900', 'W11002750', 'W11002750', 'UT01', 'Lincare', '', '', 'Lincare', 'GROUP', 'Durable Medical Equipment', '', '', NULL, 'O', '201 N Main S', 'Richfield', 'Sevier', 'UT', '84701', '4358938900', NULL, '201 N Main S', 'Richfield', 'Sevier', 'UT', '84701', '4358938900', '          ', 'WLINCARE', '', '', '0.00', '20.00', '0.00', 8, '2007-01-01', NULL, 1, 0, 0, '', '', '', '', 'HCFA|UB|', '1538238126', 0, 'N', 0, '2013-06-18', NULL, NULL, 0, 0, NULL, NULL),
('592852900', 'W11002751', 'W11002751', 'UT01', 'Lincare', '', '', 'Lincare', 'GROUP', 'Durable Medical Equipment', '', '', NULL, 'O', '291 E 1400 S Ste 5', 'St George', 'Washington', 'UT', '84790', '4356744477', NULL, '291 E 1400 S Ste 5', 'St George', 'Washington', 'UT', '84790', '4356744477', '          ', 'WLINCARE', '', '', '0.00', '20.00', '0.00', 8, '2007-01-01', NULL, 1, 0, 0, '', '', '', '', 'HCFA|UB|', '1154490753', 0, 'N', 0, '2013-06-18', NULL, NULL, 0, 0, NULL, NULL),
('592852900', 'W11002752', 'W11002752', 'UT01', 'Lincare', '', '', 'Lincare', 'GROUP', 'Durable Medical Equipment', '', '', NULL, 'O', '1735 S Redwood Rd Ste 130', 'Salt Lake City', 'Salt Lake', 'UT', '84104', '8014870202', NULL, '1735 S Redwood Rd Ste 130', 'Salt Lake City', 'Salt Lake', 'UT', '84104', '8014870202', '          ', 'WLINCARE', '', '', '0.00', '20.00', '0.00', 8, '2007-01-01', NULL, 1, 0, 0, '', '', '', '', 'HCFA|UB|', '1760490940', 0, 'N', 0, '2013-06-18', NULL, NULL, 40.7327, -111.939, NULL, NULL),
('592852900', 'W11002753', 'W11002753', 'UT01', 'Lincare', '', '', 'Lincare', 'GROUP', 'Durable Medical Equipment', '', '', NULL, 'O', '39 N Main St', 'Tooele', 'Tooele', 'UT', '84074', '4358434373', NULL, '39 N Main St', 'Tooele', 'Tooele', 'UT', '84074', '4358434373', '          ', 'WLINCARE', '', '', '0.00', '20.00', '0.00', 8, '2007-01-01', NULL, 1, 0, 0, '', '', '', '', 'HCFA|UB|', '1730197815', 0, 'N', 0, '2013-06-18', NULL, NULL, 0, 0, NULL, NULL),
('742855814', 'W11002754', 'W11002754', 'TX01', 'Toepperwein Med Clinic', 'Nadine', NULL, 'Liu', 'DO', 'Internal Medicine', 'Pediatrics', NULL, NULL, 'O', '11901 Toepperwein Ste 1402', 'San Antonio', 'Bexar', 'TX', '78233', '2105993840', NULL, '11901 Toepperwein', 'San Antonio', '', 'TX', '78233', '', '', 'TXINT', 'TXHCPCS', NULL, '0.00', '50.00', '0.00', 3, '2008-01-01', '2010-05-16', NULL, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1033165634', 0, 'n', 0, '2008-01-21', NULL, NULL, 29.5463, -98.343, NULL, NULL),
('870460171', 'W11002756', 'W11002756', 'UT01', NULL, 'William', 'J', 'Bogus', 'OD', 'Optometry', '', '', NULL, 'O', '2319 Highland Dr', 'Salt Lake City', 'Salt Lake', 'UT', '84106', '8014851371', NULL, '2319 Highland Dr', 'Salt Lake City', 'Salt Lake', 'UT', '84106', '8014851371', '', 'WISESTD', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 3, '2008-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1265414569', 0, 'n', 0, '2014-05-08', NULL, NULL, 40.7205, -111.858, NULL, NULL),
('205362765', 'W11002757', 'W11002757', 'UT01', 'Child and Family Eye Care Center', 'Robin', 'S', 'Price', 'OD', 'Optometry', '', '', NULL, 'O', '908 N 2000 W', 'Pleasant Grove', 'Utah', 'UT', '84062', '8014926393', NULL, '908 N 2000 W', 'Pleasant Grove', 'Utah', 'UT', '84062', '8014926393', '', 'WISESTD', 'WUSTDHCPC5', NULL, '0.00', '35.00', '0.00', 3, '2008-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1932205440', 0, 'n', 0, '2013-12-04', NULL, NULL, 40.3707, -111.769, NULL, NULL),
('562326691', 'W11002758', 'W11002758', 'UT01', 'Jordan Landing Clinic', 'Brenten', 'C', 'Pugh', 'MD', 'Family Practice', '', '', NULL, 'O', '7478 Campus View Dr Ste 100', 'West Jordan', 'Salt Lake', 'UT', '84084', '8012807774', NULL, '7478 Campus View Dr Ste 100', 'West Jordan', 'Salt Lake', 'UT', '84084', '8012807774', '          ', 'WiseSTD', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 3, '2007-09-01', '2011-06-14', 0, 0, 0, 'Jordan Valley Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1235158304', 0, 'N', 0, '2011-05-31', NULL, NULL, 0, 0, NULL, NULL),
('870519172', 'W11002759', 'W11002759', 'UT01', 'Utah Heart Clinic', 'James', 'Lee', 'Burke', 'MD', 'Cardiovascular Disease', '', '', NULL, 'O', '9844 S 1300 E Ste 350', 'Salt Lake City', 'Salt Lake', 'UT', '84094', '8013070893', '8014083909', '9844 S 1300 E Ste 350', 'Salt Lake City', 'Salt Lake', 'UT', '84094', '8013070893', '8014083909', 'WUSTDCARD5', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 3, '2006-06-01', '2008-05-04', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1154399459', 0, 'N', 0, '2014-05-19', NULL, NULL, 0, 0, NULL, NULL),
('870519172', 'W11002760', 'W11002760', 'UT01', 'Utah Heart Clinic', 'Peter', 'J', 'Casterella', 'MD', 'Cardiovascular Disease', '', '', NULL, 'O', '9844 S 1300 E Ste 350', 'Salt Lake City', 'Salt Lake', 'UT', '84094', '8013070893', '8014083909', '5169 S Cottonwood', 'Murray', '', 'UT', '84107', '', '', 'WUSTDCARD5', 'WUSTDHCPC5', NULL, '0.00', '35.00', '0.00', 3, '2006-06-01', '2008-05-04', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1063480655', 0, 'N', 0, '2009-02-02', NULL, NULL, 0, 0, NULL, NULL),
('870519172', 'W11002761', 'W11002761', 'UT01', 'Utah Heart Clinic', 'Brian', 'G', 'Crandall', 'MD', 'Cardiovascular Disease', '', '', NULL, 'O', '9844 S 1300 E Ste 350', 'Salt Lake City', 'Salt Lake', 'UT', '84094', '8013070893', '8014083909', '9844 S 1300 E Ste 350', 'Salt Lake City', 'Salt Lake', 'UT', '84094', '8013070893', '8014083909', 'WUSTDCARD5', 'WUSTDHCPC5', NULL, '0.00', '35.00', '0.00', 3, '2006-06-01', '2008-05-04', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1669440269', 0, 'N', 0, '2011-02-16', NULL, NULL, 0, 0, NULL, NULL),
('870519172', 'W11002762', 'W11002762', 'UT01', 'Utah Heart Clinic', 'John', 'D', 'Day', 'MD', 'Cardiovascular Disease', '', '', NULL, 'O', '9844 S 1300 E Ste 350', 'Salt Lake City', 'Salt Lake', 'UT', '84094', '8013070893', '8014083909', '9844 S 1300 E Ste 350', 'Salt Lake City', 'Salt Lake', 'UT', '84094', '8013070893', '8014083909', 'WUSTDCARD5', 'WUSTDHCPC5', NULL, '0.00', '35.00', '0.00', 3, '2006-06-01', '2008-05-04', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1811965122', 0, 'N', 0, '2011-06-29', NULL, NULL, 0, 0, NULL, NULL),
('870519172', 'W11002763', 'W11002763', 'UT01', 'Utah Heart Clinic', 'Steven', 'Curtis', 'Horton', 'MD', 'Cardiovascular Disease', 'Internal Medicine', '', NULL, 'O', '9844 S 1300 E Ste 350', 'Salt Lake City', 'Salt Lake', 'UT', '84094', '8013070893', '8014083909', '9844 S 1300 E Ste 350', 'Salt Lake City', 'Salt Lake', 'UT', '84094', '8013070893', '8014083909', 'WUSTDCARD5', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 3, '2006-06-01', '2008-05-04', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1043288640', 0, 'N', 0, '2014-05-19', NULL, NULL, 0, 0, NULL, NULL),
('870519172', 'W11002764', 'W11002764', 'UT01', 'Utah Heart Clinic', 'Donald', 'Lewis', 'Lappe', 'MD', 'Cardiovascular Disease', 'Internal Medicine', '', NULL, 'O', '9844 S 1300 E Ste 350', 'Salt Lake City', 'Salt Lake', 'UT', '84094', '8013070893', '8014083909', '9844 S 1300 E Ste 350', 'Salt Lake City', 'Salt Lake', 'UT', '84094', '8013070893', '8014083909', 'WUSTDCARD5', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 3, '2006-06-01', '2008-05-04', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1669440277', 0, 'N', 0, '2014-05-22', NULL, NULL, 0, 0, NULL, NULL),
('870519172', 'W11002765', 'W11002765', 'UT01', 'Utah Heart Clinic', 'Dean', 'A', 'Mayer', 'MD', 'Hospitalist', '', '', NULL, 'O', '9844 S 1300 E Ste 350', 'Salt Lake City', 'Salt Lake', 'UT', '84094', '8013070893', '8014083909', '9844 S 1300 E Ste 350', 'Salt Lake City', 'Salt Lake', 'UT', '84094', '8013070893', '8014083909', 'WUSTDCARD5', 'WUSTDHCPC5', NULL, '0.00', '35.00', '0.00', 3, '2006-06-01', '2008-05-04', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1316915432', 0, 'N', 0, '2011-09-26', NULL, NULL, 0, 0, NULL, NULL),
('870519172', 'W11002766', 'W11002766', 'UT01', 'Utah Heart Clinic', 'Jeffrey', 'S', 'Osborn', 'MD', 'Cardiovascular Disease', '', '', NULL, 'O', '9844 S 1300 E Ste 350', 'Salt Lake City', 'Salt Lake', 'UT', '84094', '8013070893', '8014083909', '9844 S 1300 E Ste 350', 'Salt Lake City', 'Salt Lake', 'UT', '84094', '8013070893', '8014083909', 'WUSTDCARD5', 'WUSTDHCPC5', NULL, '0.00', '35.00', '0.00', 3, '2006-06-01', '2008-05-04', 0, 0, 0, 'Salt Lake Regional Medical Center', '', '', '', 'HCFA|UB|', '1043288368', 0, 'N', 0, '2011-02-16', NULL, NULL, 0, 0, NULL, NULL),
('870519172', 'W11002767', 'W11002767', 'UT01', 'Utah Heart Clinic', 'James', 'R', 'Revenaugh', 'MD', 'Cardiovascular Disease', '', '', NULL, 'O', '9844 S 1300 E Ste 350', 'Salt Lake City', 'Salt Lake', 'UT', '84094', '8013070893', '8014083909', '9844 S 1300 E Ste 350', 'Salt Lake City', 'Salt Lake', 'UT', '84094', '8013070893', '8014083909', 'WUSTDCARD5', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 3, '2006-06-01', '2008-05-04', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1316915952', 0, 'N', 0, '2014-05-19', NULL, NULL, 0, 0, NULL, NULL),
('870519172', 'W11002768', 'W11002768', 'UT01', 'Utah Heart Clinic', 'Kevin', 'J', 'Walsh', 'MD', 'Cardiovascular Disease', '', '', NULL, 'O', '9844 S 1300 E Ste 350', 'Salt Lake City', 'Salt Lake', 'UT', '84094', '8013070893', '8014083909', '9844 S 1300 E Ste 350', 'Salt Lake City', 'Salt Lake', 'UT', '84094', '8013070893', '8014083909', 'WUSTDCARD5', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 3, '2006-06-01', '2008-05-04', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1609845734', 0, 'N', 0, '2014-05-19', NULL, NULL, 0, 0, NULL, NULL),
('870519172', 'W11002769', 'W11002769', 'UT01', 'Utah Heart Clinic', 'J Peter', '', 'Weiss', 'MD', 'Cardiovascular Disease', '', '', NULL, 'O', '9844 S 1300 E Ste 350', 'Salt Lake City', 'Salt Lake', 'UT', '84094', '8013070893', '8014083909', '9844 S 1300 E Ste 350', 'Salt Lake City', 'Salt Lake', 'UT', '84094', '8013070893', '8014083909', 'WUSTDCARD5', 'WUSTDHCPC5', NULL, '0.00', '35.00', '0.00', 3, '2006-06-01', '2008-05-04', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1528036654', 0, 'N', 0, '2011-06-29', NULL, NULL, 0, 0, NULL, NULL),
('870519172', 'W11002770', 'W11002770', 'UT01', 'Utah Heart Clinic', 'Brian', 'K', 'Whisenant', 'MD', 'Cardiovascular Disease', '', '', NULL, 'O', '9844 S 1300 E Ste 350', 'Salt Lake City', 'Salt Lake', 'UT', '84094', '8013070893', '8014083909', '9844 S 1300 E Ste 350', 'Salt Lake City', 'Salt Lake', 'UT', '84094', '8013070893', '8014083909', 'WUSTDCARD5', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 3, '2006-06-01', '2008-05-04', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1750359253', 0, 'N', 0, '2014-06-20', NULL, NULL, 0, 0, NULL, NULL),
('870519172', 'W11002771', 'W11002771', 'UT01', 'Utah Heart Clinic', 'Ruben', 'Alberto', 'Zito', 'MD', 'Cardiovascular Disease', 'Internal Medicine', '', NULL, 'O', '324 10th Ave Ste 206', 'Salt Lake City', 'Salt Lake', 'UT', '84103', '8014083900', '8014083909', '324 10th Ave Ste 206', 'Salt Lake City', 'Salt Lake', 'UT', '84103', '8014083900', '8014083909', 'WUSTDCARD5', 'WUSTDHCPC5', NULL, '0.00', '35.00', '0.00', 3, '2006-06-01', '2008-05-04', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1811907397', 0, 'N', 0, '2013-11-18', NULL, NULL, 0, 0, NULL, NULL),
('810608733', 'W11002773', 'W11002773', 'UT01', 'Nexus Pain Care', 'Peter', 'R', 'Bodnar', 'MD', 'Physical Medicine and Rehabilitation', 'Neurology', NULL, NULL, 'O', '3570 W 9000 S Ste 100', 'West Jordan', 'Salt Lake', 'UT', '84088', '8015691999', NULL, '3585 N University Ave', 'Provo', '', 'UT', '84604', '', '', 'WUSTDPAIN5', 'WUSTDHCPC5', NULL, '0.00', '35.00', '0.00', 3, '2007-12-01', '2008-11-01', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1083762389', 0, 'N', 0, '2008-01-23', NULL, NULL, 0, 0, NULL, NULL),
('870540039', 'W11002774', 'W11002774', 'UT01', 'Midtown Community Health Center', NULL, NULL, 'Midtown Community Health Center', 'GROUP', 'Family Practice', NULL, NULL, NULL, 'O', '2240 Adams Ave', 'Ogden', 'Weber', 'UT', '84401', '8013935355', '8013944609', '2240 Adams Ave', 'Ogden', '', 'UT', '84401', '', '', 'WISESTD', 'WUSTDHCPC5', NULL, '0.00', '35.00', '0.00', 3, '2008-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '0000007601', 0, 'n', 0, '2008-01-22', NULL, NULL, 41.2261, -111.968, NULL, NULL),
('870540039', 'W11002775', 'W11002775', 'UT01', 'Midtown Community Health Center', 'Richard', 'J', 'Gregoire', 'MD PHD', 'Family Practice', '', '', NULL, 'O', '2240 Adams Ave', 'Ogden', 'Weber', 'UT', '84401', '8013935355', NULL, '2240 Adams Ave', 'Ogden', 'Weber', 'UT', '84401', '8013935355', '', 'WISESTD', 'WUSTDHCPC5', NULL, '0.00', '35.00', '0.00', 3, '2008-01-01', NULL, 0, 0, 0, 'Logan Regional Hospital', '', '', '', 'HCFA|UB|', '1528066149', 0, 'n', 0, '2011-11-17', NULL, NULL, 41.2261, -111.968, NULL, NULL),
('870540039', 'W11002776', 'W11002776', 'UT01', 'Midtown Community Health Center', 'Kurt', 'E', 'Rifleman', 'MD', 'Family Practice', '', '', NULL, 'O', '2240 Adams Ave', 'Ogden', 'Weber', 'UT', '84401', '8013935355', NULL, '2240 Adams Ave', 'Ogden', 'Weber', 'UT', '84401', '8013935355', '', 'WISESTD', 'WUSTDHCPC5', NULL, '0.00', '35.00', '0.00', 3, '2008-01-01', NULL, 0, 0, 0, 'Ogden Regional Medical Center', '', '', '', 'HCFA|UB|', '1780682567', 0, 'n', 0, '2013-09-09', NULL, NULL, 41.2261, -111.968, NULL, NULL),
('870540039', 'W11002777', 'W11002777', 'UT01', 'Midtown Community Health Center', 'Kirk', 'R', 'Overdiek', 'FNP', 'Family Practice', '', '', NULL, 'O', '2240 Adams Ave', 'Ogden', 'Weber', 'UT', '84401', '8013935355', NULL, '2240 Adams Ave', 'Ogden', 'Weber', 'UT', '84401', '8013935355', '', 'WISESTD', 'WUSTDHCPC5', NULL, '0.00', '35.00', '0.00', 3, '2008-01-01', '2009-11-07', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1619160041', 0, 'n', 0, '2011-02-24', NULL, NULL, 0, 0, NULL, NULL),
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('870540039', 'W11002779', 'W11002779', 'UT01', 'Midtown Community Health Center', 'Michael', 'J', 'Lemperle', 'PAC', 'Family Practice', '', '', NULL, 'O', '2240 Adams Ave', 'Ogden', 'Weber', 'UT', '84401', '8013935355', NULL, '2240 Adams Ave', 'Ogden', 'Weber', 'UT', '84401', '8013935355', '', 'WISESTD', 'WUSTDHCPC5', NULL, '0.00', '35.00', '0.00', 3, '2008-01-01', '2008-03-28', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1720268204', 0, 'n', 0, '2013-03-12', NULL, NULL, 0, 0, NULL, NULL),
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('870540039', 'W11002781', 'W11002781', 'UT01', 'Midtown Community Health Center', 'Mark', 'D', 'Housley', 'MD', 'Family Practice', '', '', NULL, 'O', '2240 Adams Ave', 'Ogden', 'Weber', 'UT', '84401', '8013935355', NULL, '2240 Adams Ave', 'Ogden', 'Weber', 'UT', '84401', '8013935355', '', 'WISESTD', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 3, '2008-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1457358335', 0, 'N', 0, '2014-04-17', NULL, NULL, 41.2261, -111.968, NULL, NULL),
('870540039', 'W11002782', 'W11002782', 'UT01', 'Midtown Community Health Center', 'Tiffanie', 'A', 'Haun', 'FNP', 'Family Practice', '', '', NULL, 'O', '2240 Adams Ave', 'Ogden', 'Weber', 'UT', '84401', '8013935355', NULL, '2240 Adams Ave', 'Ogden', 'Weber', 'UT', '84401', '8013935355', '', 'WISESTD', 'WUSTDHCPC5', NULL, '0.00', '35.00', '0.00', 3, '2008-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1659348159', 0, 'n', 0, '2011-08-09', NULL, NULL, 41.2261, -111.968, NULL, NULL),
('870540039', 'W11002783', 'W11002783', 'UT01', 'Midtown Community Health Center', 'Nathan', 'M', 'Hadley', 'LCSW MSW', 'Mental Health', 'Social Worker', '', NULL, 'O', '2240 Adams Ave', 'Ogden', 'Weber', 'UT', '84401', '8013935355', NULL, '2240 Adams Ave', 'Ogden', 'Weber', 'UT', '84401', '8013935355', '', 'WISESTD', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 3, '2008-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1265440713', 0, 'n', 0, '2014-05-27', NULL, NULL, 41.2261, -111.968, NULL, NULL),
('870540039', 'W11002784', 'W11002784', 'UT01', 'Midtown Community Health Center', 'Kenneth', 'A', 'Garcia', 'PAC', 'Family Practice', NULL, NULL, NULL, 'B', '2240 Adams Ave', 'Ogden', 'Weber', 'UT', '84401', '8013935355', NULL, '2240 Adams Ave', 'Ogden', '', 'UT', '84401', '', '', 'WISESTD', 'WUSTDHCPC5', NULL, '0.00', '35.00', '0.00', 3, '2008-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1154413235', 0, 'Y', 0, '2008-01-22', NULL, NULL, 0, 0, NULL, NULL),
('870540039', 'W11002785', 'W11002785', 'UT01', 'Midtown Community Health Center', 'Karen', 'E', 'Anderson', 'FNP', 'Family Practice', NULL, NULL, NULL, 'O', '2240 Adams Ave', 'Ogden', 'Weber', 'UT', '84401', '8013935355', NULL, '2240 Adams Ave', 'Ogden', '', 'UT', '84401', '', '', 'WISESTD', 'WUSTDHCPC5', NULL, '0.00', '35.00', '0.00', 3, '2008-01-01', '2008-04-04', NULL, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1679691083', 0, 'n', 0, '2008-01-22', NULL, NULL, 0, 0, NULL, NULL),
('870540039', 'W11002786', 'W11002786', 'UT01', 'Davis County Medical Clinic', NULL, NULL, 'Midtown Community Health Center', 'GROUP', 'Health Department', 'Family Practice', '', NULL, 'O', '50 E State St', 'Farmington', 'Davis', 'UT', '84025', '8014513711', NULL, '50 E State St', 'Farmington', 'Davis', 'UT', '84025', '8014513711', '          ', 'WISESTD', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 3, '2008-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '0000005912', 0, 'N', 0, '2013-07-25', NULL, NULL, 40.9805, -111.886, NULL, NULL),
('870540039', 'W11002787', 'W11002787', 'UT01', 'Davis County Medical Clinic', 'Eileen', '', 'Torpy', 'LCSW', 'Mental Health', 'Social Worker', '', NULL, 'O', '50 E State St', 'Farmington', 'Davis', 'UT', '84025', '8014513711', NULL, '50 E State St', 'Farmington', 'Davis', 'UT', '84025', '8014513711', '          ', 'WISESTD', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 3, '2008-01-01', '2014-03-12', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1447365184', 0, 'N', 0, '2014-03-14', NULL, NULL, 40.9805, -111.886, NULL, NULL),
('870540039', 'W11002788', 'W11002788', 'UT01', 'Davis County Medical Clinic', 'Ryan', 'R', 'Horning', 'PAC', 'Family Practice', 'Emergency Medicine', '', NULL, 'O', '50 E State St', 'Farmington', 'Davis', 'UT', '84025', '8014513711', NULL, '50 E State St', 'Farmington', 'Davis', 'UT', '84025', '8014513711', '', 'WISESTD', 'WUSTDHCPC5', NULL, '0.00', '35.00', '0.00', 3, '2008-01-01', '2008-09-30', 0, 0, 0, 'Davis Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1497752372', 0, 'n', 0, '2010-12-08', NULL, NULL, 0, 0, NULL, NULL),
('870540039', 'W11002789', 'W11002789', 'UT01', 'Davis County Medical Clinic', 'Richard', 'J', 'Gregoire', 'MD PHD', 'Family Practice', '', '', NULL, 'O', '50 E State St', 'Farmington', 'Davis', 'UT', '84025', '8014513711', NULL, '50 E State St', 'Farmington', 'Davis', 'UT', '84025', '8014513711', '          ', 'WISESTD', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 3, '2008-01-01', '2011-11-15', 0, 0, 0, 'Logan Regional Hospital', '', '', '', 'HCFA|UB|', '1528066149', 0, 'N', 0, '2011-11-17', 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
('870540039', 'W11002790', 'W11002790', 'UT01', 'Davis County Medical Clinic', 'Adam', 'R', 'Nebeker', 'MD', 'Family Practice', NULL, NULL, NULL, 'O', '50 E State St', 'Farmington', 'Davis', 'UT', '84025', '8014513711', NULL, '2240 Adams Ave', 'Ogden', '', 'UT', '84401', '', '', 'WISESTD', 'WUSTDHCPC5', NULL, '0.00', '35.00', '0.00', 3, '2008-01-01', '2008-09-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1366449241', 0, 'n', 0, '2008-01-22', NULL, NULL, 0, 0, NULL, NULL),
('870540039', 'W11002791', 'W11002791', 'UT01', 'Davis County Medical Clinic', 'Emily', NULL, 'Ostarcevic', 'FNP', 'Family Practice', NULL, NULL, NULL, 'O', '50 E State St', 'Farmington', 'Davis', 'UT', '84025', '8014513711', NULL, '2240 Adams Ave', 'Ogden', '', 'UT', '84401', '', '', 'WISESTD', 'WUSTDHCPC5', NULL, '0.00', '35.00', '0.00', 3, '2008-01-01', '2008-06-27', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1821286923', 0, 'n', 0, '2008-01-22', NULL, NULL, 0, 0, NULL, NULL),
('870467991', 'W11002792', 'W11002792', 'UT01', 'Salt Lake Endoscopy Center', '', '', 'Salt Lake Endoscopy Center', 'GROUP', 'Endoscopy Center', '', '', NULL, 'O', '24 S 1100 E Ste 103', 'Salt Lake City', 'Salt Lake', 'UT', '84101', '8013552988', NULL, '24 S 1100 E Ste 103', 'Salt Lake City', 'Salt Lake', 'UT', '84101', '8013552988', '          ', 'WISESTD', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 3, '2008-01-01', '2010-10-19', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1609896216', 0, 'N', 0, '2012-06-29', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11002801', 'W11002801', 'WY01', 'Billings Clinic - Peds', 'Kimberly', 'L', 'Ackerman', 'FNP', 'Endocrinology', 'Pediatrics', NULL, NULL, 'O', '2800 10th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4066574150', '4066574349', 'PO Box 37000', 'Billings', '', 'MT', '59107', '', '', '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2008-02-01', '2009-04-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1922032861', 0, 'N', 0, '2010-01-15', NULL, NULL, 0, 0, NULL, NULL),
('562349471', 'W11002793', 'W11002793', 'UT01', 'New Horizon Health Care', 'Cindy', '', 'Stock', 'APRN', 'General Surgery', 'Family Practice', '', NULL, 'B', 'PO Box 708757', 'Sandy', 'Salt Lake', 'UT', '84070', '8013741010', NULL, 'PO Box 708757', 'Sandy', 'Salt Lake', 'UT', '84070', '8013741010', '', 'WiseSTD', 'WUSTDHCPC5', NULL, '0.00', '35.00', '0.00', 3, '2006-12-01', '2010-02-17', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1841470879', 0, 'Y', 0, '2013-05-06', NULL, NULL, 0, 0, NULL, NULL),
('870281028', 'W11002794', 'W11002794', 'UT01', 'Central Utah Clinic', 'Thu', 'A', 'Nguyen', 'MD', 'Neurology', '', '', NULL, 'B', 'PO Box 30079', 'Salt Lake City', 'Salt Lake', 'UT', '84130', '8013758858', NULL, 'PO Box 30079', 'Salt Lake City', 'Salt Lake', 'UT', '84130', '8013758858', '          ', 'WUUVPN10', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 6, '2007-12-19', '2010-07-14', 0, 0, 0, 'Timpanogos Regional Hospital', '', '', '', 'HCFA|UB|', '1649204389', 0, 'N', 0, '2013-11-25', NULL, NULL, 0, 0, NULL, NULL),
('870281028', 'W11002795', 'W11002795', 'UT01', 'Central Utah Clinic', 'Thu', 'A', 'Nguyen', 'MD', 'Neurology', '', '', NULL, 'O', '1175 E 50 S Ste 161', 'American Fork', 'Utah', 'UT', '84003', '8014925992', NULL, '1175 E 50 S Ste 161', 'American Fork', 'Utah', 'UT', '84003', '8014925992', '          ', 'WUUVPN10', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 6, '2007-12-19', '2010-07-14', 0, 0, 0, 'Timpanogos Regional Hospital', '', '', '', 'HCFA|UB|', '1649204389', 0, 'N', 0, '2013-11-25', NULL, NULL, 0, 0, NULL, NULL),
('205550845', 'W11002796', 'W11002796', 'UT01', 'Park City Imaging Inc', NULL, NULL, 'Park City Imaging Inc', 'GROUP', 'Imaging Center', 'Radiology', NULL, NULL, 'B', 'PO Box 470', 'Ogden', 'Weber', 'UT', '84402', '4356150250', NULL, '1850 Sidewinder Dr', 'Park City', '', 'UT', '84060', '', '', 'WISESTD', 'WUSTDHCPC5', NULL, '0.00', '35.00', '0.00', 3, '2008-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '0000008058', 0, 'Y', 0, '2008-01-22', NULL, NULL, 0, 0, NULL, NULL),
('870550021', 'W11002797', 'W11002797', 'UT01', 'Alta View Internal Medicine', 'Robin', 'S', 'Poppen', 'MD', 'Internal Medicine', '', '', NULL, 'B', '5630 Waterbury Way Ste B102', 'Salt Lake City', 'Salt Lake', 'UT', '84121', '8012742000', NULL, '5630 Waterbury Way Ste B102', 'Salt Lake City', 'Salt Lake', 'UT', '84121', '8012742000', '', 'WiseSTD', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 3, '2007-09-01', '2013-12-31', 0, 0, 0, 'St Marks Hospital', '', '', '', 'HCFA|UB|', '1588698831', 0, 'Y', 0, '2014-04-09', NULL, NULL, 0, 0, NULL, NULL),
('870550021', 'W11002798', 'W11002798', 'UT01', 'Alta View Internal Medicine', 'Robin', 'S', 'Poppen', 'MD', 'Internal Medicine', '', '', NULL, 'O', '10965 S State St Ste 100', 'Sandy', 'Salt Lake', 'UT', '84070', '8015720311', NULL, '10965 S State St Ste 100', 'Sandy', 'Salt Lake', 'UT', '84070', '8015720311', '', 'WiseSTD', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 3, '2007-09-01', '2013-12-31', 0, 0, 0, 'St Marks Hospital', '', '', '', 'HCFA|UB|', '1588698831', 0, 'N', 0, '2014-04-09', NULL, NULL, 40.5523, -111.891, NULL, NULL),
('810608733', 'W11002799', 'W11002799', 'UT01', 'Nexus Pain Care', 'Peter', 'R', 'Bodnar', 'MD', 'Physical Medicine and Rehabilitation', 'Neurology', NULL, NULL, 'B', 'PO Box 15109', 'Springfield', 'Hampden', 'MA', '01115', '8013566100', NULL, '3585 N University Ave', 'Provo', '', 'UT', '84604', '', '', 'WUSTDPAIN5', 'WUSTDHCPC5', NULL, '0.00', '35.00', '0.00', 3, '2007-12-01', '2008-11-01', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1083762389', 0, 'Y', 0, '2008-01-23', NULL, NULL, 0, 0, NULL, NULL),
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('810231784', 'W11002826', 'W11002826', 'WY01', 'Billings Clinic - Internal Medicine', 'Karen', NULL, 'Cabell', 'DO', 'Internal Medicine', NULL, NULL, NULL, 'O', '2825 8th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4062382501', '4062382771', 'PO Box 37000', 'Billings', '', 'MT', '59107', '', '', '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2008-02-01', '2009-04-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1528177284', 0, 'N', 0, '2010-01-15', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11002827', 'W11002827', 'WY01', 'Billings Clinic - Neurology', 'Patrick', NULL, 'Cahill', 'MD', 'Neurology', NULL, NULL, NULL, 'O', '2825 8th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4062382501', '4062382805', 'PO Box 37000', 'Billings', '', 'MT', '59107', '', '', '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2008-02-01', '2009-04-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1235248907', 0, 'N', 0, '2009-05-04', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11002828', 'W11002828', 'WY01', 'Billings Clinic - Orthopedics & Sports Medicine', 'Bridget', NULL, 'Cannon', 'PT', 'Physical Therapy', NULL, NULL, NULL, 'O', '2702 8th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4062382501', '4062385218', 'PO Box 37000', 'Billings', '', 'MT', '59107', '', '', '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2008-02-01', '2009-04-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1013972553', 0, 'N', 0, '2009-05-04', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11002829', 'W11002829', 'WY01', 'Billings Clinic - Radiology', 'Bryan', NULL, 'Canty', 'MD', 'Radiologist', NULL, NULL, NULL, 'O', '2800 10th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4066574150', '4066574349', 'PO Box 37000', 'Billings', '', 'MT', '59107', '', '', '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2008-02-01', '2009-04-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1841309515', 0, 'N', 0, '2009-05-04', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11002830', 'W11002830', 'WY01', 'Billings Clinic - Heights Clinic', 'Stephanie', NULL, 'Canty', 'MD', 'Family Practice', NULL, NULL, NULL, 'O', '760 Wicks Ln', 'Billings', 'Yellowstone', 'MT', '59105', '4062562575', '4062382586', 'PO Box 37000', 'Billings', '', 'MT', '59107', '', '', '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2008-02-01', '2009-04-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1093824773', 0, 'N', 0, '2009-05-04', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11002831', 'W11002831', 'WY01', 'Billings Clinic - Internal Medicine', 'Frederick', 'D', 'Carr', 'MD', 'Internal Medicine', NULL, NULL, NULL, 'O', '2825 8th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4062382501', NULL, 'PO Box 37000', 'Billings', '', 'MT', '59107', '', '', '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2008-02-01', '2009-04-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1154430767', 0, 'N', 0, '2010-01-15', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11002832', 'W11002832', 'WY01', 'Billings Clinic - Geriatrics', 'Carolin', '', 'Cassel', 'FNP', 'Mental Health', 'Psychiatry', '', NULL, 'O', '2825 8th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4062382501', '4062382413', '2825 8th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4062382501', '4062382413', '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2010-06-14', '2008-02-01', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1154330397', 0, 'N', 0, '2010-07-12', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11002833', 'W11002833', 'WY01', 'Billings Clinic - Employee Assistance Program', 'Joseph', '', 'Cassidy', 'LCPC', 'Employee Assistance Program', '', '', NULL, 'O', '1020 N 27th St', 'Billings', 'Yellowstone', 'MT', '59101', '4062382501', NULL, '1020 N 27th St', 'Billings', 'Yellowstone', 'MT', '59101', '4062382501', '', '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2008-02-01', '2009-04-30', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1326157934', 0, 'N', 0, '2014-02-04', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11002834', 'W11002834', 'WY01', 'Billings Clinic - Neurosurgery', 'Kym', NULL, 'Chandler', 'MD', 'Neurosurgery', NULL, NULL, NULL, 'O', '2825 8th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4062382501', '4062385809', 'PO Box 37000', 'Billings', '', 'MT', '59107', '', '', '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2008-02-01', '2009-04-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1720087000', 0, 'N', 0, '2009-05-04', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11002835', 'W11002835', 'WY01', 'Billings Clinic - Occupational Therapy', 'Carmalen', 'C', 'Chimenti', 'OT', 'Occupational Therapy', NULL, NULL, NULL, 'O', '2825 8th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4062382501', NULL, 'PO Box 37000', 'Billings', '', 'MT', '59107', '', '', '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2008-02-01', '2009-04-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1174706675', 0, 'N', 0, '2010-01-15', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11002836', 'W11002836', 'WY01', 'Billings Clinic - Geriatrics', 'Patricia', 'J', 'Coon', 'MD', 'Geriatrics', NULL, NULL, NULL, 'O', '2825 8th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4062382501', '4062382413', 'PO Box 37000', 'Billings', '', 'MT', '59107', '', '', '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2008-02-01', '2009-04-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1467561431', 0, 'N', 0, '2010-01-15', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11002837', 'W11002837', 'WY01', 'Billings Clinic - Ophthalmology', 'James', 'P', 'Cornetet', 'MD', 'Ophthalmology', NULL, NULL, NULL, 'O', '2825 8th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4062382501', '4062382871', 'PO Box 37000', 'Billings', '', 'MT', '59107', '', '', '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2008-02-01', '2009-04-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1306868153', 0, 'N', 0, '2010-01-15', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11002838', 'W11002838', 'WY01', 'Billings Clinic - Gen Surg', 'John', 'R', 'Craig', 'MD', 'Vascular Surgery', '', '', NULL, 'O', '2825 8th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4062382501', '4062382848', '2825 8th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4062382501', '4062382848', '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2008-02-01', '2009-04-30', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1013957695', 0, 'N', 0, '2014-04-10', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11002839', 'W11002839', 'WY01', 'Billings Clinic - Emergency', 'Barbara', NULL, 'Curry', 'MD', 'Emergency Medicine', NULL, NULL, NULL, 'O', '2800 10th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4066574150', '4066574349', 'PO Box 37000', 'Billings', '', 'MT', '59107', '', '', '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2008-02-01', '2009-04-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1649381203', 0, 'N', 0, '2009-05-04', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11002840', 'W11002840', 'WY01', 'Billings Clinic - OB/GYN', 'Dana', 'P', 'Damron', 'MD', 'Maternal Fetal Medicine', NULL, NULL, NULL, 'O', '2825 8th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4062382501', '4062382806', 'PO Box 37000', 'Billings', '', 'MT', '59107', '', '', '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2008-02-01', '2009-04-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1093826828', 0, 'N', 0, '2010-01-15', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11002841', 'W11002841', 'WY01', 'Billings Clinic - Radiology', 'Ronald', NULL, 'Darby', 'MD', 'Radiologist', NULL, NULL, NULL, 'O', '2800 10th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4066574150', '4066574349', 'PO Box 37000', 'Billings', '', 'MT', '59107', '', '', '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2008-02-01', '2009-04-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1992816722', 0, 'N', 0, '2009-05-04', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11002842', 'W11002842', 'WY01', 'Billings Clinic - Hospitalist', 'Andrea', '', 'Darilek', 'MD', 'Hospitalist', '', '', NULL, 'O', '2800 10th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4066574150', '4062382572', '2800 10th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4066574150', '4062382572', '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2008-02-01', '2009-04-30', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1053334904', 0, 'N', 0, '2014-02-04', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11002843', 'W11002843', 'WY01', 'Billings Clinic - Allergy', 'Kathleen', 'C', 'Davis', 'MD', 'Allergy and Immunology', '', '', NULL, 'O', '2825 8th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4062382501', '4062382805', '2825 8th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4062382501', '4062382805', '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2008-02-01', '2009-04-30', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1407959489', 0, 'N', 0, '2010-08-18', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11002844', 'W11002844', 'WY01', 'Billings Clinic - Orthopedics & Sports Medicine', 'Stuart', NULL, 'Davis', 'MD', 'Orthopedic Surgery', NULL, NULL, NULL, 'O', '2702 8th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4062382501', '4062385218', 'PO Box 37000', 'Billings', '', 'MT', '59107', '', '', '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2008-02-01', '2009-04-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1053321158', 0, 'N', 0, '2009-05-04', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11002845', 'W11002845', 'WY01', 'Billings Clinic - Geriatrics', 'Gabriella', '', 'Decke', 'PA-C', 'Hospitalist', '', '', NULL, 'O', '2825 8th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4062382501', '4062382413', '2825 8th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4062382501', '4062382413', '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2008-02-01', '2009-04-30', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1578665683', 0, 'N', 0, '2014-01-03', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11002846', 'W11002846', 'WY01', 'Billings Clinic - Cardiology', 'Walter', NULL, 'Degnan', 'MD', 'Cardiovascular Disease', NULL, NULL, NULL, 'O', '1020 N 27th St', 'Billings', 'Yellowstone', 'MT', '59101', '4062382000', '4062382066', 'PO Box 37000', 'Billings', '', 'MT', '59107', '', '', '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2008-02-01', '2009-04-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1558384404', 0, 'N', 0, '2009-05-04', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11002847', 'W11002847', 'WY01', 'Billings Clinic - Geriatrics', 'Jack', NULL, 'DeLeonardo', 'PA-C', 'Geriatrics', NULL, NULL, NULL, 'O', '2825 8th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4062382501', '4062382413', 'PO Box 37000', 'Billings', '', 'MT', '59107', '', '', '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2008-02-01', '2009-04-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1417068248', 0, 'N', 0, '2009-05-04', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11002848', 'W11002848', 'WY01', 'Billings Clinic - Gastro', 'Mark', NULL, 'Dell Aglio', 'MD', 'Gastroenterology', NULL, NULL, NULL, 'O', '2825 8th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4062382501', '4062382763', 'PO Box 37000', 'Billings', '', 'MT', '59107', '', '', '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2008-02-01', '2009-04-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1477656460', 0, 'N', 0, '2009-05-04', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11002849', 'W11002849', 'WY01', 'Behavioral Health Clinic', 'John', NULL, 'DeNegre', 'MD', 'Mental Health', NULL, NULL, NULL, 'O', '1020 N 27th St', 'Billings', 'Yellowstone', 'MT', '59101', '4062558550', '4062525430', 'PO Box 37000', 'Billings', '', 'MT', '59107', '', '', '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2008-02-01', '2009-04-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1134230972', 0, 'N', 0, '2009-05-04', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11002850', 'W11002850', 'WY01', 'Billings Clinic - Dietary', 'Lindsey', NULL, 'Diemert', 'RD', 'Dietician', '', '', NULL, 'B', '2800 10th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4066574150', '4066574349', 'PO Box 37000', 'Billings', '', 'MT', '59107', '', '', '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2008-02-01', '2009-04-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1831387075', 0, 'Y', 0, '2009-05-04', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11002851', 'W11002851', 'WY01', 'Billings Clinic - Neurosurgery', 'Eugen', 'J', 'Dolan', 'MD', 'Neurosurgery', NULL, NULL, NULL, 'O', '2825 8th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4062382501', '4062385809', 'PO Box 37000', 'Billings', '', 'MT', '59107', '', '', '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2008-02-01', '2009-04-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1659455129', 0, 'N', 0, '2010-01-15', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11002852', 'W11002852', 'WY01', 'Billings Clinic - Orthopedics & Sports Medicine', 'William', NULL, 'Dolan', 'PT', 'Physical Therapy', NULL, NULL, NULL, 'O', '2702 8th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4062382501', '4066573782', 'PO Box 37000', 'Billings', '', 'MT', '59107', '', '', '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2008-02-01', '2009-04-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1508919275', 0, 'N', 0, '2009-05-04', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11002853', 'W11002853', 'WY01', 'Billings Clinic - Cardiology', 'Barbara', '', 'Dudczak', 'MD', 'Cardiovascular Disease', '', '', NULL, 'O', '1020 N 27th St', 'Billings', 'Yellowstone', 'MT', '59101', '4062382000', '4062382066', '1020 N 27th St', 'Billings', 'Yellowstone', 'MT', '59101', '4062382000', '4062382066', '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2008-02-01', '2009-04-30', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1821026246', 0, 'N', 0, '2014-03-13', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11002854', 'W11002854', 'WY01', 'Billings Clinic - Gen Surg', 'Scott', 'H', 'Dull', 'MD', 'General Surgery', NULL, NULL, NULL, 'O', '2825 8th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4062382501', '4062382848', 'PO Box 37000', 'Billings', '', 'MT', '59107', '', '', '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2008-02-01', '2009-04-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1174634919', 0, 'N', 0, '2010-01-15', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11002855', 'W11002855', 'WY01', 'Billings Clinic - Internal Medicine', 'Baskar', 'S', 'DuVal', 'MD', 'Internal Medicine', NULL, NULL, NULL, 'O', '2825 8th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4062382501', '4062382771', 'PO Box 37000', 'Billings', '', 'MT', '59107', '', '', '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2008-02-01', '2009-04-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1346289758', 0, 'N', 0, '2010-01-15', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11002856', 'W11002856', 'WY01', 'Billings Clinic - Orthopedics & Sports Medicine', 'Randi', NULL, 'Ellis', 'PA-C', 'Orthopedic Surgery', NULL, NULL, NULL, 'O', '2702 8th Ave N', 'Billings', 'Yellowstone', 'MT', '59102', '4062382501', '4062385218', 'PO Box 37000', 'Billings', '', 'MT', '59107', '', '', '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2008-02-01', '2009-04-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1750301289', 0, 'N', 0, '2009-05-04', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11002857', 'W11002857', 'WY01', 'Billings Clinic - Pulmonary', 'Walter', 'R', 'Fairfax', 'MD', 'Pulmonary', NULL, NULL, NULL, 'O', '2825 8th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4062382501', '4062382813', 'PO Box 37000', 'Billings', '', 'MT', '59107', '', '', '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2008-02-01', '2009-04-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1124170170', 0, 'N', 0, '2010-01-15', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11002858', 'W11002858', 'WY01', 'Billings Clinic - Endocrinology', 'Laura', '', 'Ferries', 'MD', 'Endocrinology', '', '', NULL, 'O', '2825 8th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4062382501', '4062382413', '2825 8th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4062382501', '4062382413', '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2008-02-01', '2009-04-30', 0, 0, 0, 'Sheridan Memorial Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1700827557', 0, 'N', 0, '2012-04-27', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11002859', 'W11002859', 'WY01', 'Billings Clinic - Gastro', 'Michael', 'C', 'Fischer', 'MD', 'Gastroenterology', NULL, NULL, NULL, 'O', '2825 8th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4062382501', '4062382763', 'PO Box 37000', 'Billings', '', 'MT', '59107', '', '', '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2008-02-01', '2009-04-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1710098579', 0, 'N', 0, '2010-01-15', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11002860', 'W11002860', 'WY01', 'Billings Clinic - Orthopedics & Sports Medicine', 'Steven', NULL, 'Fischer', 'MD', 'Orthopedic Surgery', NULL, NULL, NULL, 'O', '2702 8th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4062382501', '4062385218', 'PO Box 37000', 'Billings', '', 'MT', '59107', '', '', '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2008-02-01', '2009-04-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1710098587', 0, 'N', 0, '2009-05-04', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11002861', 'W11002861', 'WY01', 'Billings Clinic - OB/GYN', 'Cheryl', NULL, 'Fletcher', 'FNP', 'Obstetrics and Gynecology', NULL, NULL, NULL, 'O', '2825 8th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4062382501', '4062382806', 'PO Box 37000', 'Billings', '', 'MT', '59107', '', '', '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2008-02-01', '2009-04-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1528179397', 0, 'N', 0, '2009-05-04', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11002862', 'W11002862', 'WY01', 'Billings Clinic - Cardiology', 'Laura', '', 'Ford Mukkamala', 'DO', 'Cardiovascular Disease', NULL, NULL, NULL, 'O', '1020 N 27th St', 'Billings', 'Yellowstone', 'MT', '59101', '4062382000', '4062382066', 'PO Box 37000', 'Billings', 'Yellowstone', 'MT', '59107', '4062382000', '4062382066', '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2008-02-01', '2009-04-30', NULL, 0, 0, '', '', '', '', 'HCFA|UB|', '1306950001', 0, 'N', 0, '2010-05-26', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11002863', 'W11002863', 'WY01', 'Billings Clinic - ENT', 'Kristy', NULL, 'Foss Stone', 'Aud', 'Audiology', NULL, NULL, NULL, 'O', '2825 8th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4062382501', '4062382765', 'PO Box 37000', 'Billings', '', 'MT', '59107', '', '', '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2008-02-01', '2009-04-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1790896561', 0, 'N', 0, '2010-01-15', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11002864', 'W11002864', 'WY01', 'Billings Clinic - PMR', 'Patricia Lyn', NULL, 'Francisco', 'PA', 'Physical Medicine and Rehabilitation', NULL, NULL, NULL, 'O', '2825 8th Ave N', 'Billings', 'Yellowstone', 'Mt', '59101', '4062382501', '4062382723', 'PO Box 37000', 'Billings', '', 'MT', '59107', '', '', '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2008-02-01', '2009-04-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1790870384', 0, 'N', 0, '2009-05-04', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11002865', 'W11002865', 'WY01', 'Billings Clinic - Neurosurgery', 'Herbert', NULL, 'Fried', 'MD', 'Neurosurgery', NULL, NULL, NULL, 'O', '2825 8th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4062382501', '4062385809', 'PO Box 37000', 'Billings', '', 'MT', '59107', '', '', '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2008-02-01', '2009-04-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1417060419', 0, 'N', 0, '2009-05-04', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11002866', 'W11002866', 'WY01', 'Billings Clinic - Hospitalist', 'Brian', '', 'Fullerton', 'MD', 'Hospitalist', '', '', NULL, 'O', '2800 10th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4066574150', '4062382413', '2800 10th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4066574150', '4062382413', '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2008-02-01', '2009-04-30', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1063435949', 0, 'N', 0, '2014-02-04', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11002867', 'W11002867', 'WY01', 'Billings Clinic - Neurology', 'Mary', 'D', 'Gaddy', 'MD', 'Neurology', NULL, NULL, NULL, 'O', '2825 8th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4062382501', '4062382805', 'PO Box 37000', 'Billings', '', 'MT', '59107', '', '', '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2008-02-01', '2009-04-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1982716551', 0, 'N', 0, '2010-01-15', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11002868', 'W11002868', 'WY01', 'Billings Clinic - Cardiology', 'Christian', NULL, 'Gaissmaier', 'MD', 'Cardovascular Disease', NULL, NULL, NULL, 'O', '1020 N 27th St', 'Billings', 'Yellowstone', 'MT', '59101', '4062382000', '4062382066', 'PO Box 37000', 'Billings', '', 'MT', '59107', '', '', '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2008-02-01', '2009-04-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1255445607', 0, 'N', 0, '2009-05-04', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11002869', 'W11002869', 'WY01', 'Billings Clinic - Internal Medicine', 'Steven', 'J', 'Gerstner', 'MD', 'Internal Medicine', NULL, NULL, NULL, 'O', '2825 8th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4062382501', '4062382771', 'PO Box 37000', 'Billings', '', 'MT', '59107', '', '', '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2008-02-01', '2009-04-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1124130695', 0, 'N', 0, '2010-01-15', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11002870', 'W11002870', 'WY01', 'Billings Clinic - GYN Oncology', 'Randall', 'K', 'Gibb', 'MD', 'Gynecologic Oncology', NULL, NULL, NULL, 'O', '2827 Fort Missoula Rd', 'Missoula', 'Petroleum', 'MT', '59084', '4062382501', '4062382394', 'PO Box 37000', 'Billings', '', 'MT', '59107', '', '', '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2008-02-01', '2009-04-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1639195944', 0, 'N', 0, '2010-01-15', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11002871', 'W11002871', 'WY01', 'Billings Clinic - Outreach Services', 'Derek', '', 'Gilbert', 'MD', 'Family Practice', '', '', NULL, 'O', '2825 8th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4062558441', '4062558405', '2825 8th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4062558441', '4062558405', '', '', '', '0.00', '17.00', '0.00', 3, '2008-02-01', '2008-08-01', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1477665925', 0, 'Y', 0, '2012-04-27', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11002872', 'W11002872', 'WY01', 'Billings Clinic - Same Day Care', 'James', 'F', 'Girolami', 'MD', 'Family Practice', NULL, NULL, NULL, 'O', '2825 8th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4062382501', '4062382868', 'PO Box 37000', 'Billings', '', 'MT', '59107', '', '', '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2008-02-01', '2009-04-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1730286261', 0, 'N', 0, '2010-01-15', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11002873', 'W11002873', 'WY01', 'Billings Clinic - Internal Medicine', 'Julian', NULL, 'Gnecco', 'MD', 'Internal Medicine', NULL, NULL, NULL, 'O', '2825 8th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4062382501', NULL, 'PO Box 37000', 'Billings', '', 'MT', '59107', '', '', '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2008-02-01', '2009-04-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1831383678', 0, 'N', 0, '2010-01-15', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11002874', 'W11002874', 'WY01', 'Behavioral Health Clinic', 'Diane D', NULL, 'Goedde', 'NP', 'Nurse Practitioner', NULL, NULL, NULL, 'O', '1020 N 27th St', 'Billings', 'Yellowstone', 'MT', '59101', '4066574150', '4062525430', 'PO Box 37000', 'Billings', '', 'MT', '59107', '', '', '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2008-02-01', '2009-04-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1922110998', 0, 'N', 0, '2009-05-04', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11002875', 'W11002875', 'WY01', 'Billings Clinic - Orthopedics & Sports Medicine', 'Mark', NULL, 'Goldy', 'PT', 'Physical Therapy', NULL, NULL, NULL, 'O', '2702 8th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4062382501', '4062385218', 'PO Box 37000', 'Billings', '', 'MT', '59107', '', '', '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2008-02-01', '2009-04-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1588776470', 0, 'N', 0, '2009-05-04', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11002876', 'W11002876', 'WY01', 'Billings Clinic - Ophthalmology', 'James', 'S', 'Good', 'MD', 'Ophthalmology', NULL, NULL, NULL, 'O', '2825 8th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4062382501', '4062382871', 'PO Box 37000', 'Billings', 'Yellowstone', 'MT', '59107', '4062382501', '4062382871', '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2008-02-01', '2009-04-30', NULL, 0, 0, '', '', '', '', 'HCFA|UB|', '1154433662', 0, 'N', 0, '2010-05-26', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11002877', 'W11002877', 'WY01', 'Billings Clinic - Radiation  Oncology', 'Christopher', 'C', 'Goulet', 'MD', 'Radiation Oncology', NULL, NULL, NULL, 'O', '2825 8th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4062382501', '4062382572', 'PO Box 37000', 'Billings', '', 'MT', '59107', '', '', '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2008-02-01', '2009-04-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1437137155', 0, 'N', 0, '2010-01-15', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11002878', 'W11002878', 'WY01', 'Billings Clinic - Radiology', 'Jonathan', NULL, 'Graeve', 'MD', 'Radiologist', NULL, NULL, NULL, 'O', '2800 10th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4066574150', '4066574349', 'PO Box 37000', 'Billings', '', 'MT', '59107', '', '', '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2008-02-01', '2009-04-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1538271507', 0, 'N', 0, '2009-05-04', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11002879', 'W11002879', 'WY01', 'Billings Clinic - Infectious Disease', 'David', 'M', 'Graham', 'MD', 'Infectious Disease', '', '', NULL, 'O', '2825 8th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4062382501', '4062382253', 'PO Box 37000', 'Billings', '', 'MT', '59107', '', '', '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2008-02-01', '2009-04-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1962425868', 0, 'N', 0, '2010-01-15', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11002880', 'W11002880', 'WY01', 'Billings Clinic - Geriatrics', 'Marilyn', '', 'Grams', 'MD', 'Geriatrics', 'Hospitalist', '', NULL, 'O', '2825 8th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4062382501', '4062382413', '2825 8th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4062382501', '4062382413', '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2008-02-01', '2009-04-30', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1669492104', 0, 'N', 0, '2010-09-01', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11002881', 'W11002881', 'WY01', 'Billings Clinic - Gen Surg', 'John', 'R', 'Gregory', 'MD', 'General Surgery', NULL, NULL, NULL, 'O', '2825 8th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4062382501', '4062382848', 'PO Box 37000', 'Billings', '', 'MT', '59107', '', '', '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2008-02-01', '2009-04-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1861504847', 0, 'N', 0, '2010-01-15', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11002882', 'W11002882', 'WY01', 'Billings Clinic - Gen Surg', 'Paul', 'F', 'Grmoljez', 'MD', 'General Surgery', NULL, NULL, NULL, 'O', '2825 8th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4062382501', '4062382848', 'PO Box 37000', 'Billings', '', 'MT', '59107', '', '', '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2008-02-01', '2009-04-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1831241785', 0, 'N', 0, '2010-01-15', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11002883', 'W11002883', 'WY01', 'Billings Clinic - Dietary', 'Kandis', NULL, 'Grose', 'RD', 'Dietician', '', '', NULL, 'B', '2800 10th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4066574150', '4066574349', 'PO Box 37000', 'Billings', '', 'MT', '59107', '', '', '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2008-02-01', '2009-04-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1205905221', 0, 'Y', 0, '2009-05-04', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11002884', 'W11002884', 'WY01', 'Billings Clinic - Peds', 'Fred', NULL, 'Gunville', 'MD', 'Pediatrics', NULL, NULL, NULL, 'O', '2800 10th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4066574150', '4066574349', 'PO Box 37000', 'Billings', '', 'MT', '59107', '', '', '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2008-02-01', '2009-04-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1912019969', 0, 'N', 0, '2009-05-04', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11002885', 'W11002885', 'WY01', 'Billings Clinic - Dietary', 'Beth', NULL, 'Hall', 'RD', 'Dietician', NULL, NULL, NULL, 'B', '2800 10th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4066574150', '4066574349', 'PO Box 37000', 'Billings', '', 'MT', '59107', '', '', '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2008-02-01', '2009-04-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1245300490', 0, 'Y', 0, '2009-05-04', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11002886', 'W11002886', 'WY01', 'Billings Clinic - Outreach Services', 'Roger', 'H', 'Halterman', 'MD', 'Internal Medicine', NULL, NULL, NULL, 'O', '2825 8th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4062558441', '4062558405', 'PO Box 37000', 'Billings', '', 'MT', '59107', '', '', '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2008-02-01', '2009-04-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1194827758', 0, 'N', 0, '2010-01-15', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11002887', 'W11002887', 'WY01', 'Billings Clinic - Same Day Care', 'Beth', 'S', 'Hamilton', 'PA-C', 'Family Practice', NULL, NULL, NULL, 'O', '2825 8th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4062382501', '4062382868', 'PO Box 37000', 'Billings', '', 'MT', '59107', '', '', '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2008-02-01', '2009-04-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1518069145', 0, 'N', 0, '2010-01-15', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11002888', 'W11002888', 'WY01', 'Billings Clinic - Orthopedics & Sports Medicine', 'Teresa', NULL, 'Hamm', 'PT', 'Physical Therapy', NULL, NULL, NULL, 'O', '2702 8th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4062382501', '4066573782', 'PO Box 37000', 'Billings', '', 'MT', '59107', '', '', '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2008-02-01', '2009-04-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1205019445', 0, 'N', 0, '2009-05-04', 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
('810231784', 'W11002889', 'W11002889', 'WY01', 'Billings Clinic - Gastro', 'Steven', 'W', 'Hammond', 'MD', 'Gastroenterology', NULL, NULL, NULL, 'O', '2825 8th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4062382501', '4062382763', 'PO Box 37000', 'Billings', '', 'MT', '59107', '', '', '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2008-02-01', '2009-04-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1588766117', 0, 'N', 0, '2010-01-15', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11002890', 'W11002890', 'WY01', 'Billings Clinic - Occupational Health & Wellness', 'Ronald', '', 'Handlos', 'PA-C', 'Occupational Medicine', '', '', NULL, 'O', '2675 Central Ave', 'Billings', 'Yellowstone', 'MT', '59102', '4062382900', '4062382978', '2675 Central Ave', 'Billings', 'Yellowstone', 'MT', '59102', '4062382900', '4062382978', '', NULL, '', '0.00', '17.00', '0.00', 3, '2008-02-01', '2009-04-15', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1679685192', 0, 'N', 0, '2014-05-30', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11002891', 'W11002891', 'WY01', 'Billings Clinic - OB/GYN', 'James', 'R', 'Harris', 'MD', 'Obstetrics and Gynecology', NULL, NULL, NULL, 'O', '2825 8th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4062382501', '4062382806', 'PO Box 37000', 'Billings', '', 'MT', '59107', '', '', '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2008-02-01', '2009-04-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1477649986', 0, 'N', 0, '2010-01-15', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11002892', 'W11002892', 'WY01', 'Billings Clinic - Dietary', 'Emily', NULL, 'Heggem', 'RD', 'Dietician', NULL, NULL, NULL, 'B', '2800 10th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4066574150', '4066574349', 'PO Box 37000', 'Billings', '', 'MT', '59107', '', '', '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2008-02-01', '2009-04-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1790896884', 0, 'Y', 0, '2009-05-04', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11002893', 'W11002893', 'WY01', 'Billings Clinic - Dietary', 'Jill', NULL, 'Henley', 'RD', 'Dietician', NULL, NULL, NULL, 'B', '2800 10th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4066574150', '4066574349', 'PO Box 37000', 'Billings', '', 'MT', '59107', '', '', '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2008-02-01', '2009-04-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1821270414', 0, 'Y', 0, '2009-05-04', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11002894', 'W11002894', 'WY01', 'Billings Clinic - Radiology', 'Lawrence', NULL, 'Herbert', 'MD', 'Radiologist', NULL, NULL, NULL, 'O', '2800 10th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4066574150', '4066574349', 'PO Box 37000', 'Billings', '', 'MT', '59107', '', '', '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2008-02-01', '2009-04-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1528170925', 0, 'N', 0, '2009-05-04', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11002895', 'W11002895', 'WY01', 'Billings Clinic - Gastro', 'Keri', 'L', 'Hill', 'MD', 'Gastroenterology', NULL, NULL, NULL, 'O', '2825 8th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4062382501', '4062382763', 'PO Box 37000', 'Billings', '', 'MT', '59107', '', '', '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2008-02-01', '2009-04-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1528095155', 0, 'N', 0, '2010-01-15', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11002896', 'W11002896', 'WY01', 'Billings Clinic - Urology', 'Michael', 'H', 'Hines', 'PA-C', 'Urology', NULL, NULL, NULL, 'O', '2825 8th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4062382501', '4062382881', 'PO Box 37000', 'Billings', '', 'MT', '59107', '', '', '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2008-02-01', '2009-04-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1205947397', 0, 'N', 0, '2010-01-15', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11002897', 'W11002897', 'WY01', 'Billings Clinic - Rehab', 'Roxanna', NULL, 'Hoch', 'PT', 'Physical Therapy', NULL, NULL, NULL, 'O', '2825 8th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4062382501', '4062382978', 'PO Box 37000', 'Billings', '', 'MT', '59107', '', '', '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2008-02-01', '2009-04-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '0116460675', 0, 'N', 0, '2009-05-04', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11002898', 'W11002898', 'WY01', 'Billings Clinic - ENT', 'Robin', 'S', 'Horrell', 'MD', 'Ear, Nose and Throat', NULL, NULL, NULL, 'O', '2825 8th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4062382501', '4062385043', 'PO Box 37000', 'Billings', '', 'MT', '59107', '', '', '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2008-02-01', '2009-04-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1497778302', 0, 'N', 0, '2010-01-15', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11002899', 'W11002899', 'WY01', 'Billings Clinic - Gen Surg', 'Terry', 'A', 'Housinger', 'MD', 'General Surgery', NULL, NULL, NULL, 'O', '2825 8th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4062382501', '4062382848', 'PO Box 37000', 'Billings', '', 'MT', '59107', '', '', '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2008-02-01', '2009-04-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1790705234', 0, 'N', 0, '2010-01-15', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11002900', 'W11002900', 'WY01', 'Billings Clinic - Orthopedics & Sports Medicine', 'Willard', NULL, 'Hull', 'MD', 'Orthopedic Surgery', '', '', NULL, 'O', '2702 8th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4062382501', '4062385218', 'PO Box 37000', 'Billings', '', 'MT', '59107', '', '', '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2008-02-01', '2009-04-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1700938651', 0, 'N', 0, '2009-05-04', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11002901', 'W11002901', 'WY01', 'Billings Clinic - Dietary', 'Regina', NULL, 'Hultin', 'RD', 'Dietician', NULL, NULL, NULL, 'B', '2800 10th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4066574150', '4066574349', 'PO Box 37000', 'Billings', '', 'MT', '59107', '', '', '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2008-02-01', '2008-06-09', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1467531871', 0, 'Y', 0, '2009-05-04', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11002902', 'W11002902', 'WY01', 'Billings Clinic - Gen Surg', 'John', NULL, 'Huntington', 'PAC', 'General Surgery', NULL, NULL, NULL, 'O', '2825 8th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4062382501', '4062382848', 'PO Box 37000', 'Billings', '', 'MT', '59107', '', '', '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2008-02-01', '2009-04-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1558312652', 0, 'N', 0, '2009-05-04', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11002903', 'W11002903', 'WY01', 'Billings Clinic - Gen Surg', 'Robert', 'N', 'Hurd', 'MD', 'General Surgery', NULL, NULL, NULL, 'O', '2825 8th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4062382501', '4062382848', 'PO Box 37000', 'Billings', '', 'MT', '59107', '', '', '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2008-02-01', '2009-04-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1376626291', 0, 'N', 0, '2010-01-15', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11002904', 'W11002904', 'WY01', 'Billings Clinic - Internal Medicine', 'Lucinda', 'M', 'Husby', 'MD', 'Internal Medicine', NULL, NULL, NULL, 'O', '2825 8th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4062382501', '4062382771', 'PO Box 37000', 'Billings', '', 'MT', '59107', '', '', '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2008-02-01', '2009-04-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1063432516', 0, 'N', 0, '2010-01-15', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11002905', 'W11002905', 'WY01', 'Billings Clinic - Employee Assistance Program', 'Cheryl', '', 'Ikeda', 'LCSW', 'Employee Assistance Program', '', '', NULL, 'O', '1020 N 27th St', 'Billings', 'Yellowstone', 'MT', '59101', '4062382501', '4062476240', '1020 N 27th St', 'Billings', 'Yellowstone', 'MT', '59101', '4062382501', '4062476240', '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2008-02-01', '2009-04-30', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1013029842', 0, 'N', 0, '2014-02-04', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11002906', 'W11002906', 'WY01', 'Behavioral Health Clinic', 'Kendall', NULL, 'Jackson', 'LCPC', 'Counseling', NULL, NULL, NULL, 'O', '1020 N 27th St', 'Billings', 'Yellowstone', 'MT', '59101', '4062558550', '4062525430', 'PO Box 37000', 'Billings', '', 'MT', '59107', '', '', '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2008-02-01', '2009-04-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1861537078', 0, 'N', 0, '2009-05-04', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11002907', 'W11002907', 'WY01', 'Billings Clinic - ENT', 'Janice', NULL, 'Johnson', 'AUD', 'Audiology', NULL, NULL, NULL, 'O', '2825 8th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4062382501', '4062382765', 'PO Box 37000', 'Billings', '', 'MT', '59107', '', '', '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2008-02-01', '2009-04-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1235202839', 0, 'N', 0, '2010-01-15', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11002908', 'W11002908', 'WY01', 'Billings Clinic - Internal Medicine', 'Julie', NULL, 'Johnson', 'MD', 'Internal Medicine', NULL, NULL, NULL, 'O', '2825 8th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4062382501', '4062382771', 'PO Box 37000', 'Billings', '', 'MT', '59107', '', '', '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2008-02-01', '2009-04-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1164534905', 0, 'N', 0, '2009-05-04', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11002909', 'W11002909', 'WY01', 'Billings Clinic - Peds', 'Linda', NULL, 'Johnson', 'MD', 'Pediatrics', NULL, NULL, NULL, 'O', '2800 10th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4066574150', '4066574349', 'PO Box 37000', 'Billings', '', 'MT', '59107', '', '', '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2008-02-01', '2009-04-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1205948064', 0, 'N', 0, '2009-05-04', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11002910', 'W11002910', 'WY01', 'Billings Clinic - OB/GYN', 'Sandra', NULL, 'Johnson', 'MD', 'Obstetrics and Gynecology', NULL, NULL, NULL, 'O', '2825 8th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4062382501', '4062382806', 'PO Box 37000', 'Billings', '', 'MT', '59107', '', '', '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2008-02-01', '2009-04-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1649382409', 0, 'N', 0, '2009-05-04', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11002911', 'W11002911', 'WY01', 'Billings Clinic - Cancer Center', 'Diane', 'L', 'Jones', 'FNP', 'Oncology', 'Hematology and Oncology', NULL, NULL, 'O', '2825 8th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4062382501', '4062382469', 'PO Box 37000', 'Billings', '', 'MT', '59107', '', '', '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2008-02-01', '2009-04-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1972555191', 0, 'N', 0, '2010-01-15', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11002912', 'W11002912', 'WY01', 'Billings Clinic - Derm', 'Mark', 'S', 'Jones', 'MD', 'Dermatology', NULL, NULL, NULL, 'O', '2825 8th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4062382501', '4062382437', 'PO Box 37000', 'Billings', '', 'MT', '59107', '', '', '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2008-02-01', '2009-04-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1700998572', 0, 'N', 0, '2010-01-15', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11002913', 'W11002913', 'WY01', 'Billings Clinic - Rehab', 'William', 'A', 'Jones', 'PT', 'Physical Therapy', NULL, NULL, NULL, 'O', '2825 8th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4062382501', '4062382978', 'PO Box 37000', 'Billings', '', 'MT', '59107', '', '', '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2008-02-01', '2009-04-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1699887000', 0, 'N', 0, '2010-01-15', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11002914', 'W11002914', 'WY01', 'Billings Clinic - Rehab', 'Susan', 'E', 'Jurovich', 'PT', 'Physical Therapy', NULL, NULL, NULL, 'O', '2825 8th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4062382501', '4062382978', 'PO Box 37000', 'Billings', '', 'MT', '59107', '', '', '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2008-02-01', '2009-04-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1770697138', 0, 'N', 0, '2010-01-15', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11002915', 'W11002915', 'WY01', 'Billings Clinic - OB/GYN', 'Yvonne', '', 'Kammerzell', 'NP', 'Obstetrics and Gynecology', '', '', NULL, 'O', '2825 8th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4062382501', '4062382806', '2825 8th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4062382501', '4062382806', '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2008-02-01', '2009-04-30', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1942301015', 0, 'N', 0, '2014-01-27', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11002916', 'W11002916', 'WY01', 'Billings Clinic - Ophthalmology', 'Mohammad', '', 'Karbassi', 'MD', 'Ophthalmology', '', '', NULL, 'O', '2825 8th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4062382501', '4062382871', '2825 8th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4062382501', '4062382871', '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2008-12-17', '2009-04-30', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1083659338', 0, 'N', 0, '2014-01-03', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11002917', 'W11002917', 'WY01', 'Billings Clinic - Ophthalmology', 'Deborah', 'G', 'Keenum', 'MD', 'Ophthalmology', NULL, NULL, NULL, 'O', '2825 8th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4062382501', '4062382871', 'PO Box 37000', 'Billings', '', 'MT', '59107', '', '', '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2008-02-01', '2009-04-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1063524486', 0, 'N', 0, '2010-01-15', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11002918', 'W11002918', 'WY01', 'Billings Clinic - Peds', 'Paul', NULL, 'Kelker', 'MD', 'Pediatrics', NULL, NULL, NULL, 'O', '2800 10th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4066574150', '4066574349', 'PO Box 37000', 'Billings', '', 'MT', '59107', '', '', '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2008-02-01', '2009-04-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1184736506', 0, 'N', 0, '2009-05-04', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11002919', 'W11002919', 'WY01', 'Billings Clinic - Outreach Services', 'John', NULL, 'Kelley', 'MD', 'Family Practice', '', '', NULL, 'O', '2825 8th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4062558441', '4062558405', 'PO Box 37000', 'Billings', '', 'MT', '59107', '', '', '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2008-02-01', '2009-04-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1962514398', 0, 'N', 0, '2010-01-15', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11002920', 'W11002920', 'WY01', 'Behavioral Health Clinic', 'Julie', NULL, 'Kelso', 'MD', 'Mental Health', NULL, NULL, NULL, 'O', '1020 N 27th St', 'Billings', 'Yellowstone', 'MT', '59101', '4062558550', '4062525430', 'PO Box 37000', 'Billings', '', 'MT', '59107', '', '', '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2008-02-01', '2009-04-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1427101856', 0, 'N', 0, '2009-05-04', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11002921', 'W11002921', 'WY01', 'Billings Clinic - Peds', 'Claire', NULL, 'Kenamore', 'MD', 'Pediatrics', NULL, NULL, NULL, 'O', '2800 10th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4066574150', '4066574349', 'PO Box 37000', 'Billings', '', 'MT', '59107', '', '', '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2008-02-01', '2009-04-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1922110352', 0, 'N', 0, '2009-05-04', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11002922', 'W11002922', 'WY01', 'Billings Clinic - Same Day Care', 'Marie', 'D', 'Kennedy', 'PA-C', 'Family Practice', NULL, NULL, NULL, 'O', '2825 8th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4062382501', '4062382868', 'PO Box 37000', 'Billings', '', 'MT', '59107', '', '', '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2008-02-01', '2009-04-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1881780807', 0, 'N', 0, '2010-01-15', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11002923', 'W11002923', 'WY01', 'Billings Clinic - ENT', 'Phillip', 'S', 'Key', 'MD', 'Ear, Nose and Throat', NULL, NULL, NULL, 'O', '2825 8th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4062382501', '4062385043', 'PO Box 37000', 'Billings', '', 'MT', '59107', '', '', '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2008-02-01', '2009-04-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1780784355', 0, 'N', 0, '2010-01-15', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11002924', 'W11002924', 'WY01', 'Billings Clinic - Internal Medicine', 'Karen', 'C', 'Klee', 'MD', 'Internal Medicine', NULL, NULL, NULL, 'O', '2825 8th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4062382501', '4062382771', 'PO Box 37000', 'Billings', '', 'MT', '59107', '', '', '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2008-02-01', '2009-04-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1033205547', 0, 'N', 0, '2010-01-15', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11002925', 'W11002925', 'WY01', 'Billings Clinic - Urology', 'Lawrence', 'W', 'Klee', 'MD', 'Urology', '', '', NULL, 'O', '2825 8th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4062382501', '4062382881', '2825 8th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4062382501', '4062382881', '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2008-02-01', '2009-04-30', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1568557080', 0, 'N', 0, '2011-08-22', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11002926', 'W11002926', 'WY01', 'Billings Clinic - Derm', 'Gail', 'A', 'Kleman', 'MD', 'Dermatology', NULL, NULL, NULL, 'O', '2825 8th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4062382501', '4062382437', 'PO Box 37000', 'Billings', '', 'MT', '59107', '', '', '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2008-02-01', '2009-04-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1932292414', 0, 'N', 0, '2010-01-15', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11002927', 'W11002927', 'WY01', 'Billings Clinic - Research', 'Howard', '', 'Knapp', 'MD', 'Internal Medicine', NULL, NULL, NULL, 'O', '1045 N 30th St', 'Billings', 'Yellowstone', 'MT', '59101', '4062558470', '4062558479', 'PO Box 37000', 'Billings', 'Yellowstone', 'MT', '59107', '4062558470', '4062558479', '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2008-02-01', '2009-04-30', NULL, 0, 0, '', '', '', '', 'HCFA|UB|', '1861413148', 0, 'N', 0, '2010-05-26', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11002928', 'W11002928', 'WY01', 'Billings Clinic - Nephrology', 'James', 'D', 'Knostman', 'MD', 'Nephrology', NULL, NULL, NULL, 'O', '2825 8th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4062382501', '4062382590', 'PO Box 37000', 'Billings', '', 'MT', '59107', '', '', '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2008-02-01', '2009-01-01', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1306929377', 0, 'N', 0, '2010-01-15', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11002929', 'W11002929', 'WY01', 'Billings Clinic - Same Day Care', 'Steven', 'E', 'Kobrine', 'MD', 'Family Practice', NULL, NULL, NULL, 'O', '2825 8th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4062382501', '4062382868', 'PO Box 37000', 'Billings', '', 'MT', '59107', '', '', '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2008-02-01', '2009-04-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1003902164', 0, 'N', 0, '2010-01-15', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11002930', 'W11002930', 'WY01', 'Billings Clinic - Occupational Health & Wellness', 'Angie', NULL, 'Kolar', 'PT', 'Physical Therapy', NULL, NULL, NULL, 'O', '1020 N 27th St', 'Billings', 'Yellowstone', 'MT', '59101', '4062382501', '4062476240', 'PO Box 37000', 'Billings', '', 'MT', '59107', '', '', '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2008-02-01', '2009-04-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1891803359', 0, 'N', 0, '2009-05-04', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11002931', 'W11002931', 'WY01', 'Billings Clinic - Occupational Health & Wellness', 'Jaspur', NULL, 'Kolar', 'PA-C', 'Occupational Medicine', NULL, NULL, NULL, 'O', '1020 N 27th St', 'Billings', 'Yellowstone', 'MT', '59101', '4062382501', '4062476240', 'PO Box 37000', 'Billings', '', 'MT', '59107', '', '', '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2008-02-01', '2009-04-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1598851560', 0, 'N', 0, '2009-05-04', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11002932', 'W11002932', 'WY01', 'Billings Clinic - CV Surgery', 'Anastasios', 'K', 'Konstantakos', 'MD', 'Cardiovascular Disease', '', '', NULL, 'O', '2825 8th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4062382501', '4062382848', 'PO Box 37000', 'Billings', '', 'MT', '59107', '', '', '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2008-02-01', '2009-04-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1902892110', 0, 'N', 0, '2010-01-15', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11002933', 'W11002933', 'WY01', 'Billings Clinic - Emergency', 'Malie', NULL, 'Kopplin', 'MD', 'Emergency Medicine', NULL, NULL, NULL, 'O', '2800 10th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4066574150', '4066574349', 'PO Box 37000', 'Billings', '', 'MT', '59107', '', '', '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2008-02-01', '2009-04-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1982797478', 0, 'N', 0, '2009-05-04', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11002934', 'W11002934', 'WY01', 'Billings Clinic - Orthopedics & Sports Medicine', 'Matthew', NULL, 'Kopplin', 'MD', 'Orthopedic Surgery', NULL, NULL, NULL, 'O', '2702 8th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4062382501', '4062385218', 'PO Box 37000', 'Billings', '', 'MT', '59107', '', '', '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2008-02-01', '2009-04-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1598850984', 0, 'N', 0, '2009-05-04', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11002935', 'W11002935', 'WY01', 'Billings Clinic - ENT', 'Stephen', 'A', 'Kramer', 'MD', 'Ear, Nose and Throat', NULL, NULL, NULL, 'O', '2825 8th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4062382501', '4062385043', 'PO Box 37000', 'Billings', '', 'MT', '59107', '', '', '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2008-02-01', '2009-04-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1225138894', 0, 'N', 0, '2010-01-15', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11002936', 'W11002936', 'WY01', 'Billings Clinic - Orthopedics & Sports Medicine', 'Kevin', NULL, 'Larson', 'PT', 'Physical Therapy', NULL, NULL, NULL, 'O', '2702 8th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4062382501', '4062385218', 'PO Box 37000', 'Billings', '', 'MT', '59107', '', '', '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2008-02-01', '2009-04-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1285828319', 0, 'N', 0, '2009-05-04', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11002937', 'W11002937', 'WY01', 'Billings Clinic - Orthopedics & Sports Medicine', 'Adam', NULL, 'Leachman', 'PT', 'Physical Therapy', NULL, NULL, NULL, 'O', '2702 8th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4062382501', '4062385218', 'PO Box 37000', 'Billings', '', 'MT', '59107', '', '', '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2008-02-01', '2009-04-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1851484315', 0, 'N', 0, '2009-05-04', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11002938', 'W11002938', 'WY01', 'Billings Clinic - Emergency', 'Curtis', NULL, 'Lee', 'MD', 'Emergency Medicine', NULL, NULL, NULL, 'O', '2800 10th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4066574150', '4066574349', 'PO Box 37000', 'Billings', '', 'MT', '59107', '', '', '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2008-02-01', '2009-04-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1891718615', 0, 'N', 0, '2009-05-04', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11002939', 'W11002939', 'WY01', 'Billings Clinic - Radiology', 'David', NULL, 'Lehnherr', 'MD', 'Radiologist', NULL, NULL, NULL, 'O', '2800 10th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4066574150', '4066574349', 'PO Box 37000', 'Billings', '', 'MT', '59107', '', '', '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2008-02-01', '2009-04-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1952494585', 0, 'N', 0, '2009-05-04', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11002940', 'W11002940', 'WY01', 'Billings Clinic - Emergency', 'Peter', '', 'Light', 'MD', 'Emergency Medicine', '', '', NULL, 'O', '2800 10th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4066574150', '4066574349', '2800 10th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4066574150', '4066574349', '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2008-02-01', '2009-04-30', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1174676845', 0, 'N', 0, '2014-02-04', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11002941', 'W11002941', 'WY01', 'Billings Clinic - Radiology', 'Jeffry', NULL, 'Lindenbaum', 'MD', 'Radiologist', NULL, NULL, NULL, 'O', '2800 10th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4066574150', '4066574349', 'PO Box 37000', 'Billings', '', 'MT', '59107', '', '', '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2008-02-01', '2009-04-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1679669261', 0, 'N', 0, '2009-05-04', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11002942', 'W11002942', 'WY01', 'Billings Clinic- Reserved Staffing', 'Mary', NULL, 'Louder', 'DO', 'Family Practice', NULL, NULL, NULL, 'O', '2825 8th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4062558441', '4062558405', 'PO Box 37000', 'Billings', '', 'MT', '59107', '', '', '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2008-02-01', '2008-03-26', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1437220241', 0, 'N', 0, '2009-05-04', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11002943', 'W11002943', 'WY01', 'Billings Clinic - OB/GYN', 'Maureen', 'C', 'Lucas', 'MD', 'Obstetrics and Gynecology', NULL, NULL, NULL, 'O', '2825 8th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4062382501', '4062382806', 'PO Box 37000', 'Billings', '', 'MT', '59107', '', '', '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2008-02-01', '2009-04-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1376521583', 0, 'N', 0, '2010-01-15', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11002944', 'W11002944', 'WY01', 'Billings Clinic - Orthopedics & Sports Medicine', 'Deke', NULL, 'Lundman', 'PT', 'Physical Therapy', NULL, NULL, NULL, 'O', '2702 8th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4062382501', '4062385218', 'PO Box 37000', 'Billings', '', 'MT', '59107', '', '', '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2008-02-01', '2009-04-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1255414124', 0, 'N', 0, '2009-05-04', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11002945', 'W11002945', 'WY01', 'Billings Clinic - Endocrinology', 'James', 'A', 'Mack', 'MD', 'Endocrinology', NULL, NULL, NULL, 'O', '2825 8th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4062382501', '4062382413', 'PO Box 37000', 'Billings', '', 'MT', '59107', '', '', '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2008-02-01', '2009-04-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1669575445', 0, 'N', 0, '2010-01-15', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11002946', 'W11002946', 'WY01', 'Billings Clinic - Emergency', 'Steven', NULL, 'Maertens', 'MD', 'Emergency Medicine', NULL, NULL, NULL, 'O', '2800 10th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4066574150', '4066574349', 'PO Box 37000', 'Billings', '', 'MT', '59107', '', '', '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2008-02-01', '2009-04-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1710198312', 0, 'N', 0, '2009-05-04', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11002947', 'W11002947', 'WY01', 'Billings Clinic - Same Day Care', 'Sheryl', 'A', 'Malinowski', 'FNP', 'Family Practice', NULL, NULL, NULL, 'O', '2825 8th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4062382501', '4062382868', 'PO Box 37000', 'Billings', '', 'MT', '59107', '', '', '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2008-02-01', '2009-04-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1790999878', 0, 'N', 0, '2010-01-15', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11002948', 'W11002948', 'WY01', 'Billings Clinic - Neurosurgery', 'Jacob', NULL, 'Mathis', 'MD', 'Neurosurgery', NULL, NULL, NULL, 'O', '2825 8th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4062382501', '4062382805', 'PO Box 37000', 'Billings', '', 'MT', '59107', '', '', '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2008-02-01', '2009-04-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1952335366', 0, 'N', 0, '2009-05-04', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11002949', 'W11002949', 'WY01', 'Billings Clinic - Occupational Health & Wellness', 'Adam', '', 'Mattingly', 'PA-C', 'Occupational Medicine', '', '', NULL, 'O', '1020 N 27th St', 'Billings', 'Yellowstone', 'MT', '59101', '4062382501', '4062476240', '1020 N 27th St', 'Billings', 'Yellowstone', 'MT', '59101', '4062382501', '4062476240', '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2008-02-01', '2009-04-30', 0, 0, 0, NULL, '', '', '', 'HCFA|UB|', '1295836831', 0, 'N', 0, '2012-03-10', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11002950', 'W11002950', 'WY01', 'Billings Clinic - OB/GYN', 'Clayton', 'H', 'McCracken III', 'MD', 'Obstetrics and Gynecology', NULL, NULL, NULL, 'O', '2825 8th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4062382501', '4062382806', 'PO Box 37000', 'Billings', '', 'MT', '59107', '', '', '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2008-02-01', '2009-04-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1760589345', 0, 'N', 0, '2010-01-15', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11002951', 'W11002951', 'WY01', 'Behavioral Health Clinic', 'Robert', NULL, 'McDermott, Jr', 'MD', 'Mental Health', NULL, NULL, NULL, 'O', '1020 N 27th St', 'Billings', 'Yellowstone', 'MT', '59101', '4062558550', '4062525430', 'PO Box 37000', 'Billings', '', 'MT', '59107', '', '', '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2008-02-01', '2009-04-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1861592438', 0, 'N', 0, '2009-05-04', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11002952', 'W11002952', 'WY01', 'Billings Clinic - Emergency', 'Lawrence', NULL, 'McEvoy', 'MD', 'Emergency Medicine', NULL, NULL, NULL, 'O', '2800 10th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4066574150', '4066574349', 'PO Box 37000', 'Billings', '', 'MT', '59107', '', '', '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2008-02-01', '2008-02-01', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1699872275', 0, 'N', 0, '2009-05-04', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11002953', 'W11002953', 'WY01', 'Billings Clinic - Nephrology', 'Heather', 'L', 'McGuire', 'MD', 'Nephrology', NULL, NULL, NULL, 'O', '2825 8th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4062382501', '4062382590', 'PO Box 37000', 'Billings', '', 'MT', '59107', '', '', '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2008-02-01', '2009-04-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1508806100', 0, 'N', 0, '2010-01-15', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11002954', 'W11002954', 'WY01', 'Billings Clinic - Urology', 'Richard', 'B', 'Melzer', 'MD', 'Urology', '', '', NULL, 'O', '2825 8th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4062382501', '4062382881', '2825 8th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4062382501', '4062382881', '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2008-02-01', '2009-04-30', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1407953086', 0, 'N', 0, '2011-08-22', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11002955', 'W11002955', 'WY01', 'Billings Clinic - Pulmonary', 'Robert', 'K', 'Merchant', 'MD', 'Pulmonary', NULL, NULL, NULL, 'O', '2825 8th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4062382501', '4062382813', 'PO Box 37000', 'Billings', '', 'MT', '59107', '', '', '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2008-02-01', '2009-04-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1487754057', 0, 'N', 0, '2010-01-15', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11002956', 'W11002956', 'WY01', 'Billings Clinic - Internal Medicine', 'Angela', 'M', 'Merrin', 'PA-C', 'Internal Medicine', NULL, NULL, NULL, 'O', '2825 8th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4062382501', '4062382413', 'PO Box 37000', 'Billings', '', 'MT', '59107', '', '', '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2008-02-01', '2009-04-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1043493802', 0, 'N', 0, '2010-01-15', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11002957', 'W11002957', 'WY01', 'Billings Clinic - Emergency', 'James', NULL, 'Miller', 'DO', 'Emergency Medicine', NULL, NULL, NULL, 'O', '2800 10th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4066574150', '4066574349', 'PO Box 37000', 'Billings', '', 'MT', '59107', '', '', '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2008-02-01', '2009-04-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1578615431', 0, 'N', 0, '2009-05-04', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11002958', 'W11002958', 'WY01', 'Billings Clinic - CV Surgery', 'J Scott', 'Scott', 'Millikan', 'MD', 'Cardiovascular Disease', NULL, NULL, NULL, 'O', '2825 8th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4062382501', '4062382848', 'PO Box 37000', 'Billings', '', 'MT', '59107', '', '', '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2008-02-01', '2009-04-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1841373693', 0, 'N', 0, '2010-01-15', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11002959', 'W11002959', 'WY01', 'Billings Clinic - Hospitalist', 'Peter', '', 'Mitchell', 'MD', 'Hospitalist', '', '', NULL, 'O', '2800 10th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4066574150', '4062382978', '2800 10th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4066574150', '4062382978', '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2008-02-01', '2009-04-30', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1306944566', 0, 'N', 0, '2014-02-04', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11002960', 'W11002960', 'WY01', 'Billings Clinic - Nephrology', 'Gregory', NULL, 'Mock', 'MD', 'Nephrology', NULL, NULL, NULL, 'O', '2825 8th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4062382501', '4062382590', 'PO Box 37000', 'Billings', '', 'MT', '59107', '', '', '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2008-02-01', '2009-04-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1942308101', 0, 'N', 0, '2009-05-04', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11002961', 'W11002961', 'WY01', 'Billings Clinic - Same Day Care', 'Michael', 'D', 'Monday', 'MD', 'Family Practice', NULL, NULL, NULL, 'O', '2825 8th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4062382501', '4062382868', 'PO Box 37000', 'Billings', '', 'MT', '59107', '', '', '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2008-02-01', '2009-04-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1013017680', 0, 'N', 0, '2010-01-15', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11002962', 'W11002962', 'WY01', 'Billings Clinic - Neurosurgery', 'Michael', 'A', 'Morone', 'MD', 'Neurosurgery', '', '', NULL, 'O', '2825 8th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4062382501', '4062385809', '2825 8th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4062382501', '4062385809', '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2008-02-01', '2009-04-30', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1407954456', 0, 'N', 0, '2012-04-16', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11002963', 'W11002963', 'WY01', 'Billings Clinic - Orthopedics & Sports Medicine', 'Stephanie', NULL, 'Morup', 'PA-C', 'Orthopedic Surgery', NULL, NULL, NULL, 'O', '2702 8th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4062382501', '4062385218', 'PO Box 37000', 'Billings', '', 'MT', '59107', '', '', '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2008-02-01', '2009-04-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1952409112', 0, 'N', 0, '2009-05-04', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11002964', 'W11002964', 'WY01', 'Billings Clinic - OB/GYN', 'Patrick', NULL, 'Muffley', 'DO', 'Obstetrics and Gynecology', NULL, NULL, NULL, 'O', '2825 8th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4062382501', '4062382806', 'PO Box 37000', 'Billings', '', 'MT', '59107', '', '', '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2008-02-01', '2008-02-27', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1528015260', 0, 'N', 0, '2009-05-04', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11002965', 'W11002965', 'WY01', 'Billings Clinic - Pathology', 'Trudie', '', 'Muir', 'MD', 'Pathology', '', '', NULL, 'O', '2800 10th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4066574150', '4066574349', '2800 10th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4066574150', '4066574349', '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2008-02-01', '2009-04-30', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1073558110', 0, 'N', 0, '2014-02-04', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11002966', 'W11002966', 'WY01', 'Billings Clinic - Gen Surg', 'Bret', 'T', 'Murray', 'MD', 'General Surgery', NULL, NULL, NULL, 'O', '2825 8th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4062382501', '4062382848', 'PO Box 37000', 'Billings', '', 'MT', '59107', '', '', '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2008-02-01', '2009-04-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1306853130', 0, 'N', 0, '2010-01-15', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11002967', 'W11002967', 'WY01', 'Billings Clinic - Neurology', 'Melody', 'A', 'Murter', 'FNP', 'Neurology', NULL, NULL, NULL, 'O', '2825 8th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4062382501', '4062382805', 'PO Box 37000', 'Billings', '', 'MT', '59107', '', '', '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2008-02-01', '2009-04-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1306896444', 0, 'N', 0, '2010-01-15', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11002968', 'W11002968', 'WY01', 'Billings Clinic - CV Surgery', 'Charles', 'Scott', 'Needham', 'MD', 'Cardiovascular Disease', '', '', NULL, 'O', '2825 8th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4062382501', '4062382848', 'PO Box 37000', 'Billings', '', 'MT', '59107', '', '', '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2008-02-01', '2009-04-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1063435899', 0, 'N', 0, '2010-01-15', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11002969', 'W11002969', 'WY01', 'Billings Clinic - Dietary', 'Krystie', NULL, 'Nelson', 'RD', 'Dietician', NULL, NULL, NULL, 'B', '2800 10th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4066574150', '4066574349', 'PO Box 37000', 'Billings', '', 'MT', '59107', '', '', '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2008-02-01', '2009-04-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1053419002', 0, 'Y', 0, '2009-05-04', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11002970', 'W11002970', 'WY01', 'Billings Clinic - Internal Medicine', 'Laurie', 'K', 'Neubauer', 'PA-C', 'Internal Medicine', NULL, NULL, NULL, 'O', '2825 8th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4062382501', '4062382413', 'PO Box 37000', 'Billings', 'Yellowstone', 'MT', '59107', '4062382501', '4062382413', '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2008-02-01', '2009-04-30', NULL, 0, 0, '', '', '', '', 'HCFA|UB|', '1326146374', 0, 'N', 0, '2010-05-26', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11002971', 'W11002971', 'WY01', 'Billings Clinic - Cancer Center', 'Jorge', 'J', 'Nieva', 'MD', 'Oncology', 'Hematology and Oncology', '', NULL, 'O', '2825 8th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4062382501', '4062382469', '2825 8th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4062382501', '4062382469', '', NULL, '', '0.00', '17.00', '0.00', 3, '2008-02-01', '2009-04-30', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1497717672', 0, 'N', 0, '2014-05-08', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11002972', 'W11002972', 'WY01', 'Billings Clinic - Emergency', 'David', NULL, 'Nigh', 'MD', 'Emergency Medicine', '', '', NULL, 'O', '2800 10th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4066574150', '4066574349', 'PO Box 37000', 'Billings', '', 'MT', '59107', '', '', '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2008-02-01', '2009-04-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1790876514', 0, 'N', 0, '2009-05-04', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11002973', 'W11002973', 'WY01', 'Billings Clinic - Occupational Health & Wellness', 'Diana', '', 'Notis', 'PT', 'Physical Therapy', '', '', NULL, 'O', '1020 N 27th St', 'Billings', 'Yellowstone', 'MT', '59101', '4062382501', '4062476240', '1020 N 27th St', 'Billings', 'Yellowstone', 'MT', '59101', '4062382501', '4062476240', '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2008-02-01', '2009-04-30', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1386744951', 0, 'N', 0, '2013-10-03', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11002974', 'W11002974', 'WY01', 'Billings Clinic - Emergency', 'Sara', NULL, 'Nyquist', 'MD', 'Emergency Medicine', NULL, NULL, NULL, 'O', '2800 10th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4066574150', '4066574349', 'PO Box 37000', 'Billings', '', 'MT', '59107', '', '', '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2008-02-01', '2009-04-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1407954662', 0, 'N', 0, '2009-05-04', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11002975', 'W11002975', 'WY01', 'Billings Clinic - Neurology', 'Dennis', 'K', 'O Brien', 'MD', 'Neurology', NULL, NULL, NULL, 'O', '2825 8th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4062382501', '4062382805', 'PO Box 37000', 'Billings', '', 'MT', '59107', '', '', '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2008-02-01', '2009-04-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1811981699', 0, 'N', 0, '2010-01-15', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11002976', 'W11002976', 'WY01', 'Billings Clinic - Research', 'Thomas', NULL, 'Olson', 'MD', 'Obstetrics and Gynecology', NULL, NULL, NULL, 'O', '1045 N 30th St', 'Billings', 'Yellowstone', 'MT', '59101', '4062558470', '4062558479', 'PO Box 37000', 'Billings', '', 'MT', '59107', '', '', '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2008-02-01', '2009-04-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '0000007966', 0, 'N', 0, '2009-05-04', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11002977', 'W11002977', 'WY01', 'Billings Clinic - OB/GYN', 'Camille', 'S', 'Osborn', 'MD', 'Obstetrics and Gynecology', '', '', NULL, 'O', '2825 8th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4062382501', '4062382806', 'PO Box 37000', 'Billings', '', 'MT', '59107', '', '', '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2008-02-01', '2009-04-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1245338292', 0, 'N', 0, '2010-01-15', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11002978', 'W11002978', 'WY01', 'Billings Clinic - Cardiology', 'Janet', '', 'Otto', 'MD', 'Electrophysiology', '', '', NULL, 'O', '1020 N 27th St', 'Billings', 'Yellowstone', 'MT', '59101', '4062382000', '4062382066', '1020 N 27th St', 'Billings', 'Yellowstone', 'MT', '59101', '4062382000', '4062382066', '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2008-02-01', '2009-04-30', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1063510220', 0, 'N', 0, '2014-02-04', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11002979', 'W11002979', 'WY01', 'Behavioral Health Clinic', 'James', NULL, 'Peak', 'MD', 'Mental Health', NULL, NULL, NULL, 'O', '1020 N 27th St', 'Billings', 'Yellowstone', 'MT', '59101', '4062558550', '4062525430', 'PO Box 37000', 'Billings', '', 'MT', '59107', '', '', '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2008-02-01', '2009-04-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1801994264', 0, 'N', 0, '2009-05-04', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11002980', 'W11002980', 'WY01', 'Billings Clinic - Neurosurgery', 'Randal', 'W', 'Pearson', 'PA-C', 'Neurosurgery', NULL, NULL, NULL, 'O', '2825 8th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4062382501', '4062382805', 'PO Box 37000', 'Billings', '', 'MT', '59107', '', '', '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2008-02-01', '2009-04-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1649370362', 0, 'N', 0, '2010-01-15', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11002981', 'W11002981', 'WY01', 'Billings Clinic - Dietary', 'Jodie', NULL, 'Pekovich', '"RD, LN"', 'Dietician', NULL, NULL, NULL, 'B', '2800 10th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4066574150', '4066574349', 'PO Box 37000', 'Billings', '', 'MT', '59107', '', '', '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2008-02-01', '2009-04-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1871659078', 0, 'Y', 0, '2009-05-04', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11002982', 'W11002982', 'WY01', 'Billings Clinic - Internal Medicine', 'Rebecca', 'L', 'Pestle', 'PA-C', 'Internal Medicine', '', '', NULL, 'O', '2825 8th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4062382501', '4062382771', '2825 8th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4062382501', '4062382771', '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2008-02-01', '2009-04-30', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1144240615', 0, 'N', 0, '2013-10-03', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11002983', 'W11002983', 'WY01', 'Billings Clinic - Neurology', 'Dale', 'M', 'Peterson', 'MD', 'Neurology', NULL, NULL, NULL, 'O', '2825 8th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4062382501', '4062382805', 'PO Box 37000', 'Billings', '', 'MT', '59107', '', '', '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2008-02-01', '2009-04-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1093815672', 0, 'N', 0, '2010-01-15', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11002984', 'W11002984', 'WY01', 'Billings Clinic - Occupational Health & Wellness', 'John', NULL, 'Petrisko', 'MD', 'Occupational Medicine', NULL, NULL, NULL, 'O', '1020 N 27th St', 'Billings', 'Yellowstone', 'MT', '59101', '4062382501', '4062476240', 'PO Box 37000', 'Billings', '', 'MT', '59107', '', '', '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2008-02-01', '2009-04-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1083728448', 0, 'N', 0, '2009-05-04', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11002985', 'W11002985', 'WY01', 'Billings Clinic - Dietary', 'Heather', NULL, 'Petty', 'RD', 'Dietician', NULL, NULL, NULL, 'B', '2800 10th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4066574150', '4066574349', 'PO Box 37000', 'Billings', '', 'MT', '59107', '', '', '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2008-02-01', '2009-04-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1093815714', 0, 'Y', 0, '2009-05-04', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11002986', 'W11002986', 'WY01', 'Billings Clinic - Hospitalist', 'Jennifer', '', 'Pflug', 'MD', 'Hospitalist', '', '', NULL, 'O', '2800 10th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4066574150', '4062382572', '2800 10th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4066574150', '4062382572', '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2008-02-01', '2009-04-30', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1912989542', 0, 'N', 0, '2012-07-23', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11002987', 'W11002987', 'WY01', 'Billings Clinic - Cardiology', 'Neil', NULL, 'Phung', 'MD', 'Cardovascular Disease', NULL, NULL, NULL, 'O', '1020 N 27th St', 'Billings', 'Yellowstone', 'MT', '59101', '4062382000', '4062382066', 'PO Box 37000', 'Billings', '', 'MT', '59107', '', '', '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2008-02-01', '2008-02-29', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1063523223', 0, 'N', 0, '2009-05-04', 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
('810231784', 'W11002988', 'W11002988', 'WY01', 'Billings Clinic - Peds', 'Michelle', NULL, 'Pierson', 'MD', 'Pediatrics', NULL, NULL, NULL, 'O', '2800 10th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4066574150', '4066574349', 'PO Box 37000', 'Billings', '', 'MT', '59107', '', '', '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2008-02-01', '2009-04-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1134149602', 0, 'N', 0, '2009-05-04', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11002989', 'W11002989', 'WY01', 'Billings Clinic - Radiology', 'Bruce', NULL, 'Pinkerton', 'MD', 'Radiologist', NULL, NULL, NULL, 'O', '2800 10th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4066574150', '4066574349', 'PO Box 37000', 'Billings', '', 'MT', '59107', '', '', '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2008-02-01', '2009-04-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1487737136', 0, 'N', 0, '2009-05-04', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11002990', 'W11002990', 'WY01', 'Billings Clinic - Orthopedics & Sports Medicine', 'Rachelle', NULL, 'Prevost', 'PT', 'Physical Therapy', NULL, NULL, NULL, 'O', '2702 8th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4062382501', '4066573782', 'PO Box 37000', 'Billings', '', 'MT', '59107', '', '', '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2008-02-01', '2009-04-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1861675001', 0, 'N', 0, '2009-05-04', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11002991', 'W11002991', 'WY01', 'Billings Clinic - ENT', 'Scott', 'D', 'Price', 'MD', 'Ear, Nose and Throat', NULL, NULL, NULL, 'O', '2825 8th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4062382501', '4062385043', 'PO Box 37000', 'Billings', '', 'MT', '59107', '', '', '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2008-02-01', '2009-04-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1275633851', 0, 'N', 0, '2010-01-15', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11002992', 'W11002992', 'WY01', 'Billings Clinic - Pulmonary', 'Robert', 'J', 'Pueringer', 'MD', 'Pulmonary', NULL, NULL, NULL, 'O', '2825 8th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4062382501', '4062382813', 'PO Box 37000', 'Billings', '', 'MT', '59107', '', '', '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2008-02-01', '2009-04-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1457442295', 0, 'N', 0, '2010-01-15', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11002993', 'W11002993', 'WY01', 'Billings Clinic - Cancer Center', 'William', 'Thomas', 'Purcell', 'MD', 'Oncology', 'Hematology and Oncology', NULL, NULL, 'O', '2825 8th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4062382501', '4062382469', 'PO Box 37000', 'Billings', '', 'MT', '59107', '', '', '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2008-02-01', '2009-04-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1336187236', 0, 'N', 0, '2010-01-15', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11002994', 'W11002994', 'WY01', 'Behavioral Health Clinic', 'Christina', NULL, 'Quijano', 'MD', 'Mental Health', NULL, NULL, NULL, 'O', '1020 N 27th St', 'Billings', 'Yellowstone', 'MT', '59101', '4062558550', '4062525430', 'PO Box 37000', 'Billings', '', 'MT', '59107', '', '', '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2008-02-01', '2009-04-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1356387112', 0, 'N', 0, '2009-05-04', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11002995', 'W11002995', 'WY01', 'Billings Clinic - Cardiology', 'Brian', '', 'Rah', 'MD', 'Cardovascular Disease', '', '', NULL, 'O', '1020 N 27th St', 'Billings', 'Yellowstone', 'MT', '59101', '4062382000', '4062382066', '1020 N 27th St', 'Billings', 'Yellowstone', 'MT', '59101', '4062382000', '4062382066', '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2008-02-01', '2009-04-30', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1518995158', 0, 'N', 0, '2014-03-13', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11002996', 'W11002996', 'WY01', 'Billings Clinic - OB/GYN', 'Mark', 'E', 'Randak', 'MD', 'Obstetrics and Gynecology', NULL, NULL, NULL, 'O', '2825 8th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4062382501', '4062382806', 'PO Box 37000', 'Billings', '', 'MT', '59107', '', '', '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2008-02-01', '2009-04-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1952470098', 0, 'N', 0, '2010-01-15', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11002997', 'W11002997', 'WY01', 'Billings Clinic - Internal Medicine', 'David', 'L', 'Rawlinson', 'DPM', 'Podiatry', NULL, NULL, NULL, 'O', '2825 8th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4062382501', '4062382771', 'PO Box 37000', 'Billings', '', 'MT', '59107', '', '', '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2008-02-01', '2009-04-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1386697142', 0, 'N', 0, '2010-01-15', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11002999', 'W11002999', 'WY01', 'Billings Clinic - Internal Medicine', 'Dennis', NULL, 'Regan', 'MD', 'Internal Medicine', NULL, NULL, NULL, 'O', '2800 10th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4066574000', '4062382771', 'PO Box 37000', 'Billings', '', 'MT', '59107', '', '', '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2008-02-01', '2009-04-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1568510907', 0, 'N', 0, '2009-05-04', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11003000', 'W11003000', 'WY01', 'Billings Clinic - Occupational Health & Wellness', 'John', NULL, 'Repac', 'OTR/L', 'Occupational Therapy', NULL, NULL, NULL, 'O', '1020 N 27th St', 'Billings', 'Yellowstone', 'MT', '59101', '4062382501', '4062476240', 'PO Box 37000', 'Billings', '', 'MT', '59107', '', '', '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2008-02-01', '2009-04-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1720161474', 0, 'N', 0, '2009-05-04', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11003001', 'W11003001', 'WY01', 'Billings Clinic - Derm', 'Albert', 'C', 'Reynaud', 'MD', 'Dermatology', NULL, NULL, NULL, 'O', '2825 8th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4062382501', '4062382437', 'PO Box 37000', 'Billings', '', 'MT', '59107', '', '', '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2008-02-01', '2009-04-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1104924000', 0, 'N', 0, '2010-01-15', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11003002', 'W11003002', 'WY01', 'Billings Clinic - Neurology', 'Scott', 'A', 'Riggins', 'MD', 'Neurology', NULL, NULL, NULL, 'O', '2825 8th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4062382501', '4062382805', 'PO Box 37000', 'Billings', '', 'MT', '59107', '', '', '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2008-02-01', '2009-04-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1679671598', 0, 'N', 0, '2010-01-15', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11003003', 'W11003003', 'WY01', 'Billings Clinic - Gen Surg', 'Bradley', 'M', 'Roberts', 'ARNP', 'General Surgery', NULL, NULL, NULL, 'O', '2825 8th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4062382501', '4062382848', 'PO Box 37000', 'Billings', '', 'MT', '59107', '', '', '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2008-02-01', '2009-04-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1649277237', 0, 'N', 0, '2010-01-15', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11003004', 'W11003004', 'WY01', 'Billings Clinic - Cardiology', 'Laura', 'K', 'Robinson', 'PA-C', 'General Surgery', 'Cardovascular Disease', NULL, NULL, 'O', '1020 N 27th St', 'Billings', 'Yellowstone', 'MT', '59101', '4062382000', '4062382066', 'PO Box 37000', 'Billings', '', 'MT', '59107', '', '', '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2008-02-01', '2009-04-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1619075546', 0, 'N', 0, '2009-05-04', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11003005', 'W11003005', 'WY01', 'Billings Clinic - Orthopedics & Sports Medicine', 'Whitney', NULL, 'Robinson', 'MD', 'Orthopedic Surgery', NULL, NULL, NULL, 'O', '2702 8th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4062382501', '4062385218', 'PO Box 37000', 'Billings', '', 'MT', '59107', '', '', '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2008-02-01', '2009-04-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1578632717', 0, 'N', 0, '2009-05-04', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11003006', 'W11003006', 'WY01', 'Billings Clinic - Neurology', 'Daniel', 'V', 'Rodriguez', 'MD', 'Neurology', '', '', NULL, 'O', '2825 8th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4062382501', '4062382805', 'PO Box 37000', 'Billings', '', 'MT', '59107', '', '', '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2008-02-01', '2009-04-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1720187651', 0, 'N', 0, '2010-01-15', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11003007', 'W11003007', 'WY01', 'Billings Clinic - Pulmonary', 'Robert', 'J', 'Rollins', 'MD', 'Pulmonary', NULL, NULL, NULL, 'O', '2825 8th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4062382501', '4062382813', 'PO Box 37000', 'Billings', '', 'MT', '59107', '', '', '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2008-02-01', '2009-04-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1427131341', 0, 'N', 0, '2010-01-15', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11003008', 'W11003008', 'WY01', 'Billings Clinic - Rehab', 'Sarah', NULL, 'Rongstad', 'ST', 'Speech Therapy', NULL, NULL, NULL, 'O', '2825 8th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4062382501', '4062382978', 'PO Box 37000', 'Billings', '', 'MT', '59107', '', '', '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2008-02-01', '2009-04-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1780867838', 0, 'N', 0, '2009-05-04', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11003009', 'W11003009', 'WY01', 'Billings Clinic - OB/GYN', 'Lisa', 'R', 'Ross', 'MD', 'Obstetrics and Gynecology', '', '', NULL, 'O', '2825 8th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4062382501', '4062382806', 'PO Box 37000', 'Billings', '', 'MT', '59107', '', '', '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2008-02-01', '2009-04-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1831181924', 0, 'N', 0, '2010-01-15', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11003010', 'W11003010', 'WY01', 'Billings Clinic - Occupational Health & Wellness', 'Scott', '', 'Ross', 'MD', 'Occupational Medicine', '', '', NULL, 'O', '1020 N 27th St', 'Billings', 'Yellowstone', 'MT', '59101', '4062382501', '4062476240', '1020 N 27th St', 'Billings', 'Yellowstone', 'MT', '59101', '4062382501', '4062476240', '', NULL, '', '0.00', '17.00', '0.00', 3, '2008-02-01', '2009-04-30', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1255414900', 0, 'N', 0, '2014-07-14', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11003011', 'W11003011', 'WY01', 'Billings Clinic - Gastro', 'Mark', 'C', 'Rumans', 'MD', 'Gastroenterology', NULL, NULL, NULL, 'O', '2825 8th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4062382501', '4062382763', 'PO Box 37000', 'Billings', '', 'MT', '59107', '', '', '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2008-02-01', '2009-04-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1699858340', 0, 'N', 0, '2010-01-15', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11003012', 'W11003012', 'WY01', 'Billings Clinic - Urology', 'Sarah', 'A', 'Ryan', 'MD', 'Urology', NULL, NULL, NULL, 'O', '2825 8th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4062382501', '4062382881', 'PO Box 37000', 'Billings', '', 'MT', '59107', '', '', '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2008-02-01', '2009-04-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1659328391', 0, 'N', 0, '2010-01-15', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11003013', 'W11003013', 'WY01', 'Billings Clinic - Internal Medicine', 'Robert', 'J', 'Sachs', 'MD', 'Internal Medicine', NULL, NULL, NULL, 'O', '2825 8th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4062382501', '4062382771', 'PO Box 37000', 'Billings', '', 'MT', '59107', '', '', '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2008-02-01', '2009-04-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1033203591', 0, 'N', 0, '2010-01-15', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11003014', 'W11003014', 'WY01', 'Billings Clinic - Cardiology', 'Scott', '', 'Sample', 'DO', 'Cardiovascular Disease', '', '', NULL, 'O', '1020 N 27th St', 'Billings', 'Yellowstone', 'MT', '59101', '4062382000', '4062382066', '1020 N 27th St', 'Billings', 'Yellowstone', 'MT', '59101', '4062382000', '4062382066', '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2008-02-01', '2009-04-30', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1558444216', 0, 'N', 0, '2014-03-13', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11003015', 'W11003015', 'WY01', 'Billings Clinic - Orthopedics & Sports Medicine', 'Timothy', NULL, 'Sanders', 'PA-C', 'Orthopedic Surgery', NULL, NULL, NULL, 'O', '2702 8th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4062382501', '4062385218', 'PO Box 37000', 'Billings', '', 'MT', '59107', '', '', '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2008-02-01', '2009-04-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1770666422', 0, 'N', 0, '2009-05-04', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11003016', 'W11003016', 'WY01', 'Billings Clinic - Cardiology', 'Charlotte', NULL, 'Sanderson', 'ACNP-C', 'Cardovascular Disease', NULL, NULL, NULL, 'O', '1020 N 27th St', 'Billings', 'Yellowstone', 'MT', '59101', '4062382000', '4062382066', 'PO Box 37000', 'Billings', '', 'MT', '59107', '', '', '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2008-02-01', '2009-04-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1942499645', 0, 'N', 0, '2009-05-04', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11003017', 'W11003017', 'WY01', 'Billings Clinic - Cancer Center', 'Roger', 'G', 'Santala', 'MD', 'Oncology', 'Hematology and Oncology', NULL, NULL, 'O', '2825 8th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4062382501', '4062382469', 'PO Box 37000', 'Billings', '', 'MT', '59107', '', '', '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2008-02-01', '2009-04-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1396828059', 0, 'N', 0, '2010-01-15', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11003018', 'W11003018', 'WY01', 'Billings Clinic - Urology', 'Sheila', 'D', 'Sarmiento', 'PA-C', 'Urology', NULL, NULL, NULL, 'O', '2825 8th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4062382501', '4062382881', 'PO Box 37000', 'Billings', '', 'MT', '59107', '', '', '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2008-02-01', '2009-04-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1841207982', 0, 'N', 0, '2010-01-15', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11003019', 'W11003019', 'WY01', 'Billings Clinic - Peds', 'J', 'Patrick', 'Sauer', 'MD', 'Pediatrics', NULL, NULL, NULL, 'O', '2800 10th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4066574150', '4066574349', 'PO Box 37000', 'Billings', '', 'MT', '59107', '', '', '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2008-02-01', '2009-04-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1295818953', 0, 'N', 0, '2009-05-04', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11003020', 'W11003020', 'WY01', 'Billings Clinic - Radiation  Oncology', 'John', 'M', 'Schallenkamp', 'MD', 'Radiation Oncology', NULL, NULL, NULL, 'O', '2825 8th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4062382501', '4062382572', 'PO Box 37000', 'Billings', '', 'MT', '59107', '', '', '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2008-02-01', '2009-04-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1265455018', 0, 'N', 0, '2010-01-15', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11003021', 'W11003021', 'WY01', 'Billings Clinic - Neurology', 'Larry', 'G', 'Scharfe', 'PA-C', 'Neurology', NULL, NULL, NULL, 'O', '2825 8th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4062382501', '4062382805', 'PO Box 37000', 'Billings', '', 'MT', '59107', '', '', '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2008-02-01', '2009-04-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1619050374', 0, 'N', 0, '2010-01-15', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11003022', 'W11003022', 'WY01', 'Billings Clinic - Orthopedics & Sports Medicine', 'Guy', NULL, 'Schmidt', 'MD', 'Orthopedic Surgery', NULL, NULL, NULL, 'O', '2702 8th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4062382501', '4062385218', 'PO Box 37000', 'Billings', '', 'MT', '59107', '', '', '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2008-02-01', '2009-04-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1922090604', 0, 'N', 0, '2009-05-04', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11003023', 'W11003023', 'WY01', 'Billings Clinic - Orthopedics & Sports Medicine', 'Lanny', NULL, 'Schneider', 'PA-C', 'Orthopedic Surgery', NULL, NULL, NULL, 'O', '2702 8th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4062382501', '4062385218', 'PO Box 37000', 'Billings', '', 'MT', '59107', '', '', '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2008-02-01', '2009-04-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1922071414', 0, 'N', 0, '2009-05-04', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11003024', 'W11003024', 'WY01', 'Billings Clinic - Orthopedics & Sports Medicine', 'Robert', NULL, 'Schultz', 'MD', 'Orthopedic Surgery', NULL, NULL, NULL, 'O', '2702 8th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4062382501', '4062385218', 'PO Box 37000', 'Billings', '', 'MT', '59107', '', '', '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2008-02-01', '2009-04-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1609959360', 0, 'N', 0, '2009-05-04', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11003025', 'W11003025', 'WY01', 'Billings Clinic - Heights Clinic', 'Andrew', NULL, 'Seddon', 'MD', 'Family Practice', NULL, NULL, NULL, 'O', '760 Wicks Ln', 'Billings', 'Yellowstone', 'MT', '59105', '4062382575', '4062382586', 'PO Box 37000', 'Billings', '', 'MT', '59107', '', '', '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2008-02-01', '2009-04-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1831242510', 0, 'N', 0, '2009-05-04', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11003026', 'W11003026', 'WY01', 'Billings Clinic - Pathology', 'Mark', '', 'Sheiko', 'MD', 'Pathology', '', '', NULL, 'O', '2800 10th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4066574150', '4066574349', '2800 10th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4066574150', '4066574349', '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2008-02-01', '2009-04-30', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1275612616', 0, 'N', 0, '2014-02-04', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11003027', 'W11003027', 'WY01', 'Billings Clinic - Rehab', 'Linda', 'R', 'Shelton', 'PT', 'Physical Therapy', NULL, NULL, NULL, 'O', '2825 8th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4062382501', '4062382978', 'PO Box 37000', 'Billings', '', 'MT', '59107', '', '', '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2008-02-01', '2009-04-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1023220225', 0, 'N', 0, '2010-01-15', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11003028', 'W11003028', 'WY01', 'Billings Clinic - PMR', 'Lynn', 'F', 'Shenk', 'DO', 'Physical Medicine and Rehabilitation', NULL, NULL, NULL, 'O', '2825 8th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4062382501', '4062382723', 'PO Box 37000', 'Billings', '', 'MT', '59107', '', '', '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2008-02-01', '2009-04-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1134208572', 0, 'N', 0, '2010-01-15', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11003029', 'W11003029', 'WY01', 'Billings Clinic - Cardiology', 'Adriana', NULL, 'Slobodova', 'MD', 'Electrophysiology', NULL, NULL, NULL, 'O', '1020 N 27th St', 'Billings', 'Yellowstone', 'MT', '59101', '4062382000', '4062382066', 'PO Box 37000', 'Billings', '', 'MT', '59107', '', '', '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2008-02-01', '2009-04-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1629116397', 0, 'N', 0, '2009-05-04', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11003030', 'W11003030', 'WY01', 'Billings Clinic - Orthopedics & Sports Medicine', 'Barry', NULL, 'Smith', 'MD', 'Orthopedic Surgery', NULL, NULL, NULL, 'O', '2702 8th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4062382501', '4062385218', 'PO Box 37000', 'Billings', '', 'MT', '59107', '', '', '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2008-02-01', '2009-04-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1417949108', 0, 'N', 0, '2009-05-04', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11003031', 'W11003031', 'WY01', 'Billings Clinic - Pathology', 'Jeffrey', NULL, 'Smith', 'MD', 'Pathology', NULL, NULL, NULL, 'O', '2800 10th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4066574150', '4066574349', 'PO Box 37000', 'Billings', '', 'MT', '59107', '', '', '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2008-02-01', '2009-04-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1568490845', 0, 'N', 0, '2009-05-04', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11003032', 'W11003032', 'WY01', 'Billings Clinic - Infectious Disease', 'Ronald', NULL, 'Smith', 'MD', 'Infectious Disease', NULL, NULL, NULL, 'O', '2825 8th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4062382501', '4062382253', 'PO Box 37000', 'Billings', '', 'MT', '59107', '', '', '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2008-02-01', '2009-04-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1427237965', 0, 'N', 0, '2009-05-04', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11003033', 'W11003033', 'WY01', 'Billings Clinic - Occupational Health & Wellness', 'Matthew', NULL, 'Solka', 'PT', 'Physical Therapy', NULL, NULL, NULL, 'O', '1020 N 27th St', 'Billings', 'Yellowstone', 'MT', '59101', '4062382501', '4062476240', 'PO Box 37000', 'Billings', '', 'MT', '59107', '', '', '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2008-02-01', '2008-06-01', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1730237272', 0, 'N', 0, '2009-05-04', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11003034', 'W11003034', 'WY01', 'Billings Clinic - Peds', 'Joan', NULL, 'Sorenson', 'MD', 'Pediatrics', NULL, NULL, NULL, 'O', '2800 10th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4066574150', '4066574349', 'PO Box 37000', 'Billings', '', 'MT', '59107', '', '', '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2008-02-01', '2009-04-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1538118138', 0, 'N', 0, '2009-05-04', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11003035', 'W11003035', 'WY01', 'Billings Clinic - Endocrinology', 'Christopher', 'H', 'Sorli', 'MD', 'Endocrinology', NULL, NULL, NULL, 'O', '2825 8th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4062382501', '4062382413', 'PO Box 37000', 'Billings', '', 'MT', '59107', '', '', '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2008-02-01', '2009-04-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1972537660', 0, 'N', 0, '2010-01-15', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11003036', 'W11003036', 'WY01', 'Billings Clinic - Orthopedics & Sports Medicine', 'Elie', NULL, 'Soueidi', 'PA-C', 'Orthopedic Surgery', NULL, NULL, NULL, 'O', '2702 8th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4062382501', '4062385218', 'PO Box 37000', 'Billings', '', 'MT', '59107', '', '', '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2008-02-01', '2009-04-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1508801002', 0, 'N', 0, '2009-05-04', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11003037', 'W11003037', 'WY01', 'Billings Clinic - Same Day Care', 'Randy', 'L', 'Spear', 'PA-C', 'Family Practice', NULL, NULL, NULL, 'O', '2825 8th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4062382501', '4062382868', 'PO Box 37000', 'Billings', '', 'MT', '59107', '', '', '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2008-02-01', '2009-04-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1740363712', 0, 'N', 0, '2010-01-15', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11003038', 'W11003038', 'WY01', 'Billings Clinic - Derm', 'Michelle', 'L', 'Spenny', 'MD', 'Dermatology', NULL, NULL, NULL, 'O', '2825 8th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4062382501', '4062382437', 'PO Box 37000', 'Billings', '', 'MT', '59107', '', '', '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2008-02-01', '2009-04-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1689753097', 0, 'N', 0, '2010-01-15', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11003039', 'W11003039', 'WY01', 'Billings Clinic - Same Day Care', 'Karen', NULL, 'Stainton', 'FNP', 'Family Practice', NULL, NULL, NULL, 'O', '2825 8th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4062382501', '4062382868', 'PO Box 37000', 'Billings', '', 'MT', '59107', '', '', '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2008-02-01', '2009-04-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1780763193', 0, 'N', 0, '2010-01-15', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11003040', 'W11003040', 'WY01', 'Billings Clinic - Ophthalmology', 'Richard', 'F', 'Stanich', 'OD', 'Optometry', NULL, NULL, NULL, 'O', '2825 8th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4062382501', '4062382871', 'PO Box 37000', 'Billings', '', 'MT', '59107', '', '', '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2008-02-01', '2009-04-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1316095854', 0, 'N', 0, '2010-01-15', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11003041', 'W11003041', 'WY01', 'Billings Clinic - Peds', 'Brian', NULL, 'Starr', 'MD', 'Pediatrics', NULL, NULL, NULL, 'O', '2800 10th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4066574150', '4066574349', 'PO Box 37000', 'Billings', '', 'MT', '59107', '', '', '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2008-02-01', '2009-04-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1316026727', 0, 'N', 0, '2009-05-04', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11003042', 'W11003042', 'WY01', 'Billings Clinic - Cardiology', 'Michelle', '', 'Stavnes', 'FNP-C', 'Geriatrics', '', '', NULL, 'O', '1020 N 27th St', 'Billings', 'Yellowstone', 'MT', '59101', '4062382000', '4062382066', '1020 N 27th St', 'Billings', 'Yellowstone', 'MT', '59101', '4062382000', '4062382066', '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2008-02-01', '2009-04-30', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1295896611', 0, 'N', 0, '2013-10-04', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11003043', 'W11003043', 'WY01', 'Billings Clinic - Pulmonary', 'Catherine', 'L', 'Stephens', 'MD', 'Pulmonary', NULL, NULL, NULL, 'O', '2825 8th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4062382501', '4062382813', 'PO Box 37000', 'Billings', '', 'MT', '59107', '', '', '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2008-02-01', '2009-04-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1144309550', 0, 'N', 0, '2010-01-15', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11003044', 'W11003044', 'WY01', 'Billings Clinic - Outreach Services', 'Jerome', 'R', 'Stewart', 'DO', 'Family Practice', 'General Practice', NULL, NULL, 'O', '2825 8th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4062558441', '4062558405', 'PO Box 37000', 'Billings', '', 'MT', '59107', '', '', '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2008-02-01', '2009-04-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1568406429', 0, 'N', 0, '2010-01-15', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11003045', 'W11003045', 'WY01', 'Billings Clinic - OBGYN', 'Nancy', 'J', 'Stockman', 'FNP', 'Obstetrics and Gynecology', NULL, NULL, NULL, 'O', '2825 8th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4062382501', '4062382806', 'PO Box 37000', 'Billings', '', 'MT', '59107', '', '', '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2008-02-01', '2009-04-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1235287673', 0, 'N', 0, '2010-01-15', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11003046', 'W11003046', 'WY01', 'Behavioral Health Clinic', 'Melody', NULL, 'Stupey', 'MD', 'Mental Health', NULL, NULL, NULL, 'O', '1020 N 27th St', 'Billings', 'Yellowstone', 'MT', '59101', '4062558550', '4062525430', 'PO Box 37000', 'Billings', '', 'MT', '59107', '', '', '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2008-02-01', '2009-04-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1235218645', 0, 'N', 0, '2009-05-04', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11003047', 'W11003047', 'WY01', 'Billings Clinic - Orthopedics & Sports Medicine', 'Brian', NULL, 'Sullivan', 'PA-C', 'Orthopedic Surgery', NULL, NULL, NULL, 'O', '2702 8th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4062382501', '4062385218', 'PO Box 37000', 'Billings', '', 'MT', '59107', '', '', '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2008-02-01', '2009-04-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1881773299', 0, 'N', 0, '2009-05-04', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11003048', 'W11003048', 'WY01', 'Billings Clinic - Internal Medicine', 'Laura', NULL, 'Szabo', 'MD', 'Internal Medicine', NULL, NULL, NULL, 'O', '2825 8th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4062382501', '4062382413', 'PO Box 37000', 'Billings', '', 'MT', '59107', '', '', '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2008-02-01', '2009-04-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1902905870', 0, 'N', 0, '2009-05-04', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11003049', 'W11003049', 'WY01', 'Billings Clinic - Orthopedics & Sports Medicine', 'April', NULL, 'Taber', 'PT', 'Physical Therapy', NULL, NULL, NULL, 'O', '2702 8th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4062382501', '4062385218', 'PO Box 37000', 'Billings', '', 'MT', '59107', '', '', '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2008-02-01', '2008-07-16', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1871776013', 0, 'N', 0, '2009-05-04', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11003050', 'W11003050', 'WY01', 'Billings Clinic - Neurology', 'Don', 'Q', 'Thai', 'MD', 'Neurology', NULL, NULL, NULL, 'O', '2825 8th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4062382501', '4062382805', 'PO Box 37000', 'Billings', '', 'MT', '59107', '', '', '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2008-02-01', '2009-04-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1992804843', 0, 'N', 0, '2010-01-15', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11003051', 'W11003051', 'WY01', 'Billings Clinic - Cardiology', 'Alan', '', 'Thometz', 'MD', 'Cardiovascular Disease', 'Electrophysiology', '', NULL, 'O', '1020 N 27th St', 'Billings', 'Yellowstone', 'MT', '59101', '4062382000', '4062382066', '1020 N 27th St', 'Billings', 'Yellowstone', 'MT', '59101', '4062382000', '4062382066', '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2008-02-01', '2009-04-30', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1104925098', 0, 'N', 0, '2014-04-09', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11003052', 'W11003052', 'WY01', 'Behavioral Health Clinic', 'Robert', NULL, 'Tompkins', 'EdD', 'Mental Health', NULL, NULL, NULL, 'O', '1020 N 27th St', 'Billings', 'Yellowstone', 'MT', '59101', '4062558550', '4062525430', 'PO Box 37000', 'Billings', '', 'MT', '59107', '', '', '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2008-02-01', '2009-04-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1861591760', 0, 'N', 0, '2009-05-04', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11003053', 'W11003053', 'WY01', 'Billings Clinic - Nephrology', 'Diane D', NULL, 'Truchot', 'FNP', 'Nephrology', NULL, NULL, NULL, 'O', '2825 8th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4062382501', '4062382469', 'PO Box 37000', 'Billings', '', 'MT', '59107', '', '', '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2008-02-01', '2009-04-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1639252521', 0, 'N', 0, '2009-05-04', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11003054', 'W11003054', 'WY01', 'Billings Clinic - Hospitalist', 'Enrico', NULL, 'Versace', 'MD', 'Hospitalist', NULL, NULL, NULL, 'O', '2800 10th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4066574150', '4062382572', 'PO Box 37000', 'Billings', '', 'MT', '59107', '', '', '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2008-02-01', '2009-04-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1790732204', 0, 'N', 0, '2009-05-04', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11003055', 'W11003055', 'WY01', 'Billings Clinic - Orthopedics & Sports Medicine', 'Troy', NULL, 'Wagner', 'PA', 'Orthopedic Surgery', NULL, NULL, NULL, 'O', '2702 8th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4062382501', '4062385218', 'PO Box 37000', 'Billings', '', 'MT', '59107', '', '', '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2008-02-01', '2009-04-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1376626036', 0, 'N', 0, '2009-05-04', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11003056', 'W11003056', 'WY01', 'Billings Clinic - Dietary', 'Tamara', NULL, 'Waite', 'RD', 'Dietician', NULL, NULL, NULL, 'B', '2800 10th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4066574150', '4066574349', 'PO Box 37000', 'Billings', '', 'MT', '59107', '', '', '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2008-02-01', '2009-04-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1023007077', 0, 'Y', 0, '2009-05-04', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11003057', 'W11003057', 'WY01', 'Billings Clinic - Orthopedics & Sports Medicine', 'Matthew', NULL, 'Walsh', 'MD', 'Orthopedic Surgery', NULL, NULL, NULL, 'O', '2702 8th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4062382501', '4062385218', 'PO Box 37000', 'Billings', '', 'MT', '59107', '', '', '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2008-02-01', '2009-04-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '0000003028', 0, 'N', 0, '2009-05-04', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11003058', 'W11003058', 'WY01', 'Billings Clinic - Ophthalmology', 'Daniel', NULL, 'Weaver', 'MD', 'Ophthalmology', NULL, NULL, NULL, 'O', '2825 8th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4062382501', '4062382871', 'PO Box 37000', 'Billings', '', 'MT', '59107', '', '', '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2008-02-01', '2009-04-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '0000003065', 0, 'N', 0, '2009-05-04', NULL, NULL, 0, 0, NULL, NULL),
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('810231784', 'W11003062', 'W11003062', 'WY01', 'Billings Clinic', 'James', '', 'Wiggins', 'MD', 'Pediatric Cardiology', '', '', NULL, 'O', '2825 8th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4062382501', NULL, '2825 8th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4062382501', '', '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2008-02-01', '2009-04-30', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1164478897', 0, 'N', 0, '2012-11-02', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11003063', 'W11003063', 'WY01', 'Billings Clinic - Same Day Care', 'Derek', '', 'Williams', 'MD', 'Family Practice', '', '', NULL, 'O', '2825 8th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4062382501', '4062382868', '2825 8th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4062382501', '4062382868', '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2008-02-01', '2009-04-03', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1811907884', 0, 'N', 0, '2012-11-02', NULL, NULL, 0, 0, NULL, NULL),
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('810231784', 'W11003065', 'W11003065', 'WY01', 'Billings Clinic - Emergency', 'Ronald', NULL, 'Winters', 'MD', 'Emergency Medicine', NULL, NULL, NULL, 'O', '2800 10th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4066574150', '4066574349', 'PO Box 37000', 'Billings', '', 'MT', '59107', '', '', '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2008-02-01', '2009-04-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1477623619', 0, 'N', 0, '2009-05-04', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11003066', 'W11003066', 'WY01', 'Billings Clinic - Dietary', 'Elizabeth', NULL, 'Wiome', 'RD', 'Dietician', NULL, NULL, NULL, 'B', '2800 10th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4066574150', '4066574349', 'PO Box 37000', 'Billings', '', 'MT', '59107', '', '', '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2008-02-01', '2009-04-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1013086263', 0, 'Y', 0, '2009-05-04', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11003067', 'W11003067', 'WY01', 'Billings Clinic - Pulmonary', 'Nicholas', '', 'Wolter', 'MD', 'Urology', '', '', NULL, 'O', '2825 8th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4062382501', '4062382813', '2825 8th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4062382501', '4062382813', '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2008-02-01', '2009-04-30', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '0000003099', 0, 'N', 0, '2014-02-04', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11003068', 'W11003068', 'WY01', 'Billings Clinic - Cancer Center', 'Mary', NULL, 'Deigert', 'PAC', 'Oncology', 'Hematology and Oncology', NULL, NULL, 'O', '2825 8th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4062382501', '4062382469', 'PO Box 37000', 'Billings', '', 'MT', '59107', '', '', '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2008-02-01', '2009-04-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1578675344', 0, 'N', 0, '2009-05-04', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11003069', 'W11003069', 'WY01', 'Billings Clinic - Emergency', 'Raymond', NULL, 'Wright', 'MD', 'Emergency Medicine', NULL, NULL, NULL, 'O', '2800 10th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4066574150', '4066574349', 'PO Box 37000', 'Billings', '', 'MT', '59107', '', '', '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2008-02-01', '2009-04-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1558440966', 0, 'N', 0, '2009-05-04', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11003070', 'W11003070', 'WY01', 'Billings Clinic - Same Day Care', 'Chill', NULL, 'Yee', 'MD', 'Family Practice', NULL, NULL, NULL, 'O', '2825 8th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4062382501', '4062382868', 'PO Box 37000', 'Billings', '', 'MT', '59107', '', '', '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2008-02-01', '2008-07-15', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1811009699', 0, 'N', 0, '2009-05-04', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11003071', 'W11003071', 'WY01', 'Behavioral Health Clinic', 'David', NULL, 'Yelvington', 'MD', 'Mental Health', NULL, NULL, NULL, 'O', '1020 N 27th St', 'Billings', 'Yellowstone', 'MT', '59101', '4062558550', '4062525430', 'PO Box 37000', 'Billings', '', 'MT', '59107', '', '', '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2008-02-01', '2009-04-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1285658427', 0, 'N', 0, '2009-05-04', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11003072', 'W11003072', 'WY01', 'Billings Clinic - Hospitalist', 'Tye', NULL, 'Young', 'DO', 'Hospitalist', NULL, NULL, NULL, 'O', '2800 10th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4066574150', '4062382572', 'PO Box 37000', 'Billings', '', 'MT', '59107', '', '', '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2008-02-01', '2009-04-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1750493532', 0, 'N', 0, '2009-05-04', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11003073', 'W11003073', 'WY01', 'Billings Clinic - Allergy', 'Michael', NULL, 'Younker', 'MD', 'Allergy and Immunology', NULL, NULL, NULL, 'O', '2825 8th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4062382501', '4062382805', 'PO Box 37000', 'Billings', '', 'MT', '59107', '', '', '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2008-02-01', '2009-04-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '0000003010', 0, 'N', 0, '2009-05-04', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11003074', 'W11003074', 'WY01', 'Billings Clinic - Gastro', 'Bradley', NULL, 'Zins', 'MD', 'Gastroenterology', NULL, NULL, NULL, 'O', '2825 8th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4062382501', '4062382763', 'PO Box 37000', 'Billings', '', 'MT', '59107', '', '', '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2008-02-01', '2009-04-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1649382433', 0, 'N', 0, '2009-05-04', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11003075', 'W11003075', 'WY01', 'Billings Clinic - Cardiology', 'Robert', NULL, 'Zirpoli', 'MD', 'Cardiovascular Disease', NULL, NULL, NULL, 'O', '1020 N 27th St', 'Billings', 'Yellowstone', 'MT', '59101', '4062382000', '4062382066', 'PO Box 37000', 'Billings', '', 'MT', '59107', '', '', '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2008-02-01', '2009-04-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '0000009750', 0, 'N', 0, '2009-05-04', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11003076', 'W11003076', 'WY01', 'Billings Clinic - Same Day Care', 'Steven', NULL, 'Williamson', 'MD', 'Family Practice', NULL, NULL, NULL, 'O', '2825 8th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4062382501', '4062382868', 'PO Box 37000', 'Billings', '', 'MT', '59107', '', '', '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2008-02-01', '2009-04-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1023197464', 0, 'N', 0, '2009-05-04', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11003077', 'W11003077', 'WY01', 'Billings Clinic - Heights Clinic', 'Dale', NULL, 'Emery', 'MD', 'Internal Medicine', NULL, NULL, NULL, 'O', '760 Wicks Ln', 'Billings', 'Yellowstone', 'MT', '59105', '4062562575', '4062382586', 'PO Box 37000', 'Billings', '', 'MT', '59107', '', '', '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2008-02-01', '2009-04-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1164533725', 0, 'N', 0, '2009-05-04', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11003078', 'W11003078', 'WY01', 'Billings Clinic - Heights Clinic', 'Glenn', NULL, 'Guzman', 'MD', 'Family Practice', NULL, NULL, NULL, 'O', '760 Wicks Ln', 'Billings', 'Yellowstone', 'MT', '59105', '4062382575', '4062382586', 'PO Box 37000', 'Billings', '', 'MT', '59107', '', '', '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2008-02-01', '2009-04-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1760594725', 0, 'N', 0, '2009-05-04', NULL, NULL, 0, 0, NULL, NULL),
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('810231784', 'W11003080', 'W11003080', 'WY01', 'Billings Clinic - Heights Clinic', 'Laura', NULL, 'Rathe', 'MD', 'Internal Medicine', NULL, NULL, NULL, 'O', '760 Wicks Ln', 'Billings', 'Yellowstone', 'MT', '59101', '4062382575', '4062382586', 'PO Box 37000', 'Billings', '', 'MT', '59107', '', '', '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2008-02-01', '2009-04-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1982702874', 0, 'N', 0, '2009-05-04', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11003081', 'W11003081', 'WY01', 'Billings Clinic - Heights Clinic', 'Larry', '', 'Severa', 'MD', 'Family Practice', '', '', NULL, 'O', '760 Wicks Ln', 'Billings', 'Yellowstone', 'MT', '59105', '4062382575', '4062382586', '760 Wicks Ln', 'Billings', 'Yellowstone', 'MT', '59105', '4062382575', '4062382586', '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2008-02-01', '2009-04-30', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1770504052', 0, 'N', 0, '2011-07-26', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11003082', 'W11003082', 'WY01', 'Billings Clinic - Heights Clinic', 'Chris', NULL, 'Sturdevant', 'PT', 'Physical Therapy', NULL, NULL, NULL, 'O', '760 Wicks Ln', 'Billings', 'Yellowstone', 'MT', '59105', '4062562575', '4062382586', 'PO Box 37000', 'Billings', '', 'MT', '59107', '', '', '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2008-02-01', '2009-04-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1154400562', 0, 'N', 0, '2009-05-04', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11003083', 'W11003083', 'WY01', 'Billings Clinic - West End Clinic', 'Leslie', NULL, 'Bennington III', 'OT', 'Occupational Therapy', NULL, NULL, NULL, 'O', '2675 Central Ave', 'Billings', 'Yellowstone', 'MT', '59102', '4062382900', '4062382978', 'PO Box 37000', 'Billings', '', 'MT', '59107', '', '', '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2008-02-01', '2009-04-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1841219706', 0, 'N', 0, '2009-05-04', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11003084', 'W11003084', 'WY01', 'Billings Clinic - West End Clinic', 'Shelly', NULL, 'Castles', 'MD', 'Family Practice', NULL, NULL, NULL, 'O', '2675 Central Ave', 'Billings', 'Yellowstone', 'MT', '59102', '4062382900', '4062382978', 'PO Box 37000', 'Billings', '', 'MT', '59107', '', '', '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2008-02-01', '2009-04-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1952410953', 0, 'N', 0, '2009-05-04', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11003085', 'W11003085', 'WY01', 'Billings Clinic - West End Clinic', 'Darci', NULL, 'Doyle', 'MSLP', 'Speech Therapy', NULL, NULL, NULL, 'O', '2675 Central Ave', 'Billings', 'Yellowstone', 'MT', '59101', '4062382900', '4062382978', 'PO Box 37000', 'Billings', '', 'MT', '59107', '', '', '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2008-02-01', '2009-04-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1407047376', 0, 'N', 0, '2009-05-04', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11003086', 'W11003086', 'WY01', 'Billings Clinic - West End Clinic', 'Jennell', NULL, 'Duey', 'MD', 'Family Practice', NULL, NULL, NULL, 'O', '2675 Central Ave', 'Billings', 'Yellowstone', 'MT', '59102', '4062382900', '4062382978', 'PO Box 37000', 'Billings', '', 'MT', '59107', '', '', '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2008-02-01', '2009-04-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1275619918', 0, 'N', 0, '2009-05-04', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11003087', 'W11003087', 'WY01', 'Billings Clinic - West End Clinic', 'Heidi', NULL, 'Duncan', 'MD', 'Family Practice', NULL, NULL, NULL, 'O', '2675 Central Ave', 'Billings', 'Yellowstone', 'MT', '59102', '4062382900', '4062382978', 'PO Box 37000', 'Billings', '', 'MT', '59107', '', '', '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2008-02-01', '2009-04-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1376645341', 0, 'N', 0, '2009-05-04', 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
('810231784', 'W11003088', 'W11003088', 'WY01', 'Billings Clinic - West End Clinic', 'Barbara', NULL, 'Fenton', 'MD', 'Internal Medicine', NULL, NULL, NULL, 'O', '2675 Central Ave', 'Billings', 'Yellowstone', 'MT', '59102', '4062382900', '4062382978', 'PO Box 37000', 'Billings', '', 'MT', '59107', '', '', '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2008-02-01', '2009-04-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1578672531', 0, 'N', 0, '2009-05-04', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11003089', 'W11003089', 'WY01', 'Billings Clinic - West End Clinic', 'Daniel', NULL, 'Gall', 'MD', 'Family Practice', NULL, NULL, NULL, 'O', '2675 Central Ave', 'Billings', 'Yellowstone', 'MT', '59102', '4062382900', '4062382978', 'PO Box 37000', 'Billings', '', 'MT', '59107', '', '', '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2008-02-01', '2009-04-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1992817951', 0, 'N', 0, '2009-05-04', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11003090', 'W11003090', 'WY01', 'Billings Clinic - West End Clinic', 'Cammi', NULL, 'Goetze', 'OT', 'Occupational Therapy', NULL, NULL, NULL, 'O', '2675 Central Ave', 'Billings', 'Yellowstone', 'MT', '59102', '4062382900', '4062382978', 'PO Box 37000', 'Billings', '', 'MT', '59107', '', '', '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2008-02-01', '2009-04-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1174606081', 0, 'N', 0, '2009-05-04', NULL, NULL, 0, 0, NULL, NULL),
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('942854057', 'W11003167', 'W11003167', 'UTIHC04', 'Bear River Valley Hospital', '', '', 'Bear River Valley Hospital ', 'GROUP', 'Hospital', '', '', NULL, 'O', '905 N 1000 W', 'Tremonton', 'Box Elder', 'UT', '84337', '4352074500', NULL, '905 N 1000 W', 'Tremonton', 'Box Elder', 'UT', '84337', '4352074500', '', '', NULL, NULL, '0.00', '5.00', '0.00', 8, '2008-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1679582944', 0, 'N', 0, '2012-04-10', NULL, NULL, 41.7162, -112.201, NULL, NULL),
('942854057', 'W11003168', 'W11003168', 'UTIHC04', 'Fillmore Community Medical Center', NULL, NULL, 'Fillmore Community Medical Center', 'GROUP', 'Hospital', NULL, NULL, NULL, 'O', '647 S Hwy 99', 'Fillmore', 'Millard', 'UT', '84631', '4357435591', NULL, NULL, NULL, '', NULL, NULL, '', '', '', NULL, NULL, '0.00', '5.00', '0.00', 8, '2008-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '0000006241', 0, 'N', 0, '2008-05-14', NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W11003169', 'W11003169', 'UTIHC04', 'Fillmore Community Medical Center', NULL, NULL, 'Fillmore Community Medical Center', 'GROUP', 'Hospital', NULL, NULL, NULL, 'B', 'PO Box 30180', 'Salt Lake City', 'Salt Lake', 'UT', '84130', '4358645591', NULL, NULL, NULL, '', NULL, NULL, '', '', '', NULL, NULL, '0.00', '5.00', '0.00', 8, '2008-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '0000006241', 0, 'Y', 0, '2008-05-14', NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W11003170', 'W11003170', 'UTIHC04', 'Heber Valley Medical Center', NULL, NULL, 'Heber Valley Medical Center', 'GROUP', 'Hospital', NULL, NULL, NULL, 'B', 'PO Box 30180', 'Salt Lake City', 'Salt Lake', 'UT', '84130', '4356542500', NULL, NULL, NULL, '', NULL, NULL, '', '', '', NULL, NULL, '0.00', '10.00', '0.00', 8, '2008-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1316055205', 0, 'Y', 0, '2009-07-09', NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W11003171', 'W11003171', 'UTIHC04', 'Heber Valley Medical Center', NULL, NULL, 'Heber Valley Medical Center', 'GROUP', 'Hospital', NULL, NULL, NULL, 'O', '1485 S Hwy 40', 'Heber City', 'Wasatch', 'UT', '84032', '4356542500', NULL, NULL, NULL, '', NULL, NULL, '', '', '', NULL, NULL, '0.00', '10.00', '0.00', 8, '2008-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1316055205', 0, 'N', 0, '2009-07-09', NULL, NULL, 40.489, -111.409, NULL, NULL),
('942854057', 'W11003172', 'W11003172', 'UTIHC01', 'Logan Regional Hospital', '', '', 'Logan Regional Hospital', 'GROUP', 'Hospital', NULL, NULL, NULL, 'O', '1400 N 500 E', 'Logan', 'Cache', 'UT', '84341', '4357161000', NULL, NULL, NULL, '', NULL, NULL, '', '', '', NULL, NULL, '0.00', '15.00', '0.00', 8, '2008-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '0000007318', 0, 'N', 0, '2008-10-06', NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W11003173', 'W11003173', 'UTIHC04', 'Logan Regional Hospital', '', '', 'Logan Regional Hospital', 'GROUP', 'Hospital', NULL, NULL, NULL, 'O', '1400 N 500 E', 'Logan', 'Cache', 'UT', '84341', '4357161000', NULL, NULL, NULL, '', NULL, NULL, '', '', '', NULL, NULL, '0.00', '15.00', '0.00', 8, '2008-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '0000007318', 0, 'N', 0, '2008-10-06', NULL, NULL, 41.7569, -111.821, NULL, NULL),
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('942854057', 'W11003175', 'W11003175', 'UTIHC01', 'Logan Regional Hospital', '', '', 'Logan Regional Hospital', 'GROUP', 'Hospital', NULL, NULL, NULL, 'B', 'PO Box 30180', 'Salt Lake City', 'Salt Lake', 'UT', '84130', '4357161000', NULL, NULL, NULL, '', NULL, NULL, '', '', '', NULL, NULL, '0.00', '15.00', '0.00', 8, '2008-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '0000007318', 0, 'Y', 0, '2008-10-06', NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W11003176', 'W11003176', 'UTIHC04', 'Sanpete Valley Hospital', NULL, NULL, 'Sanpete Valley Hospital', 'GROUP', 'Hospital', NULL, NULL, NULL, 'B', 'PO Box 30180', 'Salt Lake City', 'Salt Lake', 'UT', '84130', '4354622441', NULL, NULL, NULL, '', NULL, NULL, '', '', '', NULL, NULL, '0.00', '5.00', '0.00', 8, '2008-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '0000008588', 0, 'Y', 0, '2008-05-14', NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W11003177', 'W11003177', 'UTIHC04', 'Sanpete Valley Hospital', NULL, NULL, 'Sanpete Valley Hospital', 'GROUP', 'Hospital', NULL, NULL, NULL, 'O', '1100 S Medical Dr', 'Mount Pleasant', 'Sanpete', 'UT', '84647', '4354622441', NULL, NULL, NULL, '', NULL, NULL, '', '', '', NULL, NULL, '0.00', '5.00', '0.00', 8, '2008-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '0000008588', 0, 'N', 0, '2008-05-14', NULL, NULL, 39.5318, -111.461, NULL, NULL),
('942854057', 'W11003178', 'W11003178', 'UTIHC01', 'Sevier Valley Hospital', '', '', 'Sevier Valley Medical Center ', 'GROUP', 'Hospital', '', '', NULL, 'O', '1100 N Main St', 'Richfield', 'Sevier', 'UT', '84701', '4358934100', NULL, '1100 N Main St', 'Richfield', 'Sevier', 'UT', '84701', '4358934100', '', '', NULL, NULL, '0.00', '5.00', '0.00', 8, '2008-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1336256775', 0, 'N', 0, '2011-01-26', NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W11003179', 'W11003179', 'UTIHC04', 'Sevier Valley Hospital', '', '', 'Sevier Valley Medical Center ', 'GROUP', 'Hospital', '', '', NULL, 'O', '1100 N Main St', 'Richfield', 'Sevier', 'UT', '84701', '4358934100', NULL, '1100 N Main St', 'Richfield', 'Sevier', 'UT', '84701', '4358934100', '', '', NULL, NULL, '0.00', '5.00', '0.00', 8, '2008-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1336256775', 0, 'N', 0, '2011-01-26', NULL, NULL, 38.7844, -112.084, NULL, NULL),
('942854057', 'W11003180', 'W11003180', 'UTIHC04', 'Sevier Valley Hospital', '', '', 'Sevier Valley Medical Center ', 'GROUP', 'Hospital', '', '', NULL, 'B', 'PO Box 30180', 'Salt Lake City', 'Salt Lake', 'UT', '84130', '4358934100', NULL, 'PO Box 30180', 'Salt Lake City', 'Salt Lake', 'UT', '84130', '4358934100', '', '', NULL, NULL, '0.00', '5.00', '0.00', 8, '2008-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1336256775', 0, 'Y', 0, '2011-01-26', NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W11003181', 'W11003181', 'UTIHC01', 'Sevier Valley Hospital', '', '', 'Sevier Valley Medical Center ', 'GROUP', 'Hospital', '', '', NULL, 'B', 'PO Box 30180', 'Salt Lake City', 'Salt Lake', 'UT', '84130', '4358934100', NULL, 'PO Box 30180', 'Salt Lake City', 'Salt Lake', 'UT', '84130', '4358934100', '', '', NULL, NULL, '0.00', '5.00', '0.00', 8, '2008-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1336256775', 0, 'Y', 0, '2011-01-26', NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W11003182', 'W11003182', 'UTIHC04', 'Cassia Regional Medical Center', NULL, NULL, 'Cassia Regional Medical Center', 'GROUP', 'Hospital', NULL, NULL, NULL, 'B', 'PO Box 30180', 'Salt Lake City', 'Salt Lake', 'UT', '84130', '2086784444', NULL, NULL, NULL, '', NULL, NULL, '', '', '', NULL, NULL, '0.00', '5.00', '0.00', 8, '2008-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '0000005598', 0, 'Y', 0, '2008-05-14', NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W11003183', 'W11003183', 'UTIHC04', 'Cassia Regional Medical Center', NULL, NULL, 'Cassia Regional Medical Center', 'GROUP', 'Hospital', NULL, NULL, NULL, 'O', '1501 Hiland Ave', 'Burley', 'Cassia', 'ID', '83318', '2086784444', NULL, NULL, NULL, '', NULL, NULL, '', '', '', NULL, NULL, '0.00', '5.00', '0.00', 8, '2008-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '0000005598', 0, 'N', 0, '2008-05-14', NULL, NULL, 42.5342, -113.783, 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
('942854057', 'W11003184', 'W11003184', 'UTIHC01', 'Valley View Medical Center', NULL, NULL, 'Valley View Medical Center', 'GROUP', 'Hospital', NULL, NULL, NULL, 'B', 'PO Box 30180', 'Salt Lake City', 'Salt Lake', 'UT', '84130', '4355866587', NULL, NULL, NULL, '', NULL, NULL, '', '', '', NULL, NULL, '0.00', '10.00', '0.00', 8, '2008-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '0000009409', 0, 'Y', 0, '2008-05-14', NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W11003185', 'W11003185', 'UTIHC03', 'Valley View Medical Center', NULL, NULL, 'Valley View Medical Center', 'GROUP', 'Hospital', NULL, NULL, NULL, 'B', 'PO Box 30180', 'Salt Lake City', 'Salt Lake', 'UT', '84130', '4355866587', NULL, NULL, NULL, '', NULL, NULL, '', '', '', NULL, NULL, '0.00', '10.00', '0.00', 8, '2008-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '0000009409', 0, 'Y', 0, '2008-05-14', NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W11003186', 'W11003186', 'UTIHC04', 'Valley View Medical Center', NULL, NULL, 'Valley View Medical Center', 'GROUP', 'Hospital', NULL, NULL, NULL, 'B', 'PO Box 30180', 'Salt Lake City', 'Salt Lake', 'UT', '84130', '4355866587', NULL, NULL, NULL, '', NULL, NULL, '', '', '', NULL, NULL, '0.00', '10.00', '0.00', 8, '2008-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '0000009409', 0, 'Y', 0, '2008-05-14', NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W11003187', 'W11003187', 'UTIHC01', 'Valley View Medical Center', NULL, NULL, 'Valley View Medical Center', 'GROUP', 'Hospital', NULL, NULL, NULL, 'O', '1303 N Main St', 'Cedar City', 'Iron', 'UT', '84720', '4355866587', NULL, NULL, NULL, '', NULL, NULL, '', '', '', NULL, NULL, '0.00', '10.00', '0.00', 8, '2008-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '0000009409', 0, 'N', 0, '2008-05-14', NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W11003188', 'W11003188', 'UTIHC03', 'Valley View Medical Center', NULL, NULL, 'Valley View Medical Center', 'GROUP', 'Hospital', NULL, NULL, NULL, 'O', '1303 N Main St', 'Cedar City', 'Iron', 'UT', '84720', '4355866587', NULL, NULL, NULL, '', NULL, NULL, '', '', '', NULL, NULL, '0.00', '10.00', '0.00', 8, '2008-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '0000009409', 0, 'N', 0, '2008-05-14', NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W11003189', 'W11003189', 'UTIHC04', 'Valley View Medical Center', NULL, NULL, 'Valley View Medical Center', 'GROUP', 'Hospital', NULL, NULL, NULL, 'O', '1303 N Main St', 'Cedar City', 'Iron', 'UT', '84720', '4355866587', NULL, NULL, NULL, '', NULL, NULL, '', '', '', NULL, NULL, '0.00', '10.00', '0.00', 8, '2008-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '0000009409', 0, 'N', 0, '2008-05-14', NULL, NULL, 37.7003, -113.064, NULL, NULL),
('942854057', 'W11003190', 'W11003190', 'UTIHC01', 'Utah Valley Regional Medical Center UNIQUE SERVICES ONLY', '', '', 'Utah Valley Regional Medical Center  UNIQUE SERVICES ONLY', 'GROUP', 'Hospital', '', '', NULL, 'O', '1304 N 500 W', 'Provo', 'Utah', 'UT', '84604', '8013577850', NULL, '1304 N 500 W', 'Provo', 'Utah', 'UT', '84604', '8013577850', '          ', '', '', 'IHC02', '0.00', '10.00', '0.00', 8, '2008-01-01', '2010-10-31', 1, 0, 0, '', '', '', '', 'HCFA|UB|', '0000009371', 0, 'N', 0, '2010-11-02', NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W11003191', 'W11003191', 'UTIHC02', 'Utah Valley Regional Medical Center UNIQUE SERVICES ONLY', '', '', 'Utah Valley Regional Medical Center  UNIQUE SERVICES ONLY', 'GROUP', 'Hospital', '', '', NULL, 'O', '1304 N 500 W', 'Provo', 'Utah', 'UT', '84604', '8013577850', NULL, '1304 N 500 W', 'Provo', 'Utah', 'UT', '84604', '8013577850', '          ', '', '', 'IHC02', '0.00', '10.00', '0.00', 8, '2008-01-01', '2010-10-31', 1, 0, 0, '', '', '', '', 'HCFA|UB|', '0000009371', 0, 'N', 0, '2010-11-02', NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W11003192', 'W11003192', 'UTIHC03', 'Utah Valley Regional Medical Center UNIQUE SERVICES ONLY', '', '', 'Utah Valley Regional Medical Center  UNIQUE SERVICES ONLY', 'GROUP', 'Hospital', '', '', NULL, 'O', '1304 N 500 W', 'Provo', 'Utah', 'UT', '84604', '8013577850', NULL, '1304 N 500 W', 'Provo', 'Utah', 'UT', '84604', '8013577850', '          ', '', '', 'IHC02', '0.00', '10.00', '0.00', 8, '2008-01-01', '2010-10-31', 1, 0, 0, '', '', '', '', 'HCFA|UB|', '0000009371', 0, 'N', 0, '2010-11-02', NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W11003193', 'W11003193', 'UTIHC04', 'Utah Valley Regional Medical Center UNIQUE SERVICES ONLY', '', '', 'Utah Valley Regional Medical Center  UNIQUE SERVICES ONLY', 'GROUP', 'Hospital', '', '', NULL, 'O', '1304 N 500 W', 'Provo', 'Utah', 'UT', '84604', '8013577850', NULL, '1304 N 500 W', 'Provo', 'Utah', 'UT', '84604', '8013577850', '          ', '', '', 'IHC02', '0.00', '10.00', '0.00', 8, '2008-01-01', '2010-10-31', 1, 0, 0, '', '', '', '', 'HCFA|UB|', '0000009371', 0, 'N', 0, '2010-11-02', NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W11003194', 'W11003194', 'UTIHC01', 'Utah Valley Regional Medical Center', 'Utah Valley Regional Medical Center', '', 'UNIQUE SERVICES ONLY', 'GROUP', 'Hospital', '', '', NULL, 'B', 'PO Box 30180', 'Salt Lake City', 'Salt Lake', 'UT', '84130', '8013577850', NULL, 'PO Box 30180', 'Salt Lake City', 'Salt Lake', 'UT', '84130', '8013577850', '          ', '', '', 'IHC02', '0.00', '10.00', '0.00', 8, '2008-01-01', '2010-10-31', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '0000009271', 0, 'Y', 0, '2010-11-02', NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W11003195', 'W11003195', 'UTIHC02', 'Utah Valley Regional Medical Center', 'Utah Valley Regional Medical Center', '', 'UNIQUE SERVICES ONLY', 'GROUP', 'Hospital', '', '', NULL, 'B', 'PO Box 30180', 'Salt Lake City', 'Salt Lake', 'UT', '84130', '8013577850', NULL, 'PO Box 30180', 'Salt Lake City', 'Salt Lake', 'UT', '84130', '8013577850', '          ', '', '', 'IHC02', '0.00', '10.00', '0.00', 8, '2008-01-01', '2010-10-31', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '0000009271', 0, 'Y', 0, '2010-11-02', NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W11003196', 'W11003196', 'UTIHC03', 'Utah Valley Regional Medical Center', 'Utah Valley Regional Medical Center', '', 'UNIQUE SERVICES ONLY', 'GROUP', 'Hospital', '', '', NULL, 'B', 'PO Box 30180', 'Salt Lake City', 'Salt Lake', 'UT', '84130', '8013577850', NULL, 'PO Box 30180', 'Salt Lake City', 'Salt Lake', 'UT', '84130', '8013577850', '          ', '', '', 'IHC02', '0.00', '10.00', '0.00', 8, '2008-01-01', '2010-10-31', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '0000009271', 0, 'Y', 0, '2010-11-02', NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W11003197', 'W11003197', 'UTIHC04', 'Utah Valley Regional Medical Center', 'Utah Valley Regional Medical Center', '', 'UNIQUE SERVICES ONLY', 'GROUP', 'Hospital', '', '', NULL, 'B', 'PO Box 30180', 'Salt Lake City', 'Salt Lake', 'UT', '84130', '8013577850', NULL, 'PO Box 30180', 'Salt Lake City', 'Salt Lake', 'UT', '84130', '8013577850', '          ', '', '', 'IHC02', '0.00', '10.00', '0.00', 8, '2008-01-01', '2010-10-31', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '0000009271', 0, 'Y', 0, '2010-11-02', NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W11003198', 'W11003198', 'UTIHC01', 'Primary Childrens Medical Center', '', '', 'Primary Childrens Medical Center', 'Group (Recognized PPO but not contracted pre-', 'Hospital', '', '', NULL, 'B', 'PO Box 30180', 'Salt Lake City', 'Salt Lake', 'UT', '84130', '8016621000', '          ', 'PO Box 30180', 'Salt Lake City', 'Salt Lake', 'UT', '84130', '8016621000', '          ', '', '', 'IHC01', '0.00', '0.00', '0.00', 8, '2008-01-01', '2014-06-30', 0, 0, 0, '', '', '', '', 'HCFA|UB|DEN|', '1235148594', 0, 'Y', 0, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
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('621795215', 'W11003210', 'W11003210', 'UT01', 'Associates in Orthopedic Surgery', 'J', 'Douglas', 'Burrows', 'MD', 'Orthopedic Surgery', '', '', NULL, 'O', '3336 S Pioneer Pkwy Ste 102', 'West Valley', 'Salt Lake', 'UT', '84120', '8019643925', '8019649382', '3336 S Pioneer Pkwy Ste 102', 'West Valley', 'Salt Lake', 'UT', '84120', '8019643925', '8019649382', 'WUSTDSURG5', 'WUSTDHCPC5', NULL, '0.00', '35.00', '0.00', 6, '2007-10-01', NULL, 0, 0, 0, 'Pioneer Valley Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1477506913', 0, 'N', 0, '2013-11-14', NULL, NULL, 40.6991, -111.99, NULL, NULL),
('621795215', 'W11003211', 'W11003211', 'UT01', 'Associates in Orthopedic Surgery', 'J', 'Douglas', 'Burrows', 'MD', 'Orthopedic Surgery', '', '', NULL, 'B', 'PO Box 150', 'West Jordan', 'Salt Lake', 'UT', '84084', '8019643921', '8019649382', 'PO Box 150', 'West Jordan', 'Salt Lake', 'UT', '84084', '8019643921', '8019649382', 'WUSTDSURG5', 'WUSTDHCPC5', NULL, '0.00', '35.00', '0.00', 6, '2007-10-01', NULL, 0, 0, 0, 'Pioneer Valley Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1477506913', 0, 'Y', 0, '2013-11-14', NULL, NULL, 0, 0, NULL, NULL),
('711016940', 'W11003213', 'W11003213', 'TX01', NULL, 'Arthur', '', 'Rosenthal', 'MD', 'General Surgery', '', '', NULL, 'O', '8042 Wurzbach Rd Ste 480', 'San Antonio', 'Bexar', 'TX', '78229', '2106160657', NULL, '8042 Wurzbach Rd Ste 480', 'San Antonio', 'Bexar', 'TX', '78229', '2106160657', '', 'TXSURGA', 'TXHCPCS', NULL, '0.00', '50.00', '0.00', 3, '2007-01-01', '2012-08-19', 0, 0, 0, 'Baptist Medical Center', '', '', '', 'HCFA|UB|', '1154393247', 0, 'N', 0, '2014-01-24', NULL, NULL, 29.5151, -98.5765, NULL, NULL),
('820444821', 'W11003214', 'W11003214', 'UT01', 'Preston Family Medicine', 'Mark', 'H', 'Gibby', 'MD', 'Family Practice', '', '', NULL, 'O', '45 North 1st East', 'Preston', 'Franklin', 'ID', '83263', '2088523755', NULL, '45 North 1st East', 'Preston', 'Franklin', 'ID', '83263', '2088523755', '', 'WISESTD', 'WUSTDHCPC5', NULL, '0.00', '35.00', '0.00', 3, '2008-01-01', NULL, 0, 0, 0, 'Franklin County Medical Center', '', '', '', 'HCFA|UB|', '1104973304', 0, 'n', 0, '2011-12-29', NULL, NULL, 42.0971, -111.874, NULL, NULL),
('820444821', 'W11003215', 'W11003215', 'UT01', 'Franklin Co. Medical Center', 'Mark', 'H', 'Gibby', 'MD', 'Family Practice', '', '', NULL, 'O', '41 N 100 East', 'Preston', 'Franklin', 'ID', '83263', '2088520137', NULL, '44 North 1st East', 'Preston', 'Franklin', 'ID', '83263', '2088520137', '', 'WISESTD', 'WUSTDHCPC5', NULL, '0.00', '35.00', '0.00', 3, '2008-01-01', NULL, 0, 0, 0, 'Franklin County Medical Center', '', '', '', 'HCFA|UB|', '1104973304', 0, 'n', 0, '2011-12-29', NULL, NULL, 42.0971, -111.874, NULL, NULL),
('870638151', 'W11003217', 'W11003217', 'UT01', 'Crossroads Family Medicine', 'Janice', 'H', 'Robinson', 'FNP', 'Family Practice', '', '', NULL, 'O', '1305 N Commerce Dr Ste 120', 'Saratoga Springs', 'Utah', 'UT', '84045', '8017662121', NULL, '1305 N Commerce Dr Ste 120', 'Saratoga Springs', 'Utah', 'UT', '84045', '8017662121', '', 'WISESTD', 'WUSTDHCPC5', NULL, '0.00', '35.00', '0.00', 3, '2006-09-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1184800047', 0, 'N', 0, '2013-07-02', NULL, NULL, 40.3849, -111.914, NULL, NULL),
('742719352', 'W11003218', 'W11003218', 'TX01', 'Urology of San Antonio', 'Christopher', 'W', 'Graham', 'MD', 'Urology', '', '', NULL, 'O', '255 E Sonterra Ste 200', 'San Antonio', 'Bexar', 'TX', '78258', '2105810376', '2105810382', '255 E Sonterra Ste 200', 'San Antonio', 'Bexar', 'TX', '78258', '2105810376', '2105810382', 'TXSTD', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2007-01-01', '2012-08-19', 0, 0, 0, 'North Central Baptist Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1861472961', 0, 'N', 0, '2014-01-24', NULL, NULL, 29.6171, -98.4906, NULL, NULL),
('742719352', 'W11003219', 'W11003219', 'TX01', 'Urology of San Antonio', 'Patricia', 'P', 'Cecconi', 'MD', 'Urology', '', '', NULL, 'O', '414 Navarro Ste 900', 'San Antonio', 'Bexar', 'TX', '78205', '2104747020', '2102262192', '414 Navarro Ste 900', 'San Antonio', 'Bexar', 'TX', '78205', '2104747020', '2102262192', 'TXSTD', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2007-01-01', '2012-08-19', 0, 0, 0, 'Mission Trail Baptist Hospital', '', '', '', 'HCFA|UB|', '1558399816', 0, 'N', 0, '2014-04-11', NULL, NULL, 29.4256, -98.4895, NULL, NULL),
('742719352', 'W11003220', 'W11003220', 'TX01', 'Urology of San Antonio', 'Patricia', 'P', 'Cecconi', 'MD', 'Urology', '', '', NULL, 'O', '4212 E Southcross Blvd Ste 125', 'San Antonio', 'Bexar', 'TX', '78222', '2103376228', '2103046476', '4212 E Southcross Blvd Ste 125', 'San Antonio', 'Bexar', 'TX', '78222', '2103376228', '2103046476', 'TXSTD', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2007-01-01', '2012-08-19', 0, 0, 0, 'Mission Trail Baptist Hospital', '', '', '', 'HCFA|UB|', '1558399816', 0, 'N', 0, '2014-04-11', NULL, NULL, 29.3746, -98.4125, NULL, NULL),
('621795215', 'W11003221', 'W11003221', 'UT01', 'Pioneer Valley Hospital Physicians', 'Michael', 'R', 'McFadden', 'MD', 'Urology', '', '', NULL, 'B', 'PO Box 150', 'West Jordan', 'Salt Lake', 'UT', '84084', '8013529500', NULL, 'PO Box 150', 'West Jordan', 'Salt Lake', 'UT', '84084', '8013529500', '', 'WUSTDSURG5', 'WUSTDHCPC5', NULL, '0.00', '35.00', '0.00', 6, '2007-08-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1811067283', 0, 'Y', 0, '2014-01-27', NULL, NULL, 0, 0, NULL, NULL),
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('810231784', 'W11003230', 'W11003230', 'WY01', 'Billings Clinic - Internal Medicine', 'Eric', NULL, 'Saberhagen', 'MD', 'Internal Medicine', NULL, NULL, NULL, 'O', '2825 8th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4062382501', '4062382413', 'PO Box 37000', 'Billings', '', 'MT', '59107', '', '', '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2008-07-01', '2009-04-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1528012184', 0, 'N', 0, '2009-05-04', NULL, NULL, 0, 0, NULL, NULL),
('836000891', 'W11003223', 'W11003223', 'WY01', 'North Big Horn Hospital', '', '', 'North Big Horn Hospital', 'GROUP', 'Hospital', '', '', NULL, 'O', '1115 Lane 12', 'Lovell', 'Big Horn', 'WY', '82431', '3075485201', NULL, '1115 Lane 12', 'Lovell', 'Big Horn', 'WY', '82431', '3075485201', '          ', '', '', '', '0.00', '10.00', '0.00', 3, '2008-02-01', '2011-06-30', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '0000007899', 0, 'N', 0, '2013-08-07', NULL, NULL, 0, 0, NULL, NULL),
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('836000891', 'W11003227', 'W11003227', 'WY01', 'North Big Horn Hospital Clinic', 'Derek', '', 'Gilbert', 'MD', 'Family Practice', '', '', NULL, 'O', '1115 Lane 12', 'Lovell', 'Big Horn', 'WY', '82431', '3075485201', NULL, '1115 Lane 12', 'Lovell', 'Big Horn', 'WY', '82431', '3075485201', '          ', '', '', '', '0.00', '10.00', '0.00', 3, '2008-02-01', '2011-06-30', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1477665925', 0, 'N', 0, '2012-04-27', NULL, NULL, 0, 0, NULL, NULL),
('836000891', 'W11003228', 'W11003228', 'WY01', 'North Big Horn Hospital Clinic', 'David', '', 'Hoffman', 'MD', 'Family Practice', 'General Surgery', '', NULL, 'O', '1115 Lane 12', 'Lovell', 'Big Horn', 'WY', '82431', '3075485201', NULL, '1115 Lane 12', 'Lovell', 'Big Horn', 'WY', '82431', '3075485201', '          ', '', '', '', '0.00', '10.00', '0.00', 3, '2008-02-01', '2011-06-30', 0, 0, 0, NULL, '', '', '', 'HCFA|UB|', '1144332552', 0, 'N', 0, '2013-06-18', NULL, NULL, 0, 0, NULL, NULL),
('836000891', 'W11003229', 'W11003229', 'WY01', 'North Big Horn Hospital Clinic', 'Jack', '', 'Carpenter', 'PA', 'Family Practice', '', '', NULL, 'O', '1115 Lane 12', 'Lovell', 'Big Horn', 'WY', '82431', '3075485201', NULL, '1115 Lane 12', 'Lovell', 'Big Horn', 'WY', '82431', '3075485201', '          ', '', '', '', '0.00', '12.00', '0.00', 3, '2008-02-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1912957028', 0, 'N', 0, '2013-12-04', NULL, NULL, 44.8258, -108.39, NULL, NULL),
('810231784', 'W11003231', 'W11003231', 'WY01', 'Billings Clinic - Miles City', 'Lori', NULL, 'Kobrine', 'MD', 'Pediatrics', NULL, NULL, NULL, 'O', '620 S Haynes', 'Miles City', 'Custer', 'MT', '59301', '4062337000', '4066574349', 'PO Box 37000', 'Billings', '', 'MT', '59107', '', '', '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2008-02-01', '2008-05-27', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1376653683', 0, 'N', 0, '2009-05-04', NULL, NULL, 0, 0, NULL, NULL),
('621795215', 'W11003232', 'W11003232', 'UT01', 'Jordan Valley Internal Medicine', 'Kenneth', 'W', 'Goldberg', 'MD', 'Internal Medicine', NULL, NULL, NULL, 'O', '3590 W 9000 S Suite 240', 'West Jordan', 'Salt Lake', 'UT', '84088', '8015692384', NULL, 'PO Box 150', 'West Jordan', '', 'UT', '84088', '', '', 'WUSTDINT5', 'WUSTDHCPC5', NULL, '0.00', '35.00', '0.00', 6, '2008-01-01', '2008-06-01', 0, 0, 0, 'Jordan Valley Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1356465793', 0, 'n', 0, '2008-06-17', NULL, NULL, 0, 0, NULL, NULL),
('621795215', 'W11003233', 'W11003233', 'UT01', 'Jordan Valley Internal Medicine', 'Kevin', 'B', 'Johnson', 'MD', 'Internal Medicine', '', '', NULL, 'O', '3590 W 9000 S Suite 240', 'West Jordan', 'Salt Lake', 'UT', '84088', '8015692384', NULL, '3590 W 9000 S Suite 240', 'West Jordan', 'Salt Lake', 'UT', '84088', '8015692384', '', 'WUSTDINT5', 'WUSTDHCPC5', NULL, '0.00', '35.00', '0.00', 6, '2008-01-01', '2008-01-01', 0, 0, 0, 'Jordan Valley Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1255456497', 0, 'n', 0, '2011-09-29', NULL, NULL, 0, 0, NULL, NULL),
('621795215', 'W11003234', 'W11003234', 'UT01', 'Jordan Valley Internal Medicine', 'David', 'R', 'Zackrison', 'MD', 'Internal Medicine', NULL, NULL, NULL, 'O', '3590 W 9000 S Suite 240', 'West Jordan', 'Salt Lake', 'UT', '84088', '8015692384', NULL, '3590 W 9000 S', 'West Jordan', '', 'UT', '84088', '', '', 'WUSTDINT5', 'WUSTDHCPC5', NULL, '0.00', '35.00', '0.00', 6, '2007-12-01', '2008-06-01', 0, 0, 0, 'Jordan Valley Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1346364775', 0, 'n', 0, '2008-06-17', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11003235', 'W11003235', 'WY01', 'Billings Clinic - Neurosurgery', 'Robert', 'James', 'Hancock', 'MD', 'Vascular Surgery', NULL, NULL, NULL, 'O', '2825 8th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4062382501', '4062385809', 'PO Box 37000', 'Billings', '', 'MT', '59107', '', '', '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2008-02-01', '2009-04-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1053599407', 0, 'N', 0, '2010-01-15', NULL, NULL, 0, 0, NULL, NULL),
('826000428', 'W11003237', 'W11003237', 'UT01', 'Oneida County Clinic', 'R', 'Todd', 'Gillespie', 'PA', 'Family Practice', 'Wound Care', '', NULL, 'O', '220 Bannock St', 'Malad City', 'Oneida', 'ID', '83252', '2087662600', NULL, '220 Bannock St', 'Malad City', 'Oneida', 'ID', '83252', '2087662600', '          ', 'WISESTD', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 6, '2008-02-01', NULL, 0, 0, 0, 'Oneida County Hospital', NULL, NULL, NULL, 'HCFA|', '1922026467', 0, 'N', 0, '2012-04-13', NULL, NULL, 42.1903, -112.253, NULL, NULL),
('382084239', 'W11003236', 'W11003236', 'TX01', 'Metwest Inc dba Quest Diagnost', '', '', 'Metwest Inc dba Quest Diagnost', 'GROUP', 'Laboratory', '', '', NULL, 'B', 'PO Box 822510', 'Philadelphia', 'Philadelphia', 'PA', '19182', NULL, NULL, 'PO Box 822510', 'Philadelphia', 'Philadelphia', 'PA', '19182', '', '', 'WUQUEST5', 'TXHCPCS', NULL, '0.00', '50.00', '0.00', 3, '2007-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '0000007585', 0, 'y', 0, '2012-07-10', NULL, NULL, 0, 0, NULL, NULL),
('826000428', 'W11003238', 'W11003238', 'UT01', 'Oneida County Clinic', 'Robert', 'D', 'Hodson', 'DO', 'Family Practice', '', '', NULL, 'O', '220 Bannock St', 'Malad City', 'Oneida', 'ID', '83252', '2087662600', NULL, '220 Bannock St', 'Malad City', 'Oneida', 'ID', '83252', '2087662600', '          ', 'WISESTD', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 6, '2008-02-01', '2009-07-30', 0, 0, 0, '', '', '', '', 'HCFA|', '1265482905', 0, 'N', 0, '2012-03-26', NULL, NULL, 0, 0, NULL, NULL),
('841367175', 'W11003239', 'W11003239', 'UT01', 'Canyon View Medical Group', 'Jared', 'L', 'Bingham', 'MD', 'Family Practice', '', '', NULL, 'O', '325 West Center', 'Spanish Fork', 'Utah', 'UT', '84660', '8017543122', NULL, '325 West Center', 'Spanish Fork', 'Utah', 'UT', '84660', '8017543122', '          ', 'WUUVPN10', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 3, '2006-01-01', '2010-07-14', 0, 0, 0, 'Mountain View Hospital', '', '', '', 'HCFA|UB|', '1932154200', 0, 'N', 0, '2013-09-13', NULL, NULL, 0, 0, NULL, NULL),
('743096310', 'W11003240', 'W11003240', 'UT01', 'St Marks Pain Center', 'Benjamin', 'R', 'Humphreys', 'DO', 'Physical Medicine and Rehabilitation', 'Pain Medicine', '', NULL, 'O', '1250 E 3900 S Ste 30', 'Salt Lake City', 'Salt Lake', 'UT', '84124', '8012687725', NULL, '1250 E 3900 S Ste 30', 'Salt Lake City', 'Salt Lake', 'UT', '84124', '8012687725', '', 'WISESTD', 'WUSTDHCPC5', NULL, '0.00', '35.00', '0.00', 3, '2007-08-01', NULL, 0, 0, 0, 'Davis Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1891728036', 0, 'Y', 0, '2011-07-26', NULL, NULL, 40.6871, -111.856, NULL, NULL),
('942854057', 'W11003241', 'W11003241', 'UT02', 'Intermountain Health Care - Budge Clinic', 'Michael', 'Scott', 'Callister', 'MD', 'Urology', '', '', NULL, 'O', '1350 N 500 E', 'Logan', 'Cache', 'UT', '84341', '4357921950', '4357921615', '1350 N 500 E', 'Logan', 'Cache', 'UT', '84341', '4357921950', '4357921615', 'USTDOBG', 'USTDHCPC', NULL, '0.00', '35.00', '0.00', 8, '2008-02-01', '2008-02-01', 0, 0, 0, 'Logan Regional Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1811038060', 0, 'Y', 0, '2011-01-03', NULL, NULL, 0, 0, NULL, NULL),
('205128411', 'W11003242', 'W11003242', 'UT01', 'South Summit Pediatrics', 'Sheri', 'L', 'Vlam', 'NP', 'Pediatrics', '', '', NULL, 'O', '267 E Traversepoint Dr', 'Draper', 'Salt Lake', 'UT', '84020', '8015538300', '          ', '267 E Traversepoint Dr', 'Draper', 'Salt Lake', 'UT', '84020', '8015538300', '          ', 'WISESTD', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 3, '2007-10-01', '2014-03-16', 0, 0, 0, 'Riverton Childrens Unit Operated by Primary Childrens Medical Center', '', '', '', 'HCFA|UB|', '1669400552', 0, 'N', 0, '2014-04-02', NULL, NULL, 40.4853, -111.883, NULL, NULL),
('810608733', 'W11003243', 'W11003243', 'UT01', 'Nexus Pain Care', 'Tao', '', 'Li', 'MD', 'Physical Medicine and Rehabilitation', '', '', NULL, 'O', '3585 N University Ave Ste 150', 'Provo', 'Utah', 'UT', '84604', '8013566100', '8013562113', '3585 N University Ave Ste 150', 'Provo', 'Utah', 'UT', '84604', '8013566100', '8013562113', 'WUSTDPAIN5', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 3, '2007-11-29', NULL, 0, 0, 0, 'Timpanogos Regional Hospital', '', '', '', 'HCFA|UB|', '1376725143', 0, 'N', 0, '2014-07-24', NULL, NULL, 40.2818, -111.658, NULL, NULL),
('810608733', 'W11003244', 'W11003244', 'UT01', 'Nexus Pain Care', 'Tao', '', 'Li', 'MD', 'Physical Medicine and Rehabilitation', '', '', NULL, 'O', '3570 W 9000 S Ste 100', 'West Jordan', 'Salt Lake', 'UT', '84088', '8018336569', NULL, '3570 W 9000 S Ste 100', 'West Jordan', 'Salt Lake', 'UT', '84088', '8018336569', '', 'WUSTDPAIN5', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 3, '2007-11-29', '2011-11-15', 0, 0, 0, 'Timpanogos Regional Hospital', '', '', '', 'HCFA|UB|', '1376725143', 0, 'N', 0, '2014-06-16', NULL, NULL, 0, 0, NULL, NULL),
('680528956', 'W11003245', 'W11003245', 'TX01', NULL, 'Laura', 'A', 'Rosenkranz', 'MD', 'Gastroenterology', NULL, NULL, NULL, 'O', '19284 Stone Oak Pkwy Ste102', 'San Antonio', 'Bexar', 'TX', '78258', '2102680124', '2102680146', 'PO Box 500', 'San Antonio', '', 'TX', '782920500', '', '', 'TXSURGD', 'TXHCPCS', NULL, '0.00', '50.00', '0.00', 3, '2008-01-01', '2009-07-22', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1659479103', 0, 'N', 0, '2008-02-18', NULL, NULL, 29.6307, -98.4951, NULL, NULL),
('680528956', 'W11003246', 'W11003246', 'TX01', NULL, 'Laura', 'A', 'Rosenkranz', 'MD', 'Gastroenterology', NULL, NULL, NULL, 'O', '3338 Oakwell Ct Ste 205', 'San Antonio', 'Bexar', 'TX', '78218', '2106563715', '2102680146', 'PO Box 500', 'San Antonio', '', 'TX', '782920500', '', '', 'TXSURGD', 'TXHCPCS', NULL, '0.00', '50.00', '0.00', 3, '2008-01-01', '2009-07-22', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1659479103', 0, 'N', 0, '2008-02-18', NULL, NULL, 29.5069, -98.4303, NULL, NULL),
('870468377', 'W11003247', 'W11003247', 'UT01', 'University Health Care', 'Christopher', 'B', 'Hansen', 'MD', 'Dermatology', '', '', NULL, 'o', '50 N Medical Dr', 'Salt Lake City', 'Salt Lake', 'UT', '84132', '8015812955', NULL, '50 N Medical Dr', 'Salt Lake City', 'Salt Lake', 'UT', '84132', '8015812955', '          ', 'WUUUMG5', 'WUSTDHCPC5', '', '0.00', '25.00', '0.00', 3, '2007-07-01', '2012-09-17', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1114077849', 0, 'N', 0, '2012-09-17', NULL, NULL, 0, 0, NULL, NULL),
('870468377', 'W11003248', 'W11003248', 'UT01', 'University Health Care', 'Christopher', 'B', 'Hansen', 'MD', 'Dermatology', '', '', NULL, 'B', 'PO Box 3208', 'Salt Lake City', 'Salt Lake', 'UT', '84110', '8015876340', '8015876346', 'PO Box 3208', 'Salt Lake City', 'Salt Lake', 'UT', '84110', '8015876340', '8015876346', 'WUUUMG5', 'WUSTDHCPC5', '', '0.00', '25.00', '0.00', 3, '2007-07-01', '2012-09-17', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1114077849', 0, 'Y', 0, '2012-09-17', NULL, NULL, 0, 0, NULL, NULL),
('810608733', 'W11003249', 'W11003249', 'UT01', 'Nexus Pain Care', 'James', 'H', 'Cloyd', 'PHD', 'Mental Health', 'Psychology', '', NULL, 'B', 'PO Box 27688', 'Salt Lake City', 'Salt Lake', 'UT', '84127', '8015341360', NULL, 'PO Box 27688', 'Salt Lake City', 'Salt Lake', 'UT', '84127', '8015341360', '', 'WUSTDPAIN5', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 3, '2006-10-25', '2006-10-25', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1750450953', 0, 'Y', 0, '2014-06-04', NULL, NULL, 0, 0, NULL, NULL),
('621795215', 'W11003250', 'W11003250', 'UT01', 'Pioneer ValleyMulti Specialty Clinic', 'Victor', '', 'Cruz', 'MD', 'Colon and Rectal Surgery', '', '', NULL, 'O', '3336 S 4155 W Ste 306', 'West Valley', 'Salt Lake', 'UT', '84120', '8019643921', NULL, '3336 S 4155 W Ste 306', 'West Valley', 'Salt Lake', 'UT', '84120', '8019643921', '', 'WUSTDSURG5', 'WUSTDHCPC5', NULL, '0.00', '35.00', '0.00', 6, '2007-08-01', '2009-03-10', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1861693947', 0, 'N', 0, '2010-06-17', NULL, NULL, 0, 0, NULL, NULL),
('870346222', 'W11003251', 'W11003251', 'UT01', '', 'Michael', '', 'Broadbent', 'DMD MS', 'Oral/Maxillofacial Surgery', 'Oral Surgeon', '', NULL, 'O', '3590 Harrison Blvd Ste 2', 'Ogden', 'Weber', 'UT', '84403', '8013927176', '8013929828', '3590 Harrison Blvd Ste 2', 'Ogden', 'Weber', 'UT', '84403', '8013927176', '8013929828', 'WiseSTD', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 3, '2007-07-15', '2009-01-01', 0, 0, 0, 'Ogden Regional Medical Center', '', '', '', 'HCFA|UB|', '1205049459', 0, 'N', 0, '2014-05-14', NULL, NULL, 0, 0, NULL, NULL),
('621795215', 'W11003252', 'W11003252', 'UT01', 'Pioneer Valley Hospital Physicians', 'Rohn', 'C', 'Rigby', 'MD', 'Family Practice', 'Hospitalist', '', NULL, 'O', '3460 S Pioneer Pkwy', 'West Valley', 'Salt Lake', 'UT', '84120', '8019643947', NULL, '3460 S. Pioneer Parkway', 'West Valley', 'Salt Lake', 'UT', '84120', '8019643947', '', 'WUSTDINT5', 'WUSTDHCPC5', NULL, '0.00', '35.00', '0.00', 6, '2008-02-01', NULL, 0, 0, 0, 'Davis Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1437283553', 0, 'Y', 0, '2012-06-21', NULL, NULL, 40.6972, -111.99, NULL, NULL),
('621795215', 'W11003253', 'W11003253', 'UT01', 'Pioneer Valley Hospital Physicians', 'Rohn', 'C', 'Rigby', 'MD', 'Family Practice', 'Hospitalist', '', NULL, 'B', 'PO Box 150', 'West Jordan', 'Salt Lake', 'UT', '84084', '8019643921', NULL, 'PO Box 150', 'West Jordan', 'Salt Lake', 'UT', '84084', '8019643921', '', 'WUSTDINT5', 'WUSTDHCPC5', NULL, '0.00', '35.00', '0.00', 6, '2008-02-01', NULL, 0, 0, 0, 'Davis Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1437283553', 0, 'Y', 0, '2012-06-21', NULL, NULL, 0, 0, NULL, NULL),
('621795215', 'W11003254', 'W11003254', 'UT01', 'Pioneer ValleyMulti Specialty Clinic', 'Victor', '', 'Cruz', 'MD', 'Colon and Rectal Surgery', '', '', NULL, 'B', 'PO Box 150', 'West Jordan', 'Salt Lake', 'UT', '84084', '8019643921', NULL, 'PO Box 150', 'West Jordan', 'Salt Lake', 'UT', '84084', '8019643921', '', 'WUSTDSURG5', 'WUSTDHCPC5', NULL, '0.00', '35.00', '0.00', 6, '2007-08-01', '2009-03-10', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1861693947', 0, 'Y', 0, '2010-06-17', NULL, NULL, 0, 0, NULL, NULL),
('621795215', 'W11003255', 'W11003255', 'UT01', 'Spine & Sports Medicine', 'Charles', 'M', 'Bova', 'MD', 'Pain Management', 'Sports Medicine', '', NULL, 'O', '3336 S Pioneer Pkwy Ste 202', 'West Valley', 'Salt Lake', 'UT', '84120', '8019643536', NULL, '3336 S Pioneer Pkwy Ste 202', 'West Valley', 'Salt Lake', 'UT', '84120', '8019643536', '          ', 'WUSTDSURG5', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 6, '2008-02-01', '2008-08-29', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1013071885', 0, 'N', 0, '2012-04-11', NULL, NULL, 0, 0, NULL, NULL),
('621795215', 'W11003256', 'W11003256', 'UT01', 'Spine & Sports Medicine', 'Charles', 'M', 'Bova', 'MD', 'Pain Management', 'Sports Medicine', '', NULL, 'B', 'PO Box 150', 'West Jordan', 'Salt Lake', 'UT', '84084', '8019643947', '8019649382', 'PO Box 150', 'West Jordan', 'Salt Lake', 'UT', '84084', '8019643947', '8019649382', 'WUSTDSURG5', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 6, '2008-02-01', '2008-08-29', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1013071885', 0, 'Y', 0, '2012-04-11', NULL, NULL, 0, 0, NULL, NULL),
('621795217', 'W11003257', 'W11003257', 'UT01', 'Davis Orthopedic & Sports Rehab', 'B', 'Thomas', 'Watson', 'MD', 'Orthopedic Surgery', 'Sports Medicine', NULL, NULL, 'O', '2132 N 1700 W Ste 230', 'Layton', 'Davis', 'UT', '84041', '8017733900', NULL, '2132 N 1700 W', 'Layton', '', 'UT', '84041', '', '', 'WUSTDSURG5', 'WUSTDHCPC5', NULL, '0.00', '35.00', '0.00', 6, '2008-01-01', '2008-08-17', 0, 0, 0, 'Davis Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1225129158', 0, 'N', 0, '2008-08-15', NULL, NULL, 0, 0, NULL, NULL),
('560866881', 'W11003258', 'W11003258', 'UT01', NULL, 'Mark', 'D', 'Corgiat', 'PHD', 'Mental Health', 'Psychology', '', NULL, 'O', '4590 Harrison Blvd Ste 100', 'Ogden', 'Weber', 'UT', '84403', '8016216100', NULL, '4590 Harrison Blvd Ste 100', 'Ogden', 'Weber', 'UT', '84403', '8016216100', '', 'PHD', NULL, '', '0.00', '100.00', '0.00', 3, '2008-01-01', '2008-06-30', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1336296003', 0, 'n', 0, '2014-05-13', NULL, NULL, 0, 0, NULL, NULL),
('526354226', 'W11003259', 'W11003259', 'UT01', NULL, 'Jennifer', 'A', 'McNaught', 'LPC', 'Mental Health', 'Counseling', '', NULL, 'O', '860 E 4500 S Ste 302', 'Salt Lake City', 'Salt Lake', 'UT', '84107', '8017069272', NULL, '860 E 4500 S Ste 302', 'Salt Lake City', 'Salt Lake', 'UT', '84107', '8017069272', '', 'MA', NULL, NULL, '0.00', '100.00', '0.00', 3, '2007-12-01', '2008-06-30', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1376731281', 0, 'n', 0, '2013-02-27', NULL, NULL, 0, 0, NULL, NULL),
('742828348', 'W11003260', 'W11003260', 'TX01', 'The Lung and Wellness Clinic', 'Carlos', 'F', 'Morales', 'MD', 'Pulmonary', 'Sleep Medicine', NULL, NULL, 'O', '7940 Floyd Curl Dr Suite 860', 'San Antonio', 'Bexar', 'TX', '78229', '2106169999', NULL, '7940 Floyd Curl Dr', 'San Antonio', '', 'TX', '78229', '', '', 'TXSURGB', 'TXHCPCS', NULL, '0.00', '50.00', '0.00', 3, '2008-03-01', '2008-12-01', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1225035947', 0, 'n', 0, '2008-03-14', NULL, NULL, 29.5117, -98.5756, NULL, NULL),
('529874358', 'W11003261', 'W11003261', 'UT01', NULL, 'Katherine', 'M', 'Tolsma', 'LCSW', 'Mental Health', 'Social Worker', '', NULL, 'O', '5689 S Redwood Rd Ste 30', 'Salt Lake City', 'Salt Lake', 'UT', '84123', '8013594884', NULL, '5689 S Redwood Rd Ste 30', 'Salt Lake City', 'Salt Lake', 'UT', '84123', '8013594884', '', 'MA', NULL, NULL, '0.00', '100.00', '0.00', 3, '2008-01-01', '2008-06-30', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1417155227', 0, 'n', 0, '2014-04-15', NULL, NULL, 0, 0, NULL, NULL),
('342645102', 'W11003262', 'W11003262', 'UT01', NULL, 'Richard', 'A', 'New', 'MD', 'Mental Health', NULL, NULL, NULL, 'O', '1522 Elk Creek Dr', 'Idaho Falls', 'Bonneville', 'ID', '83404', '2085520920', NULL, '1522 Elk Dr', 'Idaho Falls', '', 'ID', '83404', '', '', 'MD', NULL, NULL, '0.00', '100.00', '0.00', 3, '2008-01-01', '2008-06-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1699718619', 0, 'n', 0, '2008-03-14', NULL, NULL, 0, 0, NULL, NULL),
('529802584', 'W11003263', 'W11003263', 'UT01', NULL, 'Carl', 'Kent', 'Hebdon', 'MD', 'Mental Health', 'Internal Medicine', '', NULL, 'O', '2040 E Murray-Holladay Rd Ste 209', 'Salt Lake City', 'Salt Lake', 'UT', '84117', '8015471991', NULL, '2040 E Murray-Holladay Rd Ste 209', 'Salt Lake City', 'Salt Lake', 'UT', '84117', '8015471991', '', 'MD', NULL, NULL, '0.00', '100.00', '0.00', 3, '2008-01-01', '2008-06-30', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1215971759', 0, 'n', 0, '2011-04-29', NULL, NULL, 0, 0, NULL, NULL),
('569903188', 'W11003264', 'W11003264', 'UT01', 'Lifetree Pain Clinic', 'Thomas', 'K', 'Trauba', 'MD', 'Mental Health', 'Psychiatry', 'Pain Management', NULL, 'O', '3838 S 700 E Ste 200', 'Salt Lake City', 'Salt Lake', 'UT', '84106', '8012614988', '          ', '3838 S 700 E Ste 200', 'Salt Lake City', 'Salt Lake', 'UT', '84106', '8012614988', '          ', 'WUSTDPAIN5', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 3, '2008-01-01', '2014-04-16', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1891793147', 0, 'Y', 0, '2014-04-16', NULL, NULL, 40.6874, -111.871, NULL, NULL),
('810231784', 'W11003265', 'W11003265', 'WY01', 'Billings Clinic', '', '', 'Billings Clinic', 'GROUP', 'Clinic', '', '', NULL, 'B', 'PO Box 35100', 'Billings', 'Yellowstone', 'MT', '59107', '4062382501', '4066574349', 'PO Box 35100', 'Billings', 'Yellowstone', 'MT', '59107', '4062382501', '4066574349', '', '', '', '0.00', '17.00', '0.00', 3, '2008-02-01', '2009-04-30', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '0000005299', 0, 'Y', 0, '2014-02-13', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11003266', 'W11003266', 'WY01', 'Billings Clinic - Infectious Disease', 'Camilla', 'R', 'Saberhagen', 'MD', 'Infectious Disease', 'Internal Medicine', NULL, NULL, 'O', '2825 8th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4062382501', '4062382253', 'PO Box 37000', 'Billings', '', 'MT', '59101', '', '', '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2008-02-01', '2009-04-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1689616914', 0, 'N', 0, '2010-01-15', NULL, NULL, 0, 0, NULL, NULL),
('742796322', 'W11003267', 'W11003267', 'TX01', 'Southwest Allergy & Asthma Clinic', 'Bruce', 'G', 'Martin', 'DO', 'Allergy and Immunology', '', '', NULL, 'O', '7711 Louis Pasteur Dr Ste 901/905', 'San Antonio', 'Bexar', 'TX', '78229', '2106160690', NULL, '7711 Louis Pasteur Dr Ste 901/905', 'San Antonio', 'Bexar', 'TX', '78229', '2106160690', '', 'TXSTD', 'TXHCPCS', NULL, '0.00', '50.00', '0.00', 3, '2008-01-01', '2012-08-19', 0, 0, 0, 'Baptist Medical Center', '', '', '', 'HCFA|UB|', '1326087081', 0, 'n', 0, '2013-05-01', NULL, NULL, 29.5088, -98.5702, NULL, NULL),
('742796322', 'W11003268', 'W11003268', 'TX01', 'Southwest Allergy & Asthma Clinic', 'Bruce', 'G', 'Martin', 'DO', 'Allergy and Immunology', '', '', NULL, 'O', '155 Sonterra Blvd Ste 101', 'San Antonio', 'Bexar', 'TX', '78258', '2104940690', NULL, '155 Sonterra Blvd Ste 101', 'San Antonio', 'Bexar', 'TX', '78258', '2104940690', '', 'TXSTD', 'TXHCPCS', NULL, '0.00', '50.00', '0.00', 3, '2008-01-01', '2012-08-19', 0, 0, 0, 'Baptist Medical Center', '', '', '', 'HCFA|UB|', '1326087081', 0, 'n', 0, '2013-05-01', NULL, NULL, 29.6171, -98.4927, NULL, NULL),
('742796322', 'W11003269', 'W11003269', 'TX01', 'Southwest Allergy & Asthma Clinic - Westover Hills', 'Bruce', 'G', 'Martin', 'DO', 'Allergy and Immunology', '', '', NULL, 'O', '3903 Wiseman Blvd Ste 202', 'San Antonio', 'Bexar', 'TX', '78257', '2107670690', NULL, '3903 Wiseman Blvd Ste 202', 'San Antonio', 'Bexar', 'TX', '78257', '2107670690', '          ', 'TXSTD', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2008-01-01', '2012-08-19', 0, 0, 0, 'Baptist Medical Center', '', '', '', 'HCFA|UB|', '1326087081', 0, 'N', 0, '2013-05-01', NULL, NULL, 29.4776, -98.695, NULL, NULL),
('753026770', 'W11003270', 'W11003270', 'UT01', 'Cascade Foot and Ankle Clinic', 'Jared', 'T', 'Clegg', 'DPM', 'Podiatry', '', '', NULL, 'B', 'PO Box 932', 'Sandy', 'Salt Lake', 'UT', '84091', '8013732499', '8013739200', 'PO Box 932', 'Sandy', 'Salt Lake', 'UT', '84091', '8013732499', '8013739200', 'WiseSTD', 'WUSTDHCPC5', NULL, '0.00', '35.00', '0.00', 3, '2006-08-01', NULL, 0, 0, 0, 'Central Valley Medical Center', '', '', '', 'HCFA|UB|', '1588664759', 0, 'Y', 0, '2013-07-26', NULL, NULL, 0, 0, NULL, NULL),
('870811099', 'W11003271', 'W11003271', 'UT01', NULL, 'Mikol', 'R', 'Anderson', 'DPM', 'Podiatry', '', '', NULL, 'O', '1250 E 3900 S Ste 420', 'Salt Lake City', 'Salt Lake', 'UT', '84124', '8012699939', NULL, '1250 E 3900 S Ste 420', 'Salt Lake City', 'Salt Lake', 'UT', '84124', '8012699939', '', 'WISESTD', 'WUSTDHCPC5', NULL, '0.00', '35.00', '0.00', 3, '2008-03-01', NULL, 0, 0, 0, 'St Marks Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1992910905', 0, 'n', 0, '2013-11-12', NULL, NULL, 40.6871, -111.856, NULL, NULL),
('870811099', 'W11003272', 'W11003272', 'UT01', NULL, 'Mikol', 'R', 'Anderson', 'DPM', 'Podiatry', '', '', NULL, 'B', 'PO Box 932', 'Sandy', 'Salt Lake', 'UT', '84091', '8012699939', NULL, 'PO Box 932', 'Sandy', 'Salt Lake', 'UT', '84091', '8012699939', '', 'WISESTD', 'WUSTDHCPC5', NULL, '0.00', '35.00', '0.00', 3, '2008-03-01', NULL, 0, 0, 0, 'St Marks Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1992910905', 0, 'Y', 0, '2013-11-12', NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W11003273', 'W11003273', 'UTIHCPHY', 'Budge Clinic Surgical Specialists', 'David', 'Michael', 'Adams', 'MD', 'Urology', '', '', NULL, 'o', '1350 N 500 E', 'Logan', 'Cache', 'UT', '84341', '4357921950', NULL, '1350 N 500 E', 'Logan', 'Cache', 'UT', '84341', '4357921950', '          ', 'USTDMULT', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 8, '2008-01-01', '2011-03-31', 0, 0, 0, 'Dixie Regional Medical Center', 'Valley View Medical Center', NULL, NULL, 'HCFA|UB|', '1669695920', 0, 'N', 0, '2013-05-23', NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W11003274', 'W11003274', 'UTIHCPHY', 'Memorial Clinic', 'Gerald', 'L', 'Allred', 'MD', 'Pediatrics', '', '', NULL, 'o', '2000 S 900 E', 'Salt Lake City', 'Salt Lake', 'UT', '84105', '8014647500', NULL, '2000 S 900 E', 'Salt Lake City', 'Salt Lake', 'UT', '84105', '8014647500', '          ', 'USTDMULT', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 8, '2008-01-01', '2013-01-26', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1174577472', 0, 'N', 0, '2013-05-17', NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W11003275', 'W11003275', 'UTIHCPHY', 'Utah Valley Pulmonary Clinic', 'William', 'T', 'Alward', 'MD', 'Critical Care', '', '', NULL, 'o', '1055 N 300 W #500', 'Provo', 'Utah', 'UT', '84604', '8013577291', NULL, '1055 N 300 W #500', 'Provo', 'Utah', 'UT', '84604', '8013577291', '', 'USTDMULT', 'WUSTDHCPC5', NULL, '0.00', '35.00', '0.00', 8, '2008-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1609880939', 0, 'n', 0, '2011-07-26', NULL, NULL, 40.2476, -111.664, NULL, NULL),
('942854057', 'W11003276', 'W11003276', 'UTIHCPHY', 'Budge Clinic Surgical Specialists', 'Allan', 'D', 'Anderson', 'MD', 'General Surgery', '', '', NULL, 'o', '1350 N 500 E', 'Logan', 'Cache', 'UT', '84341', '4357921950', NULL, '1350 N 500 E', 'Logan', 'Cache', 'UT', '84341', '4357921950', '          ', 'USTDMULT', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 8, '2008-01-01', '2011-09-30', 0, 0, 0, 'Logan Regional Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1710991344', 0, 'N', 0, '2012-02-29', NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W11003277', 'W11003277', 'UTIHCPHY', 'Budge Clinic Obstetrics & Gynecology', 'Jennifer', '', 'Anderson', 'APRN', 'Obstetrics and Gynecology', '', '', NULL, 'o', '1400 N 500 E', 'Logan', 'Cache', 'UT', '84341', '4357161920', NULL, '1400 N 500 E', 'Logan', 'Cache', 'UT', '84341', '4357161920', '', 'USTDMULT', 'WUSTDHCPC5', NULL, '0.00', '35.00', '0.00', 8, '2008-01-01', NULL, 0, 0, 0, 'Logan Regional Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1275547895', 0, 'n', 0, '2012-07-20', NULL, NULL, 41.7569, -111.821, NULL, NULL),
('942854057', 'W11003278', 'W11003278', 'UTIHCPHY', 'North Sevier Medical Clinic', 'Kevin', 'Kyhl', 'Anderson', 'PA', 'Family Practice', '', '', NULL, 'o', '530 N 250 W', 'Salina', 'Sevier', 'UT', '84654', '4355297411', NULL, '530 N 250 W', 'Salina', 'Sevier', 'UT', '84654', '4355297411', '', 'USTDMULT', 'WUSTDHCPC5', NULL, '0.00', '35.00', '0.00', 8, '2008-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1861507675', 0, 'n', 0, '2012-12-31', NULL, NULL, 38.9534, -111.863, NULL, NULL),
('942854057', 'W11003279', 'W11003279', 'UTIHCPHY', 'Zion Orthopaedics & Sports Medicine', 'Robert', 'J', 'Andruss', 'MD', 'Orthopedic Surgery', NULL, NULL, NULL, 'o', '652 S Medical Ctr Dr Ste 400', 'St George', 'Washington', 'UT', '84790', '4352512650', NULL, NULL, NULL, '', NULL, NULL, '', '', 'USTDMULT', 'WUSTDHCPC5', NULL, '0.00', '35.00', '0.00', 8, '2008-01-01', NULL, 0, 0, 0, 'Dixie Regional Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1952326373', 0, 'n', 0, '2008-05-14', NULL, NULL, 37.0498, -113.574, NULL, NULL),
('942854057', 'W11003280', 'W11003280', 'UTIHCPHY', 'Manti Family Clinic', 'Robert', 'D', 'Armstrong', 'MD', 'Family Practice', '', '', NULL, 'o', '159 N Main', 'Manti', 'Sanpete', 'UT', '84642', '4358353344', NULL, '159 N Main', 'Manti', 'Sanpete', 'UT', '84642', '4358353344', '', 'USTDMULT', 'WUSTDHCPC5', NULL, '0.00', '35.00', '0.00', 8, '2008-01-01', NULL, 0, 0, 0, 'Sanpete Valley Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1194766782', 0, 'n', 0, '2011-09-26', NULL, NULL, 39.2677, -111.643, 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
('942854057', 'W11003281', 'W11003281', 'UTIHCPHY', 'Summit Clinic', 'Delwin', 'Barton', 'Avery', 'MD', 'Family Practice', '', '', NULL, 'o', '502 S Main', 'Smithfield', 'Cache', 'UT', '84335', '4355633222', NULL, '502 S Main', 'Smithfield', 'Cache', 'UT', '84335', '4355633222', '', 'USTDMULT', 'WUSTDHCPC5', NULL, '0.00', '35.00', '0.00', 8, '2008-01-01', NULL, 0, 0, 0, 'Logan Regional Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1780698316', 0, 'n', 0, '2013-08-27', NULL, NULL, 41.826, -111.833, NULL, NULL),
('942854057', 'W11003282', 'W11003282', 'UTIHCPHY', 'Memorial Clinic', 'Rachel', 'E', 'Baar', 'MD', 'Pediatrics', NULL, NULL, NULL, 'o', '2000 S 900 E', 'Salt Lake City', 'Salt Lake', 'UT', '84105', '8014647500', NULL, NULL, NULL, '', NULL, NULL, '', '', 'USTDMULT', 'WUSTDHCPC5', NULL, '0.00', '35.00', '0.00', 8, '2008-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1740232750', 0, 'n', 0, '2008-05-14', NULL, NULL, 40.7267, -111.865, NULL, NULL),
('942854057', 'W11003283', 'W11003283', 'UTIHCPHY', 'Memorial Clinic', 'Timothy', 'D', 'Bancroft', 'MD', 'Pediatrics', '', '', NULL, 'o', '2000 S 900 E', 'Salt Lake City', 'Salt Lake', 'UT', '84105', '8014647500', NULL, '2000 S 900 E', 'Salt Lake City', 'Salt Lake', 'UT', '84105', '8014647500', '          ', 'USTDMULT', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 8, '2008-01-01', '2010-06-07', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1649219395', 0, 'N', 0, '2011-02-08', NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W11003284', 'W11003284', 'UTIHCPHY', 'Redrock Pediatrics', 'Kelly', 'Dean', 'Beaumont', 'PA', 'Pediatrics', NULL, NULL, NULL, 'o', '1380 E Medical Ctr Dr Ste 3100', 'St George', 'Washington', 'UT', '84790', '4352512740', NULL, NULL, NULL, '', NULL, NULL, '', '', 'USTDMULT', 'WUSTDHCPC5', NULL, '0.00', '35.00', '0.00', 8, '2008-01-01', NULL, 0, 0, 0, 'Dixie Regional Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1548369341', 0, 'n', 0, '2008-05-14', NULL, NULL, 37.0998, -113.554, NULL, NULL),
('942854057', 'W11003285', 'W11003285', 'UTIHCPHY', 'Budge Clinic Obstetrics & Gynecology', 'James', 'Patton', 'Benedict', 'MD', 'Obstetrics and Gynecology', NULL, NULL, NULL, 'o', '1400 N 500 E', 'Logan', 'Cache', 'UT', '84341', '4357161920', NULL, NULL, NULL, '', NULL, NULL, '', '', 'USTDMULT', 'WUSTDHCPC5', NULL, '0.00', '35.00', '0.00', 8, '2008-01-01', NULL, 0, 0, 0, 'Logan Regional Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1154335651', 0, 'n', 0, '2008-05-14', NULL, NULL, 41.7569, -111.821, NULL, NULL),
('942854057', 'W11003286', 'W11003286', 'UTIHCPHY', 'Memorial Clinic', 'Louis', 'Frank', 'Bentley', 'MD', 'Pediatrics', NULL, NULL, NULL, 'o', '2000 S 900 E', 'Salt Lake City', 'Salt Lake', 'UT', '84105', '8014647500', NULL, NULL, NULL, '', NULL, NULL, '', '', 'USTDMULT', 'WUSTDHCPC5', NULL, '0.00', '35.00', '0.00', 8, '2008-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1265471429', 0, 'n', 0, '2008-05-14', NULL, NULL, 40.7267, -111.865, NULL, NULL),
('942854057', 'W11003287', 'W11003287', 'UTIHCPHY', 'River Road InstaCare', 'Nicholas', 'H', 'Bird', 'MD', 'Wound Care', 'Hyperbaric Medicine', 'Urgent Care', NULL, 'B', '577 S River Road', 'St George', 'Washington', 'UT', '84790', '4356886300', NULL, NULL, NULL, '', NULL, NULL, '', '', 'USTDMULT', 'WUSTDHCPC5', NULL, '0.00', '35.00', '0.00', 8, '2008-01-01', '2009-05-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1811092935', 0, 'n', 0, '2010-01-12', NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W11003288', 'W11003288', 'UTIHCPHY', 'Logan WorkMed', 'Theral', 'Michael', 'Bishop', 'MD', 'Urgent Care', '', '', NULL, 'o', '412 S 200 E', 'Logan', 'Cache', 'UT', '84321', '4357132850', NULL, '412 S 200 E', 'Logan', 'Cache', 'UT', '84321', '4357132850', '          ', 'USTDMULT', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 8, '2008-01-01', '2012-06-30', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1376584300', 0, 'Y', 0, '2012-12-11', NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W11003289', 'W11003289', 'UTIHCPHY', 'Utah Valley Pulmonary Clinic', 'Clark', 'T', 'Bishop', 'MD', 'Pulmonary', NULL, NULL, NULL, 'o', '1055 N 300 W #500', 'Provo', 'Utah', 'UT', '84604', '8013577291', NULL, NULL, NULL, '', NULL, NULL, '', '', 'USTDMULT', 'WUSTDHCPC5', NULL, '0.00', '35.00', '0.00', 8, '2008-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1841206844', 0, 'n', 0, '2008-05-14', NULL, NULL, 40.2476, -111.664, NULL, NULL),
('942854057', 'W11003290', 'W11003290', 'UTIHCPHY', 'IHC Bountiful Health Center', 'Craig', 'Dan', 'Black', 'MD', 'Pediatrics', '', '', NULL, 'o', '390 N Main St', 'Bountiful', 'Davis', 'UT', '84010', '8012941000', NULL, '390 N Main St', 'Bountiful', 'Davis', 'UT', '84010', '8012941000', '          ', 'USTDMULT', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 8, '2008-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1679520035', 0, 'N', 0, '2011-11-28', NULL, NULL, 40.8935, -111.881, NULL, NULL),
('942854057', 'W11003291', 'W11003291', 'UTIHCPHY', 'North Sevier Medical Clinic', 'Kerry', 'A', 'Blackham', 'MD', 'Family Practice', '', '', NULL, 'o', '530 N 250 W', 'Salina', 'Sevier', 'UT', '84654', '4355297411', NULL, '530 N 250 W', 'Salina', 'Sevier', 'UT', '84654', '4355297411', '          ', 'USTDMULT', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 8, '2008-01-01', '2010-12-31', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1922014273', 0, 'N', 0, '2013-10-14', NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W11003292', 'W11003292', 'UTIHCPHY', 'Cardiovascular & Thoracic Surgery - St. George', 'B', 'Jason', 'Bowles', 'MD', 'Cardiovascular Disease', NULL, NULL, NULL, 'o', '1380 E Medical Ctr Dr Ste 2600', 'St George', 'Washington', 'UT', '84790', '4352512700', NULL, NULL, NULL, '', NULL, NULL, '', '', 'USTDMULT', 'WUSTDHCPC5', NULL, '0.00', '35.00', '0.00', 8, '2008-01-01', NULL, 0, 0, 0, 'Dixie Regional Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1114950714', 0, 'n', 0, '2008-05-14', NULL, NULL, 37.0998, -113.554, NULL, NULL),
('942854057', 'W11003293', 'W11003293', 'UTIHCPHY', 'Holladay Pediatrics', 'Mark', 'R', 'Briesacher', 'MD', 'Pediatrics', '', '', NULL, 'o', '2180 E 4500 S #210', 'Salt Lake City', 'Salt Lake', 'UT', '84117', '8019474242', NULL, '2180 E 4500 S #210', 'Salt Lake City', 'Salt Lake', 'UT', '84117', '8019474242', '          ', 'USTDMULT', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 8, '2008-01-01', '2012-04-30', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1154333029', 0, 'N', 0, '2012-06-01', NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W11003294', 'W11003294', 'UTIHCPHY', 'Dixie Hospitalists', 'Norman', 'Jose', 'Brito-Dellan', 'MD', 'Internal Medicine', 'Hospitalist', '', NULL, 'o', '577 S River Road', 'St George', 'Washington', 'UT', '84790', '4356886200', NULL, '577 S River Road', 'St George', 'Washington', 'UT', '84790', '4356886200', '          ', 'USTDMULT', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 8, '2008-01-01', '2011-04-15', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1164409553', 0, 'N', 0, '2011-03-01', NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W11003295', 'W11003295', 'UTIHCPHY', 'Cedar City InstaCare', 'David', 'M', 'Brooks', 'DO', 'Urgent Care', '', '', NULL, 'B', '962 S Sage Dr', 'Cedar City', 'Iron', 'UT', '84720', '4358653440', NULL, '962 S Sage Drive', 'Cedar City', 'Iron', 'UT', '84720', '4358653440', '', 'USTDMULT', 'WUSTDHCPC5', NULL, '0.00', '35.00', '0.00', 8, '2008-01-01', NULL, 0, 0, 0, 'Valley View Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1881617348', 0, 'n', 0, '2011-05-24', NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W11003296', 'W11003296', 'UTIHCPHY', 'Fillmore Clinic', 'Wayne', 'O', 'Brown', 'MD', 'Family Practice', NULL, NULL, NULL, 'o', '700 S Hwy 99 #3', 'Fillmore', 'Millard', 'UT', '84631', '4357435555', NULL, NULL, NULL, '', NULL, NULL, '', '', 'USTDMULT', 'WUSTDHCPC5', NULL, '0.00', '35.00', '0.00', 8, '2008-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1003822909', 0, 'n', 0, '2010-01-12', NULL, NULL, 38.953, -112.341, NULL, NULL),
('942854057', 'W11003297', 'W11003297', 'UTIHCPHY', 'Budge Clinic Pediatrics', 'Nordell', 'T', 'Brown', 'MD', 'Pediatrics', 'Internal Medicine', NULL, NULL, 'o', '1350 N 500 E', 'Logan', 'Cache', 'UT', '84341', '4357921940', NULL, NULL, NULL, '', NULL, NULL, '', '', 'USTDMULT', 'WUSTDHCPC5', NULL, '0.00', '35.00', '0.00', 8, '2008-01-01', NULL, 0, 0, 0, 'Logan Regional Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1144234659', 0, 'n', 0, '2008-05-14', NULL, NULL, 41.7565, -111.821, NULL, NULL),
('942854057', 'W11003298', 'W11003298', 'UTIHCPHY', 'Sevier Valley Family Practice', 'Jeffrey', 'J', 'Brown', 'DO', 'Family Practice', '', '', NULL, 'o', '70 E 1100 N', 'Richfield', 'Sevier', 'UT', '84701', '4358968254', NULL, '70 E 1100 N', 'Richfield', 'Sevier', 'UT', '84701', '4358968254', '          ', 'USTDMULT', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 8, '2008-01-01', '2008-01-01', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1205840642', 0, 'N', 0, '2013-12-18', NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W11003299', 'W11003299', 'UTIHCPHY', 'Cedar City Clinic', 'Clint', 'O', 'Bunker', 'DO', 'Family Practice', NULL, NULL, NULL, 'o', '1303 N Main #3C', 'Cedar City', 'Iron', 'UT', '84720', '4358685500', NULL, NULL, NULL, '', NULL, NULL, '', '', 'USTDMULT', 'WUSTDHCPC5', NULL, '0.00', '35.00', '0.00', 8, '2008-01-01', NULL, 0, 0, 0, 'Valley View Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1306850011', 0, 'n', 0, '2008-05-14', NULL, NULL, 37.6711, -113.103, NULL, NULL),
('942854057', 'W11003300', 'W11003300', 'UTIHCPHY', 'Memorial Clinic', 'Mary', 'Dunson', 'Burton', 'MD', 'Pediatrics', NULL, NULL, NULL, 'o', '2000 S 900 E', 'Salt Lake City', 'Salt Lake', 'UT', '84105', '8014647500', NULL, NULL, NULL, '', NULL, NULL, '', '', 'USTDMULT', 'WUSTDHCPC5', NULL, '0.00', '35.00', '0.00', 8, '2008-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1235186511', 0, 'n', 0, '2008-05-14', NULL, NULL, 40.7267, -111.865, NULL, NULL),
('942854057', 'W11003301', 'W11003301', 'UTIHCPHY', 'River Road Family Practice', 'Larry', 'A', 'Cain', 'MD', 'Family Practice', NULL, NULL, NULL, 'o', '577 S River Road', 'St George', 'Washington', 'UT', '84790', '4356886000', NULL, NULL, NULL, '', NULL, NULL, '', '', 'USTDMULT', 'WUSTDHCPC5', NULL, '0.00', '35.00', '0.00', 8, '2008-01-01', NULL, 0, 0, 0, 'Dixie Regional Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1972521201', 0, 'n', 0, '2008-05-14', NULL, NULL, 37.0986, -113.557, NULL, NULL),
('942854057', 'W11003302', 'W11003302', 'UTIHCPHY', 'South Cache Valley Clinic', 'Nathan', 'H', 'Call', 'MD', 'Family Practice', '', '', NULL, 'o', '190 S Hwy 165', 'Providence', 'Cache', 'UT', '84332', '4357553300', NULL, NULL, NULL, '', NULL, NULL, '', '', 'USTDMULT', 'WUSTDHCPC5', NULL, '0.00', '35.00', '0.00', 8, '2008-01-01', NULL, 0, 0, 0, 'Logan Regional Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1104830884', 0, 'n', 0, '2008-05-14', NULL, NULL, 41.7032, -111.828, NULL, NULL),
('942854057', 'W11003303', 'W11003303', 'UTIHCPHY', 'Budge Clinic Surgical Specialists', 'Michael', 'Scott', 'Callister', 'MD', 'Urology', '', '', NULL, 'o', '1350 N 500 E', 'Logan', 'Cache', 'UT', '84341', '4357921950', NULL, '1350 N 500 E', 'Logan', 'Cache', 'UT', '84341', '4357921950', '', 'USTDMULT', 'WUSTDHCPC5', NULL, '0.00', '35.00', '0.00', 8, '2008-01-01', NULL, 0, 0, 0, 'Logan Regional Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1811038060', 0, 'n', 0, '2011-01-03', NULL, NULL, 41.7565, -111.821, NULL, NULL),
('942854057', 'W11003304', 'W11003304', 'UTIHCPHY', 'Bryner Clinic', 'Wayne', 'Hales', 'Cannon', 'MD', 'Pediatrics', '', '', NULL, 'o', '525 E 100 S # 500', 'Salt Lake City', 'Salt Lake', 'UT', '84102', '8015197100', NULL, '525 E 100 S # 500', 'Salt Lake City', 'Salt Lake', 'UT', '84102', '8015197100', '          ', 'USTDMULT', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 8, '2008-01-01', '2012-12-31', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1881633428', 0, 'N', 0, '2013-05-30', NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W11003305', 'W11003305', 'UTIHCPHY', 'Logan InstaCare', 'Brian', 'W', 'Carlson', 'MD', 'Family Practice', '', '', NULL, 'o', '412 N 200 E', 'Logan', 'Cache', 'UT', '84321', '4357132710', NULL, '412 N 200 E', 'Logan', 'Cache', 'UT', '84321', '4357132710', '          ', 'USTDMULT', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 8, '2008-01-01', NULL, 0, 0, 0, 'Logan Regional Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1760498687', 0, 'N', 0, '2008-05-14', NULL, NULL, 41.7393, -111.83, NULL, NULL),
('942854057', 'W11003306', 'W11003306', 'UTIHCPHY', 'River Road InstaCare', 'Boyd', 'A', 'Carter', 'MD', 'Urgent Care', '', '', NULL, 'B', '577 S River Rd', 'St George', 'Washington', 'UT', '84790', '4356886300', NULL, '577 S River Rd', 'St George', 'Washington', 'UT', '84790', '4356886300', '          ', 'USTDMULT', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 8, '2008-01-01', NULL, 0, 0, 0, 'Dixie Regional Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1386667202', 0, 'Y', 0, '2011-04-28', NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W11003307', 'W11003307', 'UTIHCPHY', 'Sunset Family Practice', 'Kristine', 'Rowe', 'Carter', 'APRN', 'Urgent Care', '', '', NULL, 'B', '1739 W Sunset Blvd', 'St George', 'Washington', 'UT', '84770', '4356346000', NULL, NULL, NULL, '', NULL, NULL, '', '', 'USTDMULT', 'WUSTDHCPC5', NULL, '0.00', '35.00', '0.00', 8, '2008-01-01', NULL, 0, 0, 0, 'Dixie Regional Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1710937826', 0, 'n', 0, '2008-05-14', NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W11003308', 'W11003308', 'UTIHCPHY', 'Logan InstaCare', 'David', 'N', 'Casey', 'DO', 'Urgent Care', '', '', NULL, 'B', '235 E 400 N', 'Logan', 'Cache', 'UT', '84321', '4357521010', NULL, '235 E 400 N', 'Logan', 'Cache', 'UT', '84321', '4357521010', '', 'USTDMULT', 'WUSTDHCPC5', NULL, '0.00', '35.00', '0.00', 8, '2008-01-01', NULL, 0, 0, 0, 'Logan Regional Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1093723835', 0, 'n', 0, '2010-06-24', NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W11003309', 'W11003309', 'UTIHCPHY', 'Cedar City Clinic', 'Stephen', 'Chester', 'Castorino', 'MD', 'Internal Medicine', NULL, NULL, NULL, 'o', '1303 N Main #3C', 'Cedar City', 'Iron', 'UT', '84720', '4358685500', NULL, NULL, NULL, '', NULL, NULL, '', '', 'USTDMULT', 'WUSTDHCPC5', NULL, '0.00', '35.00', '0.00', 8, '2008-01-01', '2009-10-06', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1942413315', 0, 'n', 0, '2008-05-14', NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W11003310', 'W11003310', 'UTIHCPHY', 'Intermountain Womens Health Specialists', 'Robert', 'Wallace', 'Chalmers', 'MD', 'Obstetrics and Gynecology', '', '', NULL, 'O', '346 E 600 S', 'St George', 'Washington', 'UT', '84770', '4356884600', '          ', '346 E 600 S', 'St George', 'Washington', 'UT', '84770', '4356884600', '          ', 'USTDMULT', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 8, '2008-01-01', NULL, 0, 0, 0, 'Dixie Regional Medical Center', '', '', '', 'HCFA|UB|', '1114973708', 0, 'N', 0, '2014-05-08', NULL, NULL, 37.098, -113.576, NULL, NULL),
('942854057', 'W11003311', 'W11003311', 'UTIHCPHY', 'Southwest Cardiology - St. George', 'Keshav', '', 'Chander', 'MD', 'Cardiovascular Disease', '', '', NULL, 'o', '1380 E Medical Ctr Dr Ste 1500', 'St George', 'Washington', 'UT', '84790', '4352512500', NULL, '1380 E Medical Ctr Dr Ste 1500', 'St George', 'Washington', 'UT', '84790', '4352512500', '          ', 'USTDMULT', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 8, '2008-01-01', '2013-12-31', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1700816600', 0, 'N', 0, '2013-05-17', NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W11003312', 'W11003312', 'UTIHCPHY', 'Ephraim Clinic', 'Tristy', 'L', 'Christensen', 'MD', 'Family Practice', '', '', NULL, 'o', '525 N Main', 'Ephraim', 'Sanpete', 'UT', '84627', '4352834076', NULL, '525 N Main', 'Ephraim', 'Sanpete', 'UT', '84627', '4352834076', '', 'USTDMULT', 'WUSTDHCPC5', NULL, '0.00', '35.00', '0.00', 8, '2008-01-01', NULL, 0, 0, 0, 'Sanpete Valley Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1093753469', 0, 'n', 0, '2011-09-26', NULL, NULL, 39.371, -111.587, NULL, NULL),
('942854057', 'W11003313', 'W11003313', 'UTIHCPHY', 'Bear River Medical Clinic', 'Nichole', 'Michelle', 'Churchman', 'MD', 'Family Practice', NULL, NULL, NULL, 'o', '935 N 1000 W', 'Tremonton', 'Box Elder', 'UT', '84337', '4352074800', NULL, NULL, NULL, '', NULL, NULL, '', '', 'USTDMULT', 'WUSTDHCPC5', NULL, '0.00', '35.00', '0.00', 8, '2008-01-01', '2008-10-24', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1700916095', 0, 'n', 0, '2008-05-14', NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W11003314', 'W11003314', 'UTIHCPHY', 'Logan InstaCare', 'Thomas', 'H', 'Clark', 'MD', 'Family Practice', '', '', NULL, 'O', '235 E 400 N', 'Logan', 'Cache', 'UT', '84321', '4357521010', NULL, '235 E 400 N', 'Logan', 'Cache', 'UT', '84321', '4357521010', '          ', 'USTDMULT', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 8, '2008-01-01', '2008-01-01', 0, 0, 0, 'Logan Regional Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1295741114', 0, 'N', 0, '2013-08-27', NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W11003315', 'W11003315', 'UTIHCPHY', 'Southwest Cardiology - St. George', 'Bonnie', 'B', 'Clark', 'APRN', 'Cardiovascular Disease', NULL, NULL, NULL, 'o', '1380 E Medical Ctr Dr Ste 1500', 'St George', 'Washington', 'UT', '84790', '4352512500', NULL, NULL, NULL, '', NULL, NULL, '', '', 'USTDMULT', 'WUSTDHCPC5', NULL, '0.00', '35.00', '0.00', 8, '2008-01-01', NULL, 0, 0, 0, 'Dixie Regional Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1154355204', 0, 'n', 0, '2008-05-14', NULL, NULL, 37.0998, -113.554, NULL, NULL),
('942854057', 'W11003316', 'W11003316', 'UTIHCPHY', 'River Road Family Practice', 'Stephen', 'E', 'Clark', 'DO', 'Family Practice', NULL, NULL, NULL, 'o', '577 S River Road', 'St George', 'Washington', 'UT', '84790', '4356886000', NULL, NULL, NULL, '', NULL, NULL, '', '', 'USTDMULT', 'WUSTDHCPC5', NULL, '0.00', '35.00', '0.00', 8, '2008-01-01', NULL, 0, 0, 0, 'Dixie Regional Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1043238363', 0, 'n', 0, '2008-05-14', NULL, NULL, 37.0986, -113.557, NULL, NULL),
('942854057', 'W11003317', 'W11003317', 'UTIHCPHY', 'Budge Clinic Pediatrics', 'Derrel', 'Wolter', 'Clarke', 'MD', 'Pediatrics', NULL, NULL, NULL, 'o', '1350 N 500 E', 'Logan', 'Cache', 'UT', '84341', '4357921940', NULL, NULL, NULL, '', NULL, NULL, '', '', 'USTDMULT', 'WUSTDHCPC5', NULL, '0.00', '35.00', '0.00', 8, '2008-01-01', NULL, 0, 0, 0, 'Logan Regional Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1902812829', 0, 'n', 0, '2008-05-14', NULL, NULL, 41.7565, -111.821, NULL, NULL),
('942854057', 'W11003318', 'W11003318', 'UTIHCPHY', 'Mt. Pleasant Clinic', 'Gary', 'Monroe', 'Cole', 'DO', 'Family Practice', '', '', NULL, 'o', '1100 S Medical Dr', 'Mt Pleasant', 'Sanpete', 'UT', '84647', '4354623471', NULL, '1100 S Medical Drive', 'Mt Pleasant', 'Sanpete', 'UT', '84647', '4354623471', '', 'USTDMULT', 'WUSTDHCPC5', NULL, '0.00', '35.00', '0.00', 8, '2008-01-01', NULL, 0, 0, 0, 'Sanpete Valley Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1598705139', 0, 'n', 0, '2012-03-26', NULL, NULL, 39.5318, -111.461, NULL, NULL),
('942854057', 'W11003319', 'W11003319', 'UTIHCPHY', 'Mountain View Pediatrics', 'Mitzi', 'D', 'Conover', 'MD', 'Pediatrics', NULL, NULL, NULL, 'o', '9720 S 1300 E #100', 'Sandy', 'Salt Lake', 'UT', '84094', '8015718550', NULL, NULL, NULL, '', NULL, NULL, '', '', 'USTDMULT', 'WUSTDHCPC5', NULL, '0.00', '35.00', '0.00', 8, '2008-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1225056013', 0, 'n', 0, '2008-05-14', NULL, NULL, 40.5739, -111.853, NULL, NULL),
('942854057', 'W11003320', 'W11003320', 'UTIHCPHY', 'Cedar City Clinic', 'Robert', 'D', 'Corry', 'MD', 'Family Practice', '', '', NULL, 'o', '1303 N Main #3C', 'Cedar City', 'Iron', 'UT', '84720', '4358685500', NULL, '1303 N Main #3C', 'Cedar City', 'Iron', 'UT', '84720', '4358685500', '', 'USTDMULT', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 8, '2008-01-01', '2011-06-30', 0, 0, 0, 'Valley View Medical Center', '', '', '', 'HCFA|UB|', '1952324410', 0, 'N', 0, '2014-05-12', NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W11003321', 'W11003321', 'UTIHCPHY', 'Logan InstaCare ', 'James', 'S', 'Coy', 'MD', 'Family Practice', 'Urgent Care', NULL, NULL, 'B', '235 E 400 N', 'Logan', 'Cache', 'UT', '84321', '4357521010', NULL, NULL, NULL, '', NULL, NULL, '', '', 'USTDMULT', 'WUSTDHCPC5', NULL, '0.00', '35.00', '0.00', 8, '2008-01-01', '2008-11-05', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1174555320', 0, 'n', 0, '2008-05-14', NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W11003322', 'W11003322', 'UTIHCPHY', 'Budge Clinic Obstetrics & Gynecology', 'Kristin', 'F', 'Craig', 'MD', 'Obstetrics and Gynecology', NULL, NULL, NULL, 'o', '1400 N 500 E', 'Logan', 'Cache', 'UT', '84341', '4357161920', NULL, NULL, NULL, '', NULL, NULL, '', '', 'USTDMULT', 'WUSTDHCPC5', NULL, '0.00', '35.00', '0.00', 8, '2008-01-01', NULL, 0, 0, 0, 'Logan Regional Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1225043995', 0, 'n', 0, '2008-05-14', NULL, NULL, 41.7569, -111.821, NULL, NULL),
('942854057', 'W11003323', 'W11003323', 'UTIHCPHY', 'Sevier Valley Family Practice', 'David', 'Ray', 'Crimin', 'DO', 'Family Practice', '', '', NULL, 'o', '70 E 1100 N', 'Richfield', 'Sevier', 'UT', '84701', '4358968254', NULL, '70 E 1100 N', 'Richfield', 'Sevier', 'UT', '84701', '4358968254', '          ', 'USTDMULT', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 8, '2008-01-01', '2008-01-01', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1225044431', 0, 'N', 0, '2013-12-18', NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W11003324', 'W11003324', 'UTIHCPHY', 'Dixie Hospitalists', 'Kathleen', 'M', 'Daly', 'MD', 'Urgent Care', NULL, NULL, NULL, 'o', '577 S River Road', 'St George', 'Washington', 'UT', '84790', '4356886200', NULL, '577 S River Road', 'St George', 'Washington', 'UT', '84790', '4356886200', '          ', 'USTDMULT', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 8, '2008-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1063403723', 0, 'Y', 0, '2012-05-02', NULL, NULL, 37.0986, -113.557, NULL, NULL),
('942854057', 'W11003325', 'W11003325', 'UTIHCPHY', 'Utah Valley Heart & Lung Surgical Associates', 'James', 'T', 'Dane', 'MD', 'Cardiovascular Disease', '', '', NULL, 'o', '1055 N 300 W Ste 410', 'Provo', 'Utah', 'UT', '84604', '8013577081', '          ', '1055 N 300 W Ste 410', 'Provo', 'Utah', 'UT', '84604', '8013577081', '          ', 'USTDMULT', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 8, '2008-01-01', '2014-06-11', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1083629828', 0, 'N', 0, '2014-06-17', NULL, NULL, 40.2476, -111.664, NULL, NULL),
('942854057', 'W11003326', 'W11003326', 'UTIHCPHY', 'Pulmonary Medicine Clinic - St George', 'Samuel', 'Kwame', 'Dartey-Hayford', 'MD', 'Pulmonary', NULL, NULL, NULL, 'o', '1380 E Medical Center Dr Ste 2200', 'St George', 'Washington', 'UT', '84790', '4352512600', NULL, NULL, NULL, '', NULL, NULL, '', '', 'USTDMULT', 'WUSTDHCPC5', NULL, '0.00', '35.00', '0.00', 8, '2008-01-01', '2009-08-27', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1437129285', 0, 'n', 0, '2008-05-14', NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W11003327', 'W11003327', 'UTIHCPHY', 'River Road InstaCare', 'Daniel', '', 'Davie', 'MD', 'Urgent Care', '', '', NULL, 'B', '577 S River Road', 'St George', 'Washington', 'UT', '84790', '4356886300', NULL, '577 S River Road', 'St George', 'Washington', 'UT', '84790', '4356886300', '', 'USTDMULT', 'WUSTDHCPC5', NULL, '0.00', '35.00', '0.00', 8, '2008-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1356376677', 0, 'n', 0, '2010-06-24', NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W11003328', 'W11003328', 'UTIHCPHY', 'Mt. Pleasant Clinic', 'Allen', 'M', 'Day', 'MD', 'Family Practice', '', '', NULL, 'o', '1100 S Medical Drive', 'Mt Pleasant', 'Sanpete', 'UT', '84647', '4354623471', NULL, '1100 S Medical Drive', 'Mt Pleasant', 'Sanpete', 'UT', '84647', '4354623471', '          ', 'USTDMULT', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 8, '2008-01-01', '2012-09-01', 0, 0, 0, 'Sanpete Valley Hospital', '', '', '', 'HCFA|UB|', '1518908110', 0, 'N', 0, '2013-04-15', NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W11003329', 'W11003329', 'UTIHCPHY', 'Memorial Clinic', 'Roland', 'P', 'Dimick', 'MD', 'Pediatrics', NULL, NULL, NULL, 'o', '2000 S 900 E', 'Salt Lake City', 'Salt Lake', 'UT', '84105', '8014647500', NULL, NULL, NULL, '', NULL, NULL, '', '', 'USTDMULT', 'WUSTDHCPC5', NULL, '0.00', '35.00', '0.00', 8, '2008-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1932153145', 0, 'n', 0, '2008-05-14', NULL, NULL, 40.7267, -111.865, NULL, NULL),
('942854057', 'W11003330', 'W11003330', 'UTIHCPHY', 'DRMC Radiation Oncology', 'Craig', 'W', 'Donaldson', 'MD', 'Radiation Oncology', '', '', NULL, 'o', '544 S 400 E', 'St George', 'Washington', 'UT', '84770', '4356884175', NULL, NULL, NULL, '', NULL, NULL, '', '', 'USTDMULT', 'WUSTDHCPC5', NULL, '0.00', '35.00', '0.00', 8, '2008-01-01', NULL, 0, 0, 0, 'Valley View Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1295753325', 0, 'n', 0, '2008-05-14', NULL, NULL, 37.0989, -113.575, NULL, NULL),
('942854057', 'W11003331', 'W11003331', 'UTIHCPHY', 'Southridge Clinic', 'John', 'T', 'Duffy', 'MD', 'Pediatrics', NULL, NULL, NULL, 'o', '3723 W 12600 S Ste 450', 'Riverton', 'Salt Lake', 'UT', '84065', '8012854543', NULL, NULL, NULL, '', NULL, NULL, '', '', 'USTDMULT', 'WUSTDHCPC5', NULL, '0.00', '35.00', '0.00', 8, '2008-01-01', NULL, 0, 0, 0, 'Riverton Childrens Unit Operated by Primary Childrens Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1376654285', 0, 'n', 0, '2008-05-14', NULL, NULL, 40.5222, -111.98, NULL, NULL),
('942854057', 'W11003332', 'W11003332', 'UTIHCPHY', 'Hurricane Valley InstaCare', 'Clifford', 'Vernor', 'Dunn', 'MD', 'Urgent Care', '', '', NULL, 'B', '75 N 2260 W', 'Hurricane', 'Washington', 'UT', '84737', '4356356550', NULL, '75 N 2260 W', 'Hurricane', 'Washington', 'UT', '84737', '4356356550', '', 'USTDMULT', 'WUSTDHCPC5', NULL, '0.00', '35.00', '0.00', 8, '2008-01-01', NULL, 0, 0, 0, 'Dixie Regional Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1548468036', 0, 'n', 0, '2012-12-31', NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W11003333', 'W11003333', 'UTIHCPHY', 'Bryner Clinic', 'George', 'Homer', 'Durham', 'MD', 'Pediatrics', '', '', NULL, 'o', '525 E 100 S # 500', 'Salt Lake City', 'Salt Lake', 'UT', '84102', '8015197100', NULL, '525 E 100 S # 500', 'Salt Lake City', 'Salt Lake', 'UT', '84102', '8015197100', '          ', 'USTDMULT', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 8, '2008-01-01', '2012-12-31', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1205880499', 0, 'N', 0, '2013-08-28', NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W11003334', 'W11003334', 'UTIHCPHY', 'Hurricane Valley Clinic', 'Penny', 'Ann', 'Emett', 'APRN', 'Family Practice', NULL, NULL, NULL, 'o', '75 N 2260 W', 'Hurricane', 'Washington', 'UT', '84737', '4356356400', NULL, NULL, NULL, '', NULL, NULL, '', '', 'USTDMULT', 'WUSTDHCPC5', NULL, '0.00', '35.00', '0.00', 8, '2008-01-01', NULL, 0, 0, 0, 'Dixie Regional Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1417978917', 0, 'n', 0, '2008-05-14', NULL, NULL, 37.1771, -113.33, NULL, NULL),
('942854057', 'W11003335', 'W11003335', 'UTIHCPHY', 'Mountain View Pediatrics', 'Jeffrey', 'Gus', 'Erickson', 'MD', 'Pediatrics', NULL, NULL, NULL, 'o', '9720 S 1300 E #100', 'Sandy', 'Salt Lake', 'UT', '84094', '8015718550', NULL, NULL, NULL, '', NULL, NULL, '', '', 'USTDMULT', 'WUSTDHCPC5', NULL, '0.00', '35.00', '0.00', 8, '2008-01-31', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1902850894', 0, 'n', 0, '2008-05-14', NULL, NULL, 40.5739, -111.853, NULL, NULL),
('942854057', 'W11003336', 'W11003336', 'UTIHCPHY', 'Southridge Clinic', 'Kristina', 'E', 'Esham', 'MD', 'Pediatrics', NULL, NULL, NULL, 'o', '3723 W 12600 S Ste 450', 'Riverton', 'Salt Lake', 'UT', '84065', '8012854543', NULL, NULL, NULL, '', NULL, NULL, '', '', 'USTDMULT', 'WUSTDHCPC5', NULL, '0.00', '35.00', '0.00', 8, '2008-01-01', NULL, 0, 0, 0, 'Riverton Childrens Unit Operated by Primary Childrens Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1164533071', 0, 'n', 0, '2008-05-14', NULL, NULL, 40.5222, -111.98, NULL, NULL),
('942854057', 'W11003337', 'W11003337', 'UTIHCPHY', 'Logan InstaCare ', 'Douglas', 'N', 'Esplin', 'MD', 'Urgent Care', NULL, NULL, NULL, 'B', '235 E 400 N', 'Logan', 'Cache', 'UT', '84321', '4357521010', NULL, NULL, NULL, '', NULL, NULL, '', '', 'USTDMULT', 'WUSTDHCPC5', NULL, '0.00', '35.00', '0.00', 8, '2008-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1063421451', 0, 'n', 0, '2008-05-14', NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W11003338', 'W11003338', 'UTIHCPHY', 'Intermountain Womens Health Specialists', 'Robert', 'J', 'Fagnant', 'MD', 'Obstetrics and Gynecology', '', '', NULL, 'o', '346 E 600 S', 'St George', 'Washington', 'UT', '84770', '4356884600', NULL, '346 E 600 S', 'St George', 'Washington', 'UT', '84770', '4356884600', '', 'USTDMULT', 'WUSTDHCPC5', NULL, '0.00', '35.00', '0.00', 8, '2008-01-01', NULL, 0, 0, 0, 'Dixie Regional Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1093734360', 0, 'n', 0, '2012-09-06', NULL, NULL, 37.098, -113.576, NULL, NULL),
('942854057', 'W11003339', 'W11003339', 'UTIHCPHY', 'Budge Clinic Obstetrics & Gynecology', 'Jeanette', 'M', 'Falk', 'MD', 'Obstetrics and Gynecology', NULL, NULL, NULL, 'o', '1400 N 500 E', 'Logan', 'Cache', 'UT', '84341', '4357161920', NULL, NULL, NULL, '', NULL, NULL, '', '', 'USTDMULT', 'WUSTDHCPC5', NULL, '0.00', '35.00', '0.00', 8, '2008-01-01', '2008-09-05', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1588673974', 0, 'n', 0, '2009-10-26', NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W11003340', 'W11003340', 'UTIHCPHY', 'Holladay Pediatrics', 'Paul', 'J', 'Ferreira', 'MD', 'Pediatrics', NULL, NULL, NULL, 'o', '2180 E 4500 S #210', 'Salt Lake City', 'Salt Lake', 'UT', '84117', '8019474242', NULL, NULL, NULL, '', NULL, NULL, '', '', 'USTDMULT', 'WUSTDHCPC5', NULL, '0.00', '35.00', '0.00', 8, '2008-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1679585541', 0, 'n', 0, '2008-05-14', NULL, NULL, 40.6742, -111.829, NULL, NULL),
('942854057', 'W11003341', 'W11003341', 'UTIHCPHY', 'Budge Clinic Pediatrics', 'Clinton', 'E', 'Field', 'PhD', 'Mental Health', 'Psychology', '', NULL, 'o', '1350 N 500 E', 'Logan', 'Cache', 'UT', '84341', '4357921940', NULL, '1350 N 500 E', 'Logan', 'Cache', 'UT', '84341', '4357921940', '', 'USTDMULT', 'WUSTDHCPC5', NULL, '0.00', '35.00', '0.00', 8, '2008-01-01', NULL, 0, 0, 0, 'Logan Regional Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1467656900', 0, 'n', 0, '2012-07-02', NULL, NULL, 41.7565, -111.821, NULL, NULL),
('942854057', 'W11003342', 'W11003342', 'UTIHCPHY', 'South Cache Valley Clinic', 'R', 'Mark', 'Firth', 'MD', 'Family Practice', 'Emergency Medicine', '', NULL, 'o', '190 S Hwy 165', 'Providence', 'Cache', 'UT', '84332', '4357553300', NULL, '190 S Hwy 165', 'Providence', 'Cache', 'UT', '84332', '4357553300', '', 'USTDMULT', 'WUSTDHCPC5', NULL, '0.00', '35.00', '0.00', 8, '2008-01-01', NULL, 0, 0, 0, 'Logan Regional Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1477562767', 0, 'n', 0, '2010-11-04', NULL, NULL, 41.7032, -111.828, NULL, NULL),
('942854057', 'W11003343', 'W11003343', 'UTIHCPHY', 'Mountain View Pediatrics', 'David', 'S', 'Folland', 'MD', 'Pediatrics', NULL, NULL, NULL, 'o', '9720 S 1300 E #100', 'Sandy', 'Salt Lake', 'UT', '84094', '8015718550', NULL, NULL, NULL, '', NULL, NULL, '', '', 'USTDMULT', 'WUSTDHCPC5', NULL, '0.00', '35.00', '0.00', 8, '2008-01-01', '2009-09-01', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1528080959', 0, 'n', 0, '2008-05-14', NULL, NULL, 0, 0, NULL, NULL),
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('942854057', 'W11003346', 'W11003346', 'UTIHCPHY', 'Bryner Clinic', 'Jesse', 'Neve', 'Fox', 'MD', 'Pediatrics', '', '', NULL, 'o', '525 E 100 S # 500', 'Salt Lake City', 'Salt Lake', 'UT', '84102', '8015197100', NULL, '525 E 100 S # 500', 'Salt Lake City', 'Salt Lake', 'UT', '84102', '8015197100', '          ', 'USTDMULT', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 8, '2008-01-01', '2012-12-31', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1750329934', 0, 'N', 0, '2013-05-30', NULL, NULL, 0, 0, NULL, NULL),
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('942854057', 'W11003348', 'W11003348', 'UTIHCPHY', 'Mountain View Pediatrics', 'Nicole', 'R', 'Frei', 'MD', 'Pediatrics', NULL, NULL, NULL, 'o', '9720 S 1300 E #100', 'Sandy', 'Salt Lake', 'UT', '84094', '8015718550', NULL, NULL, NULL, '', NULL, NULL, '', '', 'USTDMULT', 'WUSTDHCPC5', NULL, '0.00', '35.00', '0.00', 8, '2008-01-01', '2008-11-05', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1437260338', 0, 'n', 0, '2008-05-14', NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W11003349', 'W11003349', 'UTIHCPHY', 'Manti Family Clinic', 'Michael', 'S', 'Frischknecht', 'MD', 'Family Practice', '', '', NULL, 'o', '159 N Main', 'Manti', 'Sanpete', 'UT', '84642', '4358353344', NULL, '159 N Main', 'Manti', 'Sanpete', 'UT', '84642', '4358353344', '', 'USTDMULT', 'WUSTDHCPC5', NULL, '0.00', '35.00', '0.00', 8, '2008-01-01', NULL, 0, 0, 0, 'Sanpete Valley Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1629019229', 0, 'n', 0, '2013-11-18', NULL, NULL, 39.2677, -111.643, NULL, NULL),
('942854057', 'W11003350', 'W11003350', 'UTIHCPHY', 'Bryner Clinic', 'Arthur', 'Y', 'Gardiner', 'MD', 'Pediatrics', '', '', NULL, 'o', '525 E 100 S # 500', 'Salt Lake City', 'Salt Lake', 'UT', '84102', '8015197100', NULL, '525 E 100 S # 500', 'Salt Lake City', 'Salt Lake', 'UT', '84102', '8015197100', '          ', 'USTDMULT', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 8, '2008-01-01', '2012-12-31', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1528015948', 0, 'N', 0, '2013-05-30', NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W11003351', 'W11003351', 'UTIHCPHY', 'Canyon View Family Practice', 'Ellen', 'F', 'Gardner', 'MD', 'Family Practice', NULL, NULL, NULL, 'o', '15 E 400 N', 'Parowan', 'Iron', 'UT', '84761', '4354773317', NULL, '15 E 400 N', 'Parowan', 'Iron', 'UT', '84761', '4354773317', '          ', 'USTDMULT', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 8, '2008-01-01', '2011-08-31', 0, 0, 0, 'Valley View Medical Center', '', '', '', 'HCFA|UB|', '1013939024', 0, 'N', 0, '2011-11-10', NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W11003352', 'W11003352', 'UTIHCPHY', 'Budge Clinic GI', 'Vikram', NULL, 'Garg', 'MD', 'Gastroenterology', NULL, NULL, NULL, 'o', '1300 N 500 E #340', 'Logan', 'Cache', 'UT', '84341', '4357165900', NULL, NULL, NULL, '', NULL, NULL, '', '', 'USTDMULT', 'WUSTDHCPC5', NULL, '0.00', '35.00', '0.00', 8, '2008-01-01', NULL, 0, 0, 0, 'Logan Regional Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1760491054', 0, 'n', 0, '2008-05-14', NULL, NULL, 41.7563, -111.821, NULL, NULL),
('942854057', 'W11003353', 'W11003353', 'UTIHCPHY', 'Cedar City Clinic', 'Daren', 'O', 'Gatherum', 'DO', 'Obstetrics and Gynecology', '', '', NULL, 'o', '1303 N Main #3C', 'Cedar City', 'Iron', 'UT', '84720', '4358685500', NULL, NULL, NULL, '', NULL, NULL, '', '', 'USTDMULT', 'WUSTDHCPC5', NULL, '0.00', '35.00', '0.00', 8, '2008-01-01', NULL, NULL, 0, 0, 'Valley View Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1770504284', 0, 'n', 0, '2010-04-23', NULL, NULL, 37.6711, -113.103, NULL, NULL),
('942854057', 'W11003354', 'W11003354', 'UTIHCPHY', 'Mountain View Pediatrics', 'Kim', 'J', 'Gehle', 'MD', 'Pediatrics', NULL, NULL, NULL, 'o', '9720 S 1300 E #100', 'Sandy', 'Salt Lake', 'UT', '84094', '8015718550', NULL, NULL, NULL, '', NULL, NULL, '', '', 'USTDMULT', 'WUSTDHCPC5', NULL, '0.00', '35.00', '0.00', 8, '2008-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1760400592', 0, 'n', 0, '2008-05-14', NULL, NULL, 40.5739, -111.853, NULL, NULL),
('942854057', 'W11003355', 'W11003355', 'UTIHCPHY', 'Cardiovascular & Thoracic Surgery - St. George', 'Trevor', 'Michael', 'Gerber', 'PA', 'Cardiovascular Disease', NULL, NULL, NULL, 'o', '1380 E Medical Ctr Dr Ste 2600', 'St George', 'Washington', 'UT', '84790', '4352512700', NULL, NULL, NULL, '', NULL, NULL, '', '', 'USTDMULT', 'WUSTDHCPC5', NULL, '0.00', '35.00', '0.00', 8, '2008-01-01', NULL, 0, 0, 0, 'Dixie Regional Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1083632335', 0, 'n', 0, '2008-05-14', NULL, NULL, 37.0998, -113.554, NULL, NULL),
('942854057', 'W11003356', 'W11003356', 'UTIHCPHY', 'Sunset Family Practice', 'William', 'P', 'Goodger', 'MD', 'Hospitalist', '', '', NULL, 'O', '1739 W Sunset Blvd', 'St George', 'Washington', 'UT', '84770', '4356346000', '4356346033', '1739 W Sunset Blvd', 'St George', 'Washington', 'UT', '84770', '4356346000', '4356346033', 'USTDMULT', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 8, '2008-01-01', NULL, 0, 0, 0, 'Dixie Regional Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1104833987', 0, 'N', 0, '2013-11-18', NULL, NULL, 37.1227, -113.62, NULL, NULL),
('942854057', 'W11003357', 'W11003357', 'UTIHCPHY', 'Cardiovascular & Thoracic Surgery - St. George', 'Paul', 'Wallace', 'Goodrich', 'PA', 'Cardiovascular Disease', NULL, NULL, NULL, 'o', '1380 E Medical Ctr Dr Ste 2600', 'St George', 'Washington', 'UT', '84790', '4352512700', NULL, NULL, NULL, '', NULL, NULL, '', '', 'USTDMULT', 'WUSTDHCPC5', NULL, '0.00', '35.00', '0.00', 8, '2008-01-01', NULL, 0, 0, 0, 'Dixie Regional Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1942234976', 0, 'n', 0, '2008-05-14', NULL, NULL, 37.0998, -113.554, NULL, NULL),
('942854057', 'W11003358', 'W11003358', 'UTIHCPHY', 'Richfield Family Practice', 'Mark', 'Robert', 'Greenwood', 'MD', 'Family Practice', 'Urgent Care', '', NULL, 'o', '460 N Main', 'Richfield', 'Sevier', 'UT', '84701', '4358965496', NULL, '460 N Main', 'Richfield', 'Sevier', 'UT', '84701', '4358965496', '', 'USTDMULT', 'WUSTDHCPC5', NULL, '0.00', '35.00', '0.00', 8, '2008-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1083620298', 0, 'n', 0, '2014-04-08', NULL, NULL, 38.7745, -112.085, NULL, NULL),
('942854057', 'W11003359', 'W11003359', 'UTIHCPHY', 'Richfield Family Practice', 'Mark', 'William', 'Greenwood', 'MD', 'Family Practice', NULL, NULL, NULL, 'o', '460 N Main', 'Richfield', 'Sevier', 'UT', '84701', '4358965496', NULL, NULL, NULL, '', NULL, NULL, '', '', 'USTDMULT', 'WUSTDHCPC5', NULL, '0.00', '35.00', '0.00', 8, '2008-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1164437067', 0, 'n', 0, '2010-01-12', NULL, NULL, 38.7745, -112.085, NULL, NULL),
('942854057', 'W11003360', 'W11003360', 'UTIHCPHY', 'Fillmore Clinic', 'Craig', 'M', 'Grose', 'MD', 'Family Practice', NULL, NULL, NULL, 'o', '700 S Hwy 99 #3', 'Fillmore', 'Millard', 'UT', '84631', '4357435555', NULL, NULL, NULL, '', NULL, NULL, '', '', 'USTDMULT', 'WUSTDHCPC5', NULL, '0.00', '35.00', '0.00', 8, '2008-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1003854878', 0, 'n', 0, '2010-01-12', NULL, NULL, 38.953, -112.341, NULL, NULL),
('942854057', 'W11003361', 'W11003361', 'UTIHCPHY', 'Zion Orthopaedics & Sports Medicine', 'K', 'C', 'Hafen', 'PA', 'Orthopedic Surgery', NULL, NULL, NULL, 'o', '652 S Medical Ctr Rd Ste 400', 'St George', 'Washington', 'UT', '84790', '4352512650', NULL, NULL, NULL, '', NULL, NULL, '', '', 'USTDMULT', 'WUSTDHCPC5', NULL, '0.00', '35.00', '0.00', 8, '2008-01-01', NULL, 0, 0, 0, 'Dixie Regional Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1194740522', 0, 'n', 0, '2008-05-14', NULL, NULL, 37.0498, -113.574, NULL, NULL),
('942854057', 'W11003362', 'W11003362', 'UTIHCPHY', 'River Road Internal Medicine', 'Jerold', 'L', 'Hagen', 'MD', 'Internal Medicine', '', '', NULL, 'o', '577 S River Road', 'St George', 'Washington', 'UT', '84790', '4356886200', NULL, '577 S River Road', 'St George', 'Washington', 'UT', '84790', '4356886200', '          ', 'USTDMULT', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 8, '2008-01-01', '2013-06-30', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1639102635', 0, 'N', 0, '2013-07-12', NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W11003363', 'W11003363', 'UTIHCPHY', 'Ephraim Clinic', 'T', 'Randy', 'Hansen', 'MD', 'General Surgery', '', '', NULL, 'o', '525 N Main', 'Ephraim', 'Sanpete', 'UT', '84627', '4352834076', NULL, '525 N Main', 'Ephraim', 'Sanpete', 'UT', '84627', '4352834076', '', 'USTDMULT', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 8, '2008-01-01', '2008-09-12', 0, 0, 0, 'Mountain West Medical Center', '', '', '', 'HCFA|UB|', '1861433443', 0, 'n', 0, '2014-05-30', NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W11003364', 'W11003364', 'UTIHCPHY', 'Budge Clinic Surgical Specialists', 'David', 'L', 'Harker', 'MD', 'General Surgery', '', '', NULL, 'o', '1350 N 500 E', 'Logan', 'Cache', 'UT', '84341', '4357921950', NULL, '1350 N 500 E', 'Logan', 'Cache', 'UT', '84341', '4357921950', '          ', 'USTDMULT', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 8, '2008-01-01', NULL, 0, 0, 0, 'Logan Regional Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1710996020', 0, 'N', 0, '2012-02-29', NULL, NULL, 41.7565, -111.821, NULL, NULL),
('942854057', 'W11003365', 'W11003365', 'UTIHCPHY', 'Budge Clinic Internal Medicine', 'Charlotte', NULL, 'Harris', 'APRN', 'Mental Health', NULL, NULL, NULL, 'o', '1350 N 500 E', 'Logan', 'Cache', 'UT', '84341', '4357921980', NULL, NULL, NULL, '', NULL, NULL, '', '', 'USTDMULT', 'WUSTDHCPC5', NULL, '0.00', '35.00', '0.00', 8, '2008-01-01', '2008-11-05', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1801981113', 0, 'n', 0, '2008-05-14', NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W11003366', 'W11003366', 'UTIHCPHY', 'Summit Clinic', 'Gary', 'Lee', 'Harris', 'MD', 'Family Practice', '', '', NULL, 'o', '502 S Main', 'Smithfield', 'Cache', 'UT', '84335', '4355633222', NULL, '502 S Main', 'Smithfield', 'Cache', 'UT', '84335', '4355633222', '', 'USTDMULT', 'WUSTDHCPC5', NULL, '0.00', '35.00', '0.00', 8, '2008-01-01', NULL, 0, 0, 0, 'Logan Regional Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1154330462', 0, 'n', 0, '2011-04-28', NULL, NULL, 41.826, -111.833, NULL, NULL),
('942854057', 'W11003367', 'W11003367', 'UTIHCPHY', 'Memorial Clinic', 'Kevin', 'L', 'Havlik', 'MD', 'Pediatrics', '', '', NULL, 'o', '2000 S 900 E', 'Salt Lake City', 'Salt Lake', 'UT', '84105', '8014647500', NULL, '2000 S 900 E', 'Salt Lake City', 'Salt Lake', 'UT', '84105', '8014647500', '', 'USTDMULT', 'WUSTDHCPC5', NULL, '0.00', '35.00', '0.00', 8, '2008-01-01', NULL, 0, 0, 0, NULL, 'Primary Childrens Medical Center', NULL, '', 'HCFA|UB|', '1558315796', 0, 'n', 0, '2013-05-17', NULL, NULL, 40.7267, -111.865, NULL, NULL),
('942854057', 'W11003368', 'W11003368', 'UTIHCPHY', 'Cedar City InstaCare', 'Anne', 'M', 'Hawkins', 'MD', 'Urgent Care', '', '', NULL, 'B', '962 S Sage Drive', 'Cedar City', 'Iron', 'UT', '84720', '4358653440', NULL, '962 S Sage Drive', 'Cedar City', 'Iron', 'UT', '84720', '4358653440', '          ', 'USTDMULT', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 8, '2008-01-01', '2011-08-14', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1801845755', 0, 'N', 0, '2008-05-14', NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W11003369', 'W11003369', 'UTIHCPHY', 'Cedar City WorkMed', 'Kimberly', 'Dawn', 'Haycock', 'PA-C', 'Family Practice', 'Occupational Therapy', NULL, NULL, 'o', '1303 N Main Street', 'Cedar City', 'Iron', 'UT', '84720', '4358685575', NULL, NULL, NULL, '', NULL, NULL, '', '', 'USTDMULT', 'WUSTDHCPC5', NULL, '0.00', '35.00', NULL, 8, '2008-01-01', '2007-12-31', 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1205862208', 0, 'n', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W11003370', 'W11003370', 'UTIHCPHY', 'Cedar City Clinic', 'Bruce', 'A', 'Hendrix', 'MD', 'Internal Medicine', '', '', NULL, 'o', '1303 N Main #3C', 'Cedar City', 'Iron', 'UT', '84720', '4358685500', '          ', '1303 N Main #3C', 'Cedar City', 'Iron', 'UT', '84720', '4358685500', '          ', 'USTDMULT', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 8, '2008-01-01', '2014-04-15', 0, 0, 0, 'Valley View Medical Center', '', '', '', 'HCFA|UB|', '1336153030', 0, 'N', 0, '2014-06-27', NULL, NULL, 37.6711, -113.103, NULL, NULL),
('942854057', 'W11003371', 'W11003371', 'UTIHCPHY', 'Snow College Clinic', 'Barbara', 'L', 'Hennagir', 'PA-C', 'Family Practice', '', '', NULL, 'o', '150 E College Avenue', 'Ephraim', 'Sanpete', 'UT', '84627', '4352837216', NULL, '150 E College Avenue', 'Ephraim', 'Sanpete', 'UT', '84627', '4352837216', '          ', 'USTDMULT', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 8, '2008-01-01', '2010-11-01', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1538215181', 0, 'N', 0, '2011-09-26', NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W11003372', 'W11003372', 'UTIHCPHY', 'Cedar City WorkMed', 'Erica', 'R', 'Hensman', 'PA', 'Occupational Therapy', '', '', NULL, 'o', '1303 N Main St', 'Cedar City', 'Iron', 'UT', '84720', '4358685575', NULL, '1303 N Main St', 'Cedar City', 'Iron', 'UT', '84720', '4358685575', '', 'USTDMULT', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 8, '2008-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1649287905', 0, 'n', 0, '2014-06-27', NULL, NULL, 37.7003, -113.064, NULL, NULL),
('942854057', 'W11003373', 'W11003373', 'UTIHCPHY', 'Canyon View Orthopedics & Podiatry Associates ', 'Thomas', 'O', 'Higginbotham', 'MD', 'Orthopedic Surgery', '', '', NULL, 'o', '1300 N 500 E #130', 'Logan', 'Cache', 'UT', '84341', '4357162800', NULL, NULL, NULL, '', NULL, NULL, '', '', 'USTDMULT', 'WUSTDHCPC5', NULL, '0.00', '35.00', '0.00', 8, '2008-01-01', NULL, 0, 0, 0, 'Logan Regional Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1588673800', 0, 'n', 0, '2008-05-14', NULL, NULL, 41.7563, -111.821, NULL, NULL),
('942854057', 'W11003374', 'W11003374', 'UTIHCPHY', 'Utah Valley Pulmonary Clinic', 'Tracy', 'Arnold', 'Hill', 'MD', 'Pulmonary', NULL, NULL, NULL, 'o', '1055 N 300 W #500', 'Provo', 'Utah', 'UT', '84604', '8013577291', NULL, NULL, NULL, '', NULL, NULL, '', '', 'USTDMULT', 'WUSTDHCPC5', NULL, '0.00', '35.00', '0.00', 8, '2008-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1992711253', 0, 'n', 0, '2008-05-14', NULL, NULL, 40.2476, -111.664, NULL, NULL),
('942854057', 'W11003375', 'W11003375', 'UTIHCPHY', 'Bryner Clinic', 'Laurie', 'Lynne', 'Hilyer', 'MD', 'Pediatrics', '', '', NULL, 'o', '525 E 100 S # 500', 'Salt Lake City', 'Salt Lake', 'UT', '84102', '8015197100', NULL, '525 E 100 S # 500', 'Salt Lake City', 'Salt Lake', 'UT', '84102', '8015197100', '          ', 'USTDMULT', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 8, '2008-01-01', '2012-12-31', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1326093758', 0, 'N', 0, '2013-05-30', NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W11003376', 'W11003376', 'UTIHCPHY', 'Pulmonary Medicine Clinic - St George', 'Terri', 'L', 'Hoffman', 'MD', 'Internal Medicine', 'Pulmonology', '', NULL, 'o', '1380 E Medical Center Drive #1400', 'St George', 'Washington', 'UT', '84790', '4352512600', NULL, '1380 E Medical Center Drive #1400', 'St George', 'Washington', 'UT', '84790', '4352512600', '', 'USTDMULT', 'WUSTDHCPC5', NULL, '0.00', '35.00', '0.00', 8, '2008-01-01', '2008-11-05', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1871512137', 0, 'n', 0, '2012-03-26', 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
('942854057', 'W11003377', 'W11003377', 'UTIHCPHY', 'Canyon View Orthopedics & Podiatry Associates ', 'Eric', 'Wayne', 'Hooley', 'MD', 'Orthopedic Surgery', NULL, NULL, NULL, 'o', '1300 N 500 E #130', 'Logan', 'Cache', 'UT', '84341', '4357162800', NULL, NULL, NULL, '', NULL, NULL, '', '', 'USTDMULT', 'WUSTDHCPC5', NULL, '0.00', '35.00', '0.00', 8, '2008-01-01', NULL, 0, 0, 0, 'Logan Regional Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1548230014', 0, 'n', 0, '2008-05-14', NULL, NULL, 41.7563, -111.821, NULL, NULL),
('942854057', 'W11003378', 'W11003378', 'UTIHCPHY', 'Budge Clinic Pediatrics', 'Tyson', 'Stuart', 'Horkley', 'MD', 'Pediatrics', NULL, NULL, NULL, 'o', '1350 N 500 E', 'Logan', 'Cache', 'UT', '84341', '4357921940', NULL, NULL, NULL, '', NULL, NULL, '', '', 'USTDMULT', 'WUSTDHCPC5', NULL, '0.00', '35.00', '0.00', 8, '2008-01-01', NULL, 0, 0, 0, 'Logan Regional Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1023150851', 0, 'n', 0, '2008-05-14', NULL, NULL, 41.7565, -111.821, NULL, NULL),
('942854057', 'W11003379', 'W11003379', 'UTIHCPHY', 'Budge Clinic Obstetrics & Gynecology', 'Ernest', 'Brett', 'Horsley', 'DO', 'Obstetrics and Gynecology', NULL, NULL, NULL, 'o', '1400 N 500 E', 'Logan', 'Cache', 'UT', '84341', '4357161920', NULL, NULL, NULL, '', NULL, NULL, '', '', 'USTDMULT', 'WUSTDHCPC5', NULL, '0.00', '35.00', NULL, 8, '2000-01-01', '2000-01-01', 0, NULL, 0, 'Logan Regional Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1003826439', 0, 'n', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W11003380', 'W11003380', 'UTIHCPHY', 'Logan WorkMed', 'Michael', 'C', 'Housley', 'MD', 'Family Practice', NULL, NULL, NULL, 'o', '412 N 200 E', 'Logan', 'Cache', 'UT', '84321', '4357132850', NULL, NULL, NULL, '', NULL, NULL, '', '', 'USTDMULT', 'WUSTDHCPC5', NULL, '0.00', '35.00', '0.00', 8, '2008-01-01', NULL, 0, 0, 0, 'Logan Regional Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1295744522', 0, 'n', 0, '2008-05-14', NULL, NULL, 41.7393, -111.83, NULL, NULL),
('942854057', 'W11003381', 'W11003381', 'UTIHCPHY', 'Logan InstaCare ', 'Karri', NULL, 'Hoyt', 'PA', 'Urgent Care', NULL, NULL, NULL, 'B', '235 E 400 N', 'Logan', 'Cache', 'UT', '84321', '4357521010', NULL, NULL, NULL, '', NULL, NULL, '', '', 'USTDMULT', 'WUSTDHCPC5', NULL, '0.00', '35.00', '0.00', 8, '2008-01-01', '2008-06-05', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1659381085', 0, 'n', 0, '2008-05-14', NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W11003382', 'W11003382', 'UTIHCPHY', 'River Road Family Practice', 'Jonathan', 'P', 'Hubbard', 'DO', 'Family Practice', '', '', NULL, 'o', '577 S River Road', 'St George', 'Washington', 'UT', '84790', '4356886000', NULL, '577 S River Road', 'St George', 'Washington', 'UT', '84790', '4356886000', '', 'USTDMULT', 'WUSTDHCPC5', NULL, '0.00', '35.00', '0.00', 8, '2008-01-01', '2008-05-01', 0, 0, 0, 'Dixie Regional Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1609894922', 0, 'n', 0, '2013-09-13', NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W11003383', 'W11003383', 'UTIHCPHY', 'Budge Clinic Internal Medicine', 'Jeffrey', 'Mark', 'Huffman', 'MD', 'Internal Medicine', '', '', NULL, 'o', '1350 N 500 E', 'Logan', 'Cache', 'UT', '84341', '4357921980', NULL, '1350 N 500 E', 'Logan', 'Cache', 'UT', '84341', '4357921980', '', 'USTDMULT', 'WUSTDHCPC5', NULL, '0.00', '35.00', '0.00', 8, '2008-01-01', NULL, 0, 0, 0, 'Logan Regional Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1760492219', 0, 'n', 0, '2013-12-30', NULL, NULL, 41.7565, -111.821, NULL, NULL),
('942854057', 'W11003384', 'W11003384', 'UTIHCPHY', 'Tremonton Clinic', 'Melanie', 'C', 'Hughes', 'APRN', 'Family Practice', '', '', NULL, 'o', '935 N 1000 W', 'Tremonton', 'Box Elder', 'UT', '84337', '4352074800', '', '935 N 1000 W', 'Tremonton', 'Box Elder', 'UT', '84337', '4352074800', '', 'USTDMULT', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 8, '2008-01-01', '2011-01-31', 0, 0, 0, 'Bear River Valley Hospital', '', '', '', 'HCFA|UB|', '1417945023', 0, 'N', 0, '2014-07-24', NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W11003385', 'W11003385', 'UTIHCPHY', 'Canyon View Orthopedics & Podiatry Associates', 'W', 'Scott', 'Hunt', 'PA', 'Orthopedic Surgery', '', '', NULL, 'o', '1300 N 500 E #130', 'Logan', 'Cache', 'UT', '84341', '4357162800', NULL, '1300 N 500 E #130', 'Logan', 'Cache', 'UT', '84341', '4357162800', '', 'USTDMULT', 'WUSTDHCPC5', NULL, '0.00', '35.00', '0.00', 8, '2008-01-01', NULL, 0, 0, 0, 'Logan Regional Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1871503201', 0, 'n', 0, '2011-05-24', NULL, NULL, 41.7563, -111.821, NULL, NULL),
('942854057', 'W11003386', 'W11003386', 'UTIHCPHY', 'DRMC Radiation Oncology', 'Christian', 'Cooper', 'Hyde', 'MD', 'Radiation Oncology', '', '', NULL, 'o', '544 S 400 E', 'St George', 'Washington', 'UT', '84770', '4356884175', NULL, '544 S 400 E', 'St George', 'Washington', 'UT', '84770', '4356884175', '          ', 'USTDMULT', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 8, '2008-01-01', '2012-07-07', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1316972086', 0, 'N', 0, '2012-09-10', NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W11003387', 'W11003387', 'UTIHCPHY', 'Cache Valley Family Practice', 'Douglas', 'R', 'Hyldahl', 'MD', 'Family Practice', '', '', NULL, 'o', '412 N 200 E', 'Logan', 'Cache', 'UT', '84321', '4357132800', NULL, '412 N 200 E', 'Logan', 'Cache', 'UT', '84321', '4357132800', '', 'USTDMULT', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 8, '2008-01-01', NULL, 0, 0, 0, 'Logan Regional Hospital', '', '', '', 'HCFA|UB|', '1083624555', 0, 'n', 0, '2014-06-30', NULL, NULL, 41.7393, -111.83, NULL, NULL),
('942854057', 'W11003388', 'W11003388', 'UTIHCPHY', 'Isom Plastic Surgery', 'Casey', 'N', 'Isom', 'MD', 'Plastic Surgery', '', '', NULL, 'o', '1350 N 500 E Ste 310', 'Logan', 'Cache', 'UT', '84341', '4357871108', NULL, '1350 N 500 E Ste 310', 'Logan', 'Cache', 'UT', '84341', '4357871108', '          ', 'USTDMULT', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 8, '2008-01-01', NULL, 0, 0, 0, 'Logan Regional Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1215964275', 0, 'N', 0, '2008-05-14', NULL, NULL, 41.7565, -111.821, NULL, NULL),
('942854057', 'W11003389', 'W11003389', 'UTIHCPHY', 'Ephraim Clinic', 'Eileen', 'K', 'Jackson', 'MD', 'Family Practice', '', '', NULL, 'o', '525 N Main', 'Ephraim', 'Sanpete', 'UT', '84627', '4352834076', NULL, '525 N Main', 'Ephraim', 'Sanpete', 'UT', '84627', '4352834076', '', 'USTDMULT', 'WUSTDHCPC5', NULL, '0.00', '35.00', '0.00', 8, '2008-01-01', NULL, 0, 0, 0, 'Sanpete Valley Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1518906320', 0, 'n', 0, '2011-09-26', NULL, NULL, 39.371, -111.587, NULL, NULL),
('942854057', 'W11003390', 'W11003390', 'UTIHCPHY', 'Fillmore Clinic', 'Brent', 'D', 'Jackson', 'MD', 'Family Practice', '', '', NULL, 'o', '700 S Hwy 99 #3', 'Fillmore', 'Millard', 'UT', '84631', '4357435555', NULL, '700 S Hwy 99 #3', 'Fillmore', 'Millard', 'UT', '84631', '4357435555', '          ', 'USTDMULT', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 8, '2008-01-01', '2012-07-31', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1962418210', 0, 'N', 0, '2013-05-30', NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W11003391', 'W11003391', 'UTIHCPHY', 'Mountain View Pediatrics', 'Karen', 'Edith', 'Jackson', 'APRN', 'Pediatrics', NULL, NULL, NULL, 'o', '9720 S 1300 E #100', 'Sandy', 'Salt Lake', 'UT', '84094', '8015718550', NULL, NULL, NULL, '', NULL, NULL, '', '', 'USTDMULT', 'WUSTDHCPC5', NULL, '0.00', '35.00', '0.00', 8, '2008-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1174545503', 0, 'n', 0, '2008-05-14', NULL, NULL, 40.5739, -111.853, NULL, NULL),
('942854057', 'W11003392', 'W11003392', 'UTIHCPHY', 'Mountain View Pediatrics', 'Richard', 'L', 'Jackson', 'MD', 'Pediatrics', '', '', NULL, 'o', '9720 S 1300 E #100', 'Sandy', 'Salt Lake', 'UT', '84094', '8015718550', NULL, '9720 S 1300 E #100', 'Sandy', 'Salt Lake', 'UT', '84094', '8015718550', '', 'USTDMULT', 'WUSTDHCPC5', NULL, '0.00', '35.00', '0.00', 8, '2008-01-01', NULL, 0, 0, 0, 'St Marks Hospital', 'Jordan Valley Medical Center', '', '', 'HCFA|UB|', '1295780559', 0, 'n', 0, '2013-08-22', NULL, NULL, 40.5739, -111.853, NULL, NULL),
('942854057', 'W11003393', 'W11003393', 'UTIHCPHY', 'Pulmonary Medicine Clinic - St George', 'Charlie', 'R', 'Jacques', 'APRN', 'Mental Health', 'Advanced Practice Registered Nurse', 'Pulmonary', NULL, 'o', '1380 E Medical Ctr Dr Ste 1400', 'St George', 'Washington', 'UT', '84790', '4352512600', NULL, '1380 E Medical Ctr Dr Ste 1400', 'St George', 'Washington', 'UT', '84790', '4352512600', '          ', 'USTDMULT', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 8, '2008-01-01', '2013-09-30', 0, 0, 0, 'Dixie Regional Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1336162890', 0, 'N', 0, '2013-09-05', NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W11003394', 'W11003394', 'UTIHCPHY', 'Southwest Cardiology - St. George', 'John', 'H', 'Jentzer', 'MD', 'Cardiovascular Disease', '', '', NULL, 'o', '1380 E Medical Center Drive #1500', 'St George', 'Washington', 'UT', '84790', '4352512500', NULL, '1380 E Medical Center Drive #1500', 'St George', 'Washington', 'UT', '84790', '4352512500', '          ', 'USTDMULT', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 8, '2008-01-01', '2011-10-31', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1366413924', 0, 'N', 0, '2012-04-10', NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W11003395', 'W11003395', 'UTIHCPHY', 'Zion Orthopaedics & Sports Medicine', 'David', 'S', 'Jevsevar', 'MD', 'Orthopedic Surgery', NULL, NULL, NULL, 'o', '652 S Medical Ctr Rd Ste 400', 'St George', 'Washington', 'UT', '84790', '4352512650', NULL, NULL, NULL, '', NULL, NULL, '', '', 'USTDMULT', 'WUSTDHCPC5', NULL, '0.00', '35.00', '0.00', 8, '2008-01-01', NULL, 0, 0, 0, 'Dixie Regional Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1760407183', 0, 'n', 0, '2008-05-14', NULL, NULL, 37.0498, -113.574, NULL, NULL),
('942854057', 'W11003396', 'W11003396', 'UTIHCPHY', 'Redrock Pediatrics', 'Amanda', 'Melanie', 'Jocelyn', 'APRN', 'Pediatrics', NULL, NULL, NULL, 'o', '1380 E Medical Ctr Dr Ste 3100', 'St George', 'Washington', 'UT', '84790', '4352512740', NULL, NULL, NULL, '', NULL, NULL, '', '', 'USTDMULT', 'WUSTDHCPC5', NULL, '0.00', '35.00', '0.00', 8, '2008-01-01', NULL, 0, 0, 0, 'Dixie Regional Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1376739102', 0, 'n', 0, '2008-05-14', NULL, NULL, 37.0998, -113.554, NULL, NULL),
('942854057', 'W11003397', 'W11003397', 'UTIHCPHY', 'Cedar City WorkMed', 'Dayne', NULL, 'Johnson', 'PA-C', 'Occupational Therapy', 'Family Practice', NULL, NULL, 'o', '1303 N Main Street', 'Cedar City', 'Iron', 'UT', '84720', '4358685575', NULL, NULL, NULL, '', NULL, NULL, '', '', 'USTDMULT', 'WUSTDHCPC5', NULL, '0.00', '35.00', NULL, 8, '2008-01-01', '2007-12-31', 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1669505178', 0, 'n', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W11003398', 'W11003398', 'UTIHCPHY', 'Cache Valley Family Practice', 'Patricia', 'Suzanne', 'Jones', 'PA', 'Family Practice', NULL, NULL, NULL, 'o', '412 N 200 E', 'Logan', 'Cache', 'UT', '84321', '4357132800', NULL, NULL, NULL, 'Cache', NULL, NULL, '4357132800', '          ', 'USTDMULT', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 8, '2008-01-01', '2009-09-30', NULL, 0, NULL, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1508876079', 0, 'N', 0, '2008-05-14', NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W11003399', 'W11003399', 'UTIHCPHY', 'River Road Internal Medicine', 'Thomas', 'K', 'Jones', 'MD', 'Internal Medicine', NULL, NULL, NULL, 'o', '577 S River Road', 'St George', 'Washington', 'UT', '84790', '4356886200', NULL, NULL, NULL, '', NULL, NULL, '', '', 'USTDMULT', 'WUSTDHCPC5', NULL, '0.00', '35.00', '0.00', 8, '2008-01-01', NULL, 0, 0, 0, 'Dixie Regional Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1861410276', 0, 'n', 0, '2008-05-14', NULL, NULL, 37.0986, -113.557, NULL, NULL),
('942854057', 'W11003400', 'W11003400', 'UTIHCPHY', 'Redrock Pediatrics', 'Rajiv', 'J', 'Kaddu', 'MD', 'Pediatrics', 'Pediatric Gastroenterology', '', NULL, 'o', '1380 E Medical Ctr Dr Ste 3100', 'St George', 'Washington', 'UT', '84790', '4352512740', NULL, '1380 E Medical Center Drive #3100', 'St George', 'Washington', 'UT', '84790', '4352512740', '', 'USTDMULT', 'WUSTDHCPC5', NULL, '0.00', '35.00', '0.00', 8, '2008-01-01', NULL, 0, 0, 0, 'Dixie Regional Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1275566291', 0, 'n', 0, '2011-09-26', NULL, NULL, 37.0998, -113.554, NULL, NULL),
('942854057', 'W11003401', 'W11003401', 'UTIHCPHY', 'Budge Clinic Surgical Specialists', 'Jeffrey', 'S', 'Keyser', 'MD', 'Ear, Nose and Throat', '', '', NULL, 'o', '1350 N 500 E', 'Logan', 'Cache', 'UT', '84341', '4357921950', NULL, '1350 N 500 E', 'Logan', 'Cache', 'UT', '84341', '4357921950', '', 'USTDMULT', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 8, '2008-01-01', NULL, 0, 0, 0, 'Logan Regional Hospital', '', '', '', 'HCFA|UB|', '1588674055', 0, 'n', 0, '2014-05-13', NULL, NULL, 41.7565, -111.821, NULL, NULL),
('942854057', 'W11003402', 'W11003402', 'UTIHCPHY', 'Cardiovascular & Thoracic Surgery - St. George', 'Michael', 'David', 'Khoury', 'MD', 'Vascular Surgery', NULL, NULL, NULL, 'o', '1380 E Medical Ctr Dr Ste 2600', 'St George', 'Washington', 'UT', '84790', '4352512700', NULL, NULL, NULL, '', NULL, NULL, '', '', 'USTDMULT', 'WUSTDHCPC5', NULL, '0.00', '35.00', '0.00', 8, '2008-01-01', NULL, 0, 0, 0, 'Dixie Regional Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1992792659', 0, 'n', 0, '2008-05-14', NULL, NULL, 37.0998, -113.554, NULL, NULL),
('942854057', 'W11003403', 'W11003403', 'UTIHCPHY', 'Canyon View Orthopedics & Podiatry Associates ', 'Bryan', 'C', 'King', 'MD', 'Orthopedic Surgery', NULL, NULL, NULL, 'o', '1300 N 500 E #130', 'Logan', 'Cache', 'UT', '84341', '4357162800', NULL, NULL, NULL, '', NULL, NULL, '', '', 'USTDMULT', 'WUSTDHCPC5', NULL, '0.00', '35.00', '0.00', 8, '2008-01-01', NULL, 0, 0, 0, 'Logan Regional Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1194735670', 0, 'n', 0, '2008-05-14', NULL, NULL, 41.7563, -111.821, NULL, NULL),
('942854057', 'W11003404', 'W11003404', 'UTIHCPHY', 'Logan InstaCare', 'Kurt', 'V', 'King', 'MD', 'Internal Medicine', 'Emergency Medicine', '', NULL, 'B', '235 E 400 N', 'Logan', 'Cache', 'UT', '84321', '4357521010', NULL, '235 E 400 N', 'Logan', 'Cache', 'UT', '84321', '4357521010', '', 'USTDMULT', 'WUSTDHCPC5', NULL, '0.00', '35.00', '0.00', 8, '2008-01-01', NULL, 0, 0, 0, 'Logan Regional Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1649267949', 0, 'n', 0, '2013-08-27', NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W11003405', 'W11003405', 'UTIHCPHY', 'Dixie Pulmonary Critical Care', 'Michael', 'R', 'Kline', 'MD', 'Pulmonary', 'Family Practice', 'Internal Medicine', NULL, 'O', '1380 E Medical Ctr Dr', 'St George', 'Washington', 'UT', '84790', '4352512600', '4352512610', '1380 E Medical Ctr Dr', 'St George', 'Washington', 'UT', '84790', '4352512600', '4352512610', 'USTDMULT', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 8, '2008-01-01', NULL, 0, 0, 0, 'Dixie Regional Medical Center', '', '', '', 'HCFA|UB|', '1073531331', 0, 'N', 0, '2014-06-17', NULL, NULL, 37.0998, -113.554, NULL, NULL),
('942854057', 'W11003406', 'W11003406', 'UTIHCPHY', 'Dixie Plastic & Reconstructive Surgery', 'Aaron', 'O', 'Klomp', 'MD', 'Plastic Surgery', NULL, NULL, NULL, 'o', '652 S Medical Ctr Dr Ste 300', 'St George', 'Washington', 'UT', '84790', '4352513670', NULL, NULL, NULL, '', NULL, NULL, '', '', 'USTDMULT', 'WUSTDHCPC5', NULL, '0.00', '35.00', '0.00', 8, '2008-01-01', NULL, 0, 0, 0, 'Dixie Regional Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1588611602', 0, 'n', 0, '2010-01-12', NULL, NULL, 37.0498, -113.574, NULL, NULL),
('942854057', 'W11003407', 'W11003407', 'UTIHCPHY', 'Logan InstaCare', 'April', 'L', 'Larkin', 'MD', 'Urgent Care', '', '', NULL, 'B', '235 E 400 N', 'Logan', 'Cache', 'UT', '84321', '4357521010', NULL, '235 E 400 N', 'Logan', 'Cache', 'UT', '84321', '4357521010', '', 'USTDMULT', 'WUSTDHCPC5', NULL, '0.00', '35.00', '0.00', 8, '2008-01-01', NULL, 0, 0, 0, 'Logan Regional Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1518971134', 0, 'n', 0, '2013-08-27', NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W11003408', 'W11003408', 'UTIHCPHY', 'Hurricane Valley Clinic', 'George', 'Gregory', 'Last', 'MD', 'Family Practice', '', '', NULL, 'o', '75 N 2260 W', 'Hurricane', 'Washington', 'UT', '84737', '4356356400', NULL, '75 N 2260 W', 'Hurricane', 'Washington', 'UT', '84737', '4356356400', '', 'USTDMULT', 'WUSTDHCPC5', NULL, '0.00', '35.00', '0.00', 8, '2008-01-01', NULL, 0, 0, 0, 'Dixie Regional Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1235150731', 0, 'n', 0, '2013-12-30', NULL, NULL, 37.1771, -113.33, NULL, NULL),
('942854057', 'W11003409', 'W11003409', 'UTIHCPHY', 'Rim Rock Orthopaedics', 'Zachary', 'R', 'Leitze', 'MD', 'Orthopedic Surgery', '', '', NULL, 'o', '652 S Medical Ctr Dr Ste 120', 'St George', 'Washington', 'UT', '84790', '4356284460', NULL, '652 S Medical Center Dr Ste 120', 'St George', 'Washington', 'UT', '84790', '4356284460', '', 'USTDMULT', 'WUSTDHCPC5', NULL, '0.00', '35.00', '0.00', 8, '2008-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1053341115', 0, 'n', 0, '2010-06-25', NULL, NULL, 37.0498, -113.574, NULL, NULL),
('942854057', 'W11003410', 'W11003410', 'UTIHCPHY', 'Memorial Clinic', 'Peter', 'C', 'Lindgren', 'MD', 'Pediatrics', NULL, NULL, NULL, 'o', '2000 S 900 E', 'Salt Lake City', 'Salt Lake', 'UT', '84105', '8014647500', NULL, NULL, NULL, '', NULL, NULL, '', '', 'USTDMULT', 'WUSTDHCPC5', NULL, '0.00', '35.00', '0.00', 8, '2008-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1255370961', 0, 'n', 0, '2008-05-14', NULL, NULL, 40.7267, -111.865, NULL, NULL),
('942854057', 'W11003411', 'W11003411', 'UTIHCPHY', 'Canyon View Family Practice', 'Donna', 'J', 'Lister', 'APRN', 'Family Practice', NULL, NULL, NULL, 'o', '15 E 400 N', 'Parowan', 'Iron', 'UT', '84761', '4354773317', NULL, NULL, NULL, '', NULL, NULL, '', '', 'USTDMULT', 'WUSTDHCPC5', NULL, '0.00', '35.00', '0.00', 8, '2008-01-01', NULL, 0, 0, 0, 'Valley View Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1104848118', 0, 'n', 0, '2008-05-14', NULL, NULL, 37.8411, -112.83, NULL, NULL),
('942854057', 'W11003412', 'W11003412', 'UTIHCPHY', 'Hillcrest Pediatrics', 'Kristin', 'A', 'Lynch', 'MD', 'Pediatrics', '', '', NULL, 'o', '5063 S Cottonwood St #160', 'Murray', 'Salt Lake', 'UT', '84157', '8015071850', NULL, '5063 S Cottonwood St #160', 'Murray', 'Salt Lake', 'UT', '84157', '8015071850', '', 'USTDMULT', 'WUSTDHCPC5', NULL, '0.00', '35.00', '0.00', 8, '2008-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1588602320', 0, 'n', 0, '2010-10-28', NULL, NULL, 40.6615, -111.893, NULL, NULL),
('942854057', 'W11003413', 'W11003413', 'UTIHCPHY', 'Canyon View Orthopedics & Podiatry Associates', 'Trek', 'Daniel', 'Lyons', 'MD', 'Sports Medicine', '', '', NULL, 'o', '1300 N 500 E #130', 'Logan', 'Cache', 'UT', '84341', '4357162800', NULL, '1300 N 500 E #130', 'Logan', 'Cache', 'UT', '84341', '4357162800', '', 'USTDMULT', 'WUSTDHCPC5', NULL, '0.00', '35.00', '0.00', 8, '2008-01-01', NULL, 0, 0, 0, 'Logan Regional Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1043210248', 0, 'n', 0, '2011-11-02', NULL, NULL, 41.7563, -111.821, NULL, NULL),
('942854057', 'W11003414', 'W11003414', 'UTIHCPHY', 'River Road Internal Medicine', 'Renu', NULL, 'Mahajan', 'MD', 'Internal Medicine', NULL, NULL, NULL, 'o', '577 S River Road', 'St George', 'Washington', 'UT', '84790', '4356886200', NULL, NULL, NULL, '', NULL, NULL, '', '', 'USTDMULT', 'WUSTDHCPC5', NULL, '0.00', '35.00', '0.00', 8, '2008-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1609809607', 0, 'n', 0, '2008-05-14', NULL, NULL, 37.0986, -113.557, NULL, NULL),
('942854057', 'W11003415', 'W11003415', 'UTIHCPHY', 'Southern Utah Behavioral Health', 'Mark', 'E', 'Manley', 'MD', 'Mental Health', '', '', NULL, 'o', '1054 E Riverside Drive #202', 'St George', 'Washington', 'UT', '84790', '4356346100', NULL, '1054 E Riverside Drive #202', 'St George', 'Washington', 'UT', '84790', '4356346100', '          ', 'USTDMULT', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 8, '2008-01-01', '2011-06-23', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1942225750', 0, 'N', 0, '2011-05-24', NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W11003416', 'W11003416', 'UTIHCPHY', 'Southern Utah Behavioral Health', 'David', 'R', 'Marchant', 'APRN', 'Mental Health', NULL, NULL, NULL, 'o', '1054 E Riverside Drive #202', 'St George', 'Washington', 'UT', '84790', '4356346100', NULL, NULL, NULL, '', NULL, NULL, '', '', 'USTDMULT', 'WUSTDHCPC5', NULL, '0.00', '35.00', '0.00', 8, '2008-01-01', '2008-11-05', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1386663649', 0, 'n', 0, '2008-05-14', NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W11003417', 'W11003417', 'UTIHCPHY', 'Redrock Pediatrics', 'Michael', 'C', 'Marsden', 'DO', 'Pediatrics', NULL, NULL, NULL, 'o', '1380 E Medical Ctr Dr Ste 3100', 'St George', 'Washington', 'UT', '84790', '4352512740', NULL, NULL, NULL, '', NULL, NULL, '', '', 'USTDMULT', 'WUSTDHCPC5', NULL, '0.00', '35.00', '0.00', 8, '2008-01-01', NULL, NULL, 0, 0, 'Dixie Regional Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1568480804', 0, 'n', 0, '2010-04-23', NULL, NULL, 37.0998, -113.554, NULL, NULL),
('942854057', 'W11003418', 'W11003418', 'UTIHCPHY', 'Cedar City Clinic', 'Thomas', 'T', 'Marshall', 'MD', 'Family Practice', NULL, NULL, NULL, 'o', '1303 N Main #3C', 'Cedar City', 'Iron', 'UT', '84720', '4358685500', NULL, NULL, NULL, '', NULL, NULL, '', '', 'USTDMULT', 'WUSTDHCPC5', NULL, '0.00', '35.00', '0.00', 8, '2008-01-01', NULL, 0, 0, 0, 'Valley View Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1770506230', 0, 'n', 0, '2008-05-14', NULL, NULL, 37.6711, -113.103, NULL, NULL),
('942854057', 'W11003419', 'W11003419', 'UTIHCPHY', 'Budge Clinic Pediatrics', 'Prafulla', 'D', 'Martin-Garg', 'MD', 'Pediatrics', NULL, NULL, NULL, 'o', '1350 N 500 E', 'Logan', 'Cache', 'UT', '84341', '4357921940', NULL, NULL, NULL, '', NULL, NULL, '', '', 'USTDMULT', 'WUSTDHCPC5', NULL, '0.00', '35.00', '0.00', 8, '2008-01-01', NULL, 0, 0, 0, 'Logan Regional Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1437168721', 0, 'n', 0, '2008-05-14', NULL, NULL, 41.7565, -111.821, NULL, NULL),
('942854057', 'W11003420', 'W11003420', 'UTIHCPHY', 'Budge Clinic Obstetrics & Gynecology', 'Kimberly', 'D', 'McCulloch', 'MD', 'Obstetrics and Gynecology', NULL, NULL, NULL, 'o', '1400 N 500 E', 'Logan', 'Cache', 'UT', '84341', '4357161920', NULL, NULL, NULL, '', NULL, NULL, '', '', 'USTDMULT', 'WUSTDHCPC5', NULL, '0.00', '35.00', '0.00', 8, '2008-01-01', NULL, 0, 0, 0, 'Logan Regional Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1154331585', 0, 'n', 0, '2008-05-14', NULL, NULL, 41.7569, -111.821, NULL, NULL),
('942854057', 'W11003421', 'W11003421', 'UTIHCPHY', 'Bear River Family Medicine', 'Chad', 'L', 'Merrell', 'MD', 'Family Practice', NULL, NULL, NULL, 'o', '935 N 1000 W', 'Tremonton', 'Box Elder', 'UT', '84337', '4352074800', NULL, NULL, NULL, '', NULL, NULL, '', '', 'USTDMULT', 'WUSTDHCPC5', NULL, '0.00', '35.00', '0.00', 8, '2008-01-01', NULL, NULL, 0, 0, 'Bear River Valley Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1730176512', 0, 'n', 0, '2008-05-14', NULL, NULL, 41.7162, -112.201, NULL, NULL),
('942854057', 'W11003422', 'W11003422', 'UTIHCPHY', 'Bear River Family Medicine', 'Rodney', 'W', 'Merrell', 'MD', 'Family Practice', '', '', NULL, 'o', '935 N 1000 W', 'Tremonton', 'Box Elder', 'UT', '84337', '4352074800', NULL, '935 N 1000 W', 'Tremonton', 'Box Elder', 'UT', '84337', '4352074800', '          ', 'USTDMULT', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 8, '2008-01-01', NULL, 0, 0, 0, 'Bear River Valley Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1932196771', 0, 'N', 0, '2011-08-09', NULL, NULL, 41.7162, -112.201, NULL, NULL),
('942854057', 'W11003423', 'W11003423', 'UTIHCPHY', 'Cardiovascular & Thoracic Surgery - St. George', 'Roger', 'C', 'Millar', 'MD', 'Cardiovascular Disease', '', '', NULL, 'o', '1380 E Medical Center Drive #2600', 'St George', 'Washington', 'UT', '84790', '4352512700', NULL, '1380 E Medical Center Drive #2600', 'St George', 'Washington', 'UT', '84790', '4352512700', '          ', 'USTDMULT', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 8, '2008-01-01', '2012-06-30', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1295753549', 0, 'N', 0, '2012-06-29', NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W11003424', 'W11003424', 'UTIHCPHY', 'Cedar City Clinic', 'Lisa', 'Ann', 'Mills', 'DO', 'Obstetrics and Gynecology', NULL, NULL, NULL, 'o', '1303 N Main #3C', 'Cedar City', 'Iron', 'UT', '84720', '4358685500', NULL, NULL, NULL, '', NULL, NULL, '', '', 'USTDMULT', 'WUSTDHCPC5', NULL, '0.00', '35.00', '0.00', 8, '2008-01-01', '2009-01-21', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1265421481', 0, 'n', 0, '2008-05-14', NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W11003425', 'W11003425', 'UTIHCPHY', 'Utah Valley Heart & Lung Surgical Associates', 'John', 'H', 'Mitchell', 'MD', 'Cardiovascular Disease', '', '', NULL, 'o', '1055 N 300 W Ste 410', 'Provo', 'Utah', 'UT', '84604', '8013577081', NULL, '1055 N 300 W Ste 410', 'Provo', 'Utah', 'UT', '84604', '8013577081', '', 'USTDMULT', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 8, '2008-01-01', '2008-01-01', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1699781674', 0, 'N', 0, '2014-07-09', NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W11003426', 'W11003426', 'UTIHCPHY', 'Sunset InstaCare', 'Dennis', 'J', 'Moore', 'MD', 'Family Practice', '', '', NULL, 'B', '1739 W Sunset Blvd', 'St George', 'Washington', 'UT', '84770', '4356346050', NULL, NULL, NULL, '', NULL, NULL, '', '', 'USTDMULT', 'WUSTDHCPC5', NULL, '0.00', '35.00', '0.00', 8, '2008-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1306864624', 0, 'n', 0, '2008-05-14', NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W11003427', 'W11003427', 'UTIHCPHY', 'Logan Clinic', 'Glenn', 'Owens', 'Mortensen', 'MD', 'Family Practice', NULL, NULL, NULL, 'o', '412 N 200 E', 'Logan', 'Cache', 'UT', '84321', '4357132800', NULL, NULL, NULL, '', NULL, NULL, '', '', 'USTDMULT', 'WUSTDHCPC5', NULL, '0.00', '35.00', '0.00', 8, '2008-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1184634669', 0, 'n', 0, '2008-05-14', NULL, NULL, 41.7393, -111.83, NULL, NULL),
('942854057', 'W11003428', 'W11003428', 'UTIHCPHY', 'Budge Clinic Obstetrics & Gynecology', 'Ena', 'C', 'Murillo', 'APRN', 'Obstetrics and Gynecology', NULL, NULL, NULL, 'o', '1400 N 500 E', 'Logan', 'Cache', 'UT', '84341', '4357161920', NULL, NULL, NULL, '', NULL, NULL, '', '', 'USTDMULT', 'WUSTDHCPC5', NULL, '0.00', '35.00', '0.00', 8, '2008-01-01', NULL, 0, 0, 0, 'Logan Regional Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1659463404', 0, 'n', 0, '2008-05-14', NULL, NULL, 41.7569, -111.821, NULL, NULL),
('942854057', 'W11003429', 'W11003429', 'UTIHCPHY', 'Bear River Specialists', 'Kevin', 'A', 'Murphy', 'MD', 'General Surgery', 'Internal Medicine', '', NULL, 'o', '935 N 1000 W', 'Tremonton', 'Box Elder', 'UT', '84337', '4352074800', NULL, '935 N 1000 W', 'Tremonton', 'Box Elder', 'UT', '84337', '4352074800', '', 'USTDMULT', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 8, '2008-01-01', NULL, 0, 0, 0, 'Brigham City Community Hospital', '', '', '', 'HCFA|UB|', '1083641385', 0, 'n', 0, '2014-05-12', NULL, NULL, 41.7162, -112.201, NULL, NULL),
('942854057', 'W11003430', 'W11003430', 'UTIHCPHY', 'Canyon View Orthopedics & Podiatry Associates ', 'David', 'P', 'Murray', 'MD', 'Orthopedic Surgery', NULL, NULL, NULL, 'o', '1300 N 500 E #130', 'Logan', 'Cache', 'UT', '84341', '4357162800', NULL, NULL, NULL, '', NULL, NULL, '', '', 'USTDMULT', 'WUSTDHCPC5', NULL, '0.00', '35.00', '0.00', 8, '2008-01-01', NULL, 0, 0, 0, 'Logan Regional Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1417967902', 0, 'n', 0, '2008-05-14', NULL, NULL, 41.7563, -111.821, NULL, NULL),
('942854057', 'W11003431', 'W11003431', 'UTIHCPHY', 'River Road InstaCare', 'Susan', 'M', 'Myers', 'MD', 'Urgent Care', '', '', NULL, 'B', '577 S River Road', 'St George', 'Washington', 'UT', '84790', '4356886300', NULL, NULL, NULL, '', NULL, NULL, '', '', 'USTDMULT', 'WUSTDHCPC5', NULL, '0.00', '35.00', '0.00', 8, '2008-01-01', NULL, 0, 0, 0, 'Dixie Regional Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1326063140', 0, 'n', 0, '2008-05-14', NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W11003432', 'W11003432', 'UTIHCPHY', 'Southridge Clinic', 'Marisa', 'J', 'Nagle', 'MD', 'Pediatrics', NULL, NULL, NULL, 'o', '3723 W 12600 S Ste 450', 'Riverton', 'Salt Lake', 'UT', '84065', '8012854543', NULL, NULL, NULL, '', NULL, NULL, '', '', 'USTDMULT', 'WUSTDHCPC5', NULL, '0.00', '35.00', '0.00', 8, '2008-01-01', NULL, 0, 0, 0, 'Riverton Childrens Unit Operated by Primary Childrens Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1417095837', 0, 'n', 0, '2008-05-14', NULL, NULL, 40.5222, -111.98, NULL, NULL),
('942854057', 'W11003433', 'W11003433', 'UTIHCPHY', 'Budge Clinic Internal Medicine', 'Robert', 'Michael', 'Nash', 'MD', 'Internal Medicine', NULL, NULL, NULL, 'o', '1350 N 500 E', 'Logan', 'Cache', 'UT', '84341', '4357921980', NULL, NULL, NULL, '', NULL, NULL, '', '', 'USTDMULT', 'WUSTDHCPC5', NULL, '0.00', '35.00', '0.00', 8, '2008-01-01', NULL, 0, 0, 0, 'Logan Regional Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1033129523', 0, 'n', 0, '2008-05-14', NULL, NULL, 41.7565, -111.821, NULL, NULL),
('942854057', 'W11003434', 'W11003434', 'UTIHCPHY', 'Cedar City WorkMed', 'Steven', 'Richard', 'Newman', 'MD', 'Family Practice', 'Sports Medicine', 'Occupational Therapy', NULL, 'o', '1303 N Main St', 'Cedar City', 'Iron', 'UT', '84720', '4358685575', NULL, '1303 N Main St', 'Cedar City', 'Iron', 'UT', '84720', '4358685575', '', 'USTDMULT', 'WUSTDHCPC5', NULL, '0.00', '35.00', '0.00', 8, '2008-01-01', NULL, 0, 0, 0, 'Valley View Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1134157613', 0, 'n', 0, '2013-04-15', NULL, NULL, 37.7003, -113.064, NULL, NULL),
('942854057', 'W11003435', 'W11003435', 'UTIHCPHY', 'IHC Bountiful Health Center', 'Douglas', 'B', 'Nielsen', 'MD', 'Pediatrics', NULL, NULL, NULL, 'o', '390 N Main St', 'Bountiful', 'Davis', 'UT', '84010', '8012941000', NULL, NULL, NULL, '', NULL, NULL, '', '', 'USTDMULT', 'WUSTDHCPC5', NULL, '0.00', '35.00', '0.00', 8, '2008-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1366481806', 0, 'n', 0, '2008-05-14', NULL, NULL, 40.8935, -111.881, NULL, NULL),
('942854057', 'W11003436', 'W11003436', 'UTIHCPHY', 'Mt. Pleasant Clinic', 'Charles', 'E', 'Nunn', 'MD', 'Family Practice', '', '', NULL, 'o', '1100 S Medical Drive', 'Mt Pleasant', 'Sanpete', 'UT', '84647', '4354623471', NULL, '1100 S Medical Drive', 'Mt Pleasant', 'Sanpete', 'UT', '84647', '4354623471', '          ', 'USTDMULT', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 8, '2008-01-01', '2012-09-30', 0, 0, 0, 'Sanpete Valley Hospital', '', '', '', 'HCFA|UB|', '1346280955', 0, 'N', 0, '2013-04-15', NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W11003437', 'W11003437', 'UTIHCPHY', 'Redrock Pediatrics', 'Martin', 'J', 'Nygaard', 'MD', 'Pediatrics', NULL, NULL, NULL, 'o', '1380 E Medical Center Drive #3100', 'St George', 'Washington', 'UT', '84790', '4352512740', NULL, '1380 E Medical Center Drive #3100', 'St George', 'Washington', 'UT', '84790', '4352512740', '          ', 'USTDMULT', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 8, '2008-01-01', '2011-02-28', 0, 0, 0, 'Dixie Regional Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1659305688', 0, 'N', 0, '2011-06-23', NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W11003438', 'W11003438', 'UTIHCPHY', 'Budge Clinic Pediatrics', 'J', 'Dennis', 'Odell', 'MD', 'Pediatrics', '', '', NULL, 'o', '1350 N 500 E', 'Logan', 'Cache', 'UT', '84341', '4357921940', NULL, '1350 N 500 E', 'Logan', 'Cache', 'UT', '84341', '4357921940', '', 'USTDMULT', 'WUSTDHCPC5', NULL, '0.00', '35.00', '0.00', 8, '2008-01-01', NULL, 0, 0, 0, 'Logan Regional Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1477563864', 0, 'n', 0, '2013-11-20', NULL, NULL, 41.7565, -111.821, NULL, NULL),
('942854057', 'W11003439', 'W11003439', 'UTIHCPHY', 'Ephraim Clinic', 'Darrel', 'Ward', 'Olsen', 'MD', 'Family Practice', '', '', NULL, 'o', '525 N Main', 'Ephraim', 'Sanpete', 'UT', '84627', '4352834076', NULL, '525 N Main', 'Ephraim', 'Sanpete', 'UT', '84627', '4352834076', '', 'USTDMULT', 'WUSTDHCPC5', NULL, '0.00', '35.00', '0.00', 8, '2008-01-01', NULL, 0, 0, 0, 'Sanpete Valley Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1649218462', 0, 'n', 0, '2011-09-26', NULL, NULL, 39.371, -111.587, NULL, NULL),
('942854057', 'W11003440', 'W11003440', 'UTIHCPHY', 'St George WorkMed', 'Vicky', 'L', 'ONeil', 'APRN', 'Mental Health', 'Advanced Practice Registered Nurse', 'Occupational Therapy', NULL, 'o', '385 N 3050 E', 'St George', 'Washington', 'UT', '84790', '4352512630', NULL, '385 N 3050 E', 'St George', 'Washington', 'UT', '84790', '4352512630', '', 'USTDMULT', 'WUSTDHCPC5', NULL, '0.00', '35.00', '0.00', 8, '2008-01-01', '2008-01-01', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1396847380', 0, 'n', 0, '2011-05-03', NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W11003441', 'W11003441', 'UTIHCPHY', 'Sandy Clinic', 'Lisa', 'D', 'Palmieri', 'MD', 'Pediatrics', NULL, NULL, NULL, 'o', '9500 S 1300 E', 'Sandy', 'Salt Lake', 'UT', '84094', '8015012100', NULL, NULL, NULL, '', NULL, NULL, '', '', 'USTDMULT', 'WUSTDHCPC5', NULL, '0.00', '35.00', '0.00', 8, '2008-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1285742874', 0, 'n', 0, '2008-05-14', NULL, NULL, 40.5787, -111.853, NULL, NULL),
('942854057', 'W11003442', 'W11003442', 'UTIHCPHY', 'River Road Internal Medicine', 'J', 'Scott', 'Parkinson', 'DO', 'Hospitalist', '', '', NULL, 'o', '577 S River Road', 'St George', 'Washington', 'UT', '84790', '4356886200', NULL, '577 S River Road', 'St George', 'Washington', 'UT', '84790', '4356886200', '', 'USTDMULT', 'WUSTDHCPC5', NULL, '0.00', '35.00', '0.00', 8, '2008-01-01', NULL, 0, 0, 0, 'Dixie Regional Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1316965627', 0, 'n', 0, '2011-09-26', NULL, NULL, 37.0986, -113.557, NULL, NULL),
('942854057', 'W11003443', 'W11003443', 'UTIHCPHY', 'Utah Valley Pulmonary Clinic', 'Michael', 'J', 'Pearce', 'MD', 'Pulmonary', NULL, NULL, NULL, 'o', '1055 N 300 W #500', 'Provo', 'Utah', 'UT', '84604', '8013577291', NULL, NULL, NULL, '', NULL, NULL, '', '', 'USTDMULT', 'WUSTDHCPC5', NULL, '0.00', '35.00', '0.00', 8, '2008-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1568478832', 0, 'n', 0, '2008-05-14', NULL, NULL, 40.2476, -111.664, NULL, NULL),
('942854057', 'W11003444', 'W11003444', 'UTIHCPHY', 'Canyon View Orthopedics & Podiatry Associates', 'Curtis', 'Charles', 'Pedersen', 'DPM', 'Podiatry', '', '', NULL, 'o', '1300 N 500 E #130', 'Logan', 'Cache', 'UT', '84341', '4357162800', NULL, '1300 N 500 E #130', 'Logan', 'Cache', 'UT', '84341', '4357162800', '          ', 'USTDMULT', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 8, '2008-01-01', NULL, 0, 0, 0, 'Logan Regional Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1366452757', 0, 'N', 0, '2012-11-07', NULL, NULL, 41.7563, -111.821, NULL, NULL),
('942854057', 'W11003445', 'W11003445', 'UTIHCPHY', 'Rim Rock Orthopaedics', 'Stephen', 'L', 'Penman', 'PA', 'Orthopedic Surgery', NULL, NULL, NULL, 'o', '652 S Medical Ctr Dr Ste 120', 'St George', 'Washington', 'UT', '84790', '4352513600', NULL, NULL, NULL, '', NULL, NULL, '', '', 'USTDMULT', 'WUSTDHCPC5', NULL, '0.00', '35.00', '0.00', 8, '2008-01-01', NULL, 0, 0, 0, 'Dixie Regional Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1104850502', 0, 'n', 0, '2008-05-14', NULL, NULL, 37.0498, -113.574, NULL, NULL),
('942854057', 'W11003446', 'W11003446', 'UTIHCPHY', 'Logan InstaCare', 'Rebecca', 'Copp', 'Phillips', 'MD', 'Urgent Care', '', '', NULL, 'B', '235 E 400 N', 'Logan', 'Cache', 'UT', '84321', '4357521010', NULL, '235 E 400 N', 'Logan', 'Cache', 'UT', '84321', '4357521010', '', 'USTDMULT', 'WUSTDHCPC5', NULL, '0.00', '35.00', '0.00', 8, '2008-01-01', NULL, 0, 0, 0, 'Logan Regional Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1871696898', 0, 'n', 0, '2013-08-27', NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W11003447', 'W11003447', 'UTIHCPHY', 'Budge Clinic Surgical Specialists', 'Brent', 'D', 'Pitcher', 'PA', 'Urology', '', '', NULL, 'o', '1350 N 500 E', 'Logan', 'Cache', 'UT', '84341', '4357921950', NULL, '1350 N 500 E', 'Logan', 'Cache', 'UT', '84341', '4357921950', '          ', 'USTDMULT', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 8, '2008-01-01', '2013-11-08', 0, 0, 0, 'Logan Regional Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1881876860', 0, 'N', 0, '2013-11-19', NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W11003448', 'W11003448', 'UTIHCPHY', 'Logan InstaCare ', 'Thomas', 'W', 'Price', 'PA', 'Urgent Care', NULL, NULL, NULL, 'B', '235 E 400 N', 'Logan', 'Cache', 'UT', '84321', '4357521010', NULL, NULL, NULL, '', NULL, NULL, '', '', 'USTDMULT', 'WUSTDHCPC5', NULL, '0.00', '35.00', '0.00', 8, '2008-01-01', '2008-01-01', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1053402982', 0, 'n', 0, '2008-05-14', NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W11003449', 'W11003449', 'UTIHCPHY', 'Southwest Cardiology - St. George', 'Mark', 'William', 'Pulsipher', 'MD', 'Cardiovascular Disease', '', '', NULL, 'o', '1380 E Medical Ctr Dr Ste 1500', 'St George', 'Washington', 'UT', '84790', '4352512500', NULL, '1380 E Medical Center Drive #1500', 'St George', 'Washington', 'UT', '84790', '4352512500', '', 'USTDMULT', 'WUSTDHCPC5', NULL, '0.00', '35.00', '0.00', 8, '2008-01-01', NULL, 0, 0, 0, 'Dixie Regional Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1689631913', 0, 'n', 0, '2012-04-10', NULL, NULL, 37.0998, -113.554, NULL, NULL),
('942854057', 'W11003450', 'W11003450', 'UTIHCPHY', 'IHC Bountiful Health Center', 'Randy', 'Scott', 'Reese', 'MD', 'Pediatrics', NULL, NULL, NULL, 'o', '390 N Main St', 'Bountiful', 'Davis', 'UT', '84010', '8012941000', NULL, NULL, NULL, '', NULL, NULL, '', '', 'USTDMULT', 'WUSTDHCPC5', NULL, '0.00', '35.00', '0.00', 8, '2008-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1669412649', 0, 'n', 0, '2008-05-14', NULL, NULL, 40.8935, -111.881, NULL, NULL),
('942854057', 'W11003451', 'W11003451', 'UTIHCPHY', 'Bryner Clinic', 'Kim', 'N', 'Rigby', 'MD', 'Pediatrics', '', '', NULL, 'o', '525 E 100 S # 500', 'Salt Lake City', 'Salt Lake', 'UT', '84102', '8015197100', NULL, '525 E 100 S # 500', 'Salt Lake City', 'Salt Lake', 'UT', '84102', '8015197100', '          ', 'USTDMULT', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 8, '2008-01-01', '2012-12-31', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1568408086', 0, 'N', 0, '2013-05-30', NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W11003452', 'W11003452', 'UTIHCPHY', 'Budge Clinic Pediatrics', 'Sheryl', 'A', 'Roper-Hodges', 'APRN', 'Pediatrics', '', '', NULL, 'o', '1350 N 500 E', 'Logan', 'Cache', 'UT', '84341', '4357921940', NULL, '1350 N 500 E', 'Logan', 'Cache', 'UT', '84341', '4357921940', '          ', 'USTDMULT', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 8, '2008-01-01', '2013-05-31', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1639188956', 0, 'N', 0, '2013-07-12', NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W11003453', 'W11003453', 'UTIHCPHY', 'Utah Valley Pulmonary Clinic', 'Douglas', 'Scott', 'Ross', 'MD', 'Sleep Disorders', 'Pulmonary', NULL, NULL, 'o', '1055 N 300 W #500', 'Provo', 'Utah', 'UT', '84604', '8013577291', NULL, NULL, NULL, '', NULL, NULL, '', '', 'USTDMULT', 'WUSTDHCPC5', NULL, '0.00', '35.00', '0.00', 8, '2008-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1780690198', 0, 'n', 0, '2008-05-14', NULL, NULL, 40.2476, -111.664, NULL, NULL),
('942854057', 'W11003454', 'W11003454', 'UTIHCPHY', 'Cedar City WorkMed', 'Gerald', 'Kim', 'Rowland', 'MD', 'Occupational Therapy', 'Emergency Medicine', NULL, NULL, 'o', '1303 N Main Street', 'Cedar City', 'Iron', 'UT', '84720', '4358685575', NULL, NULL, NULL, '', NULL, NULL, '', '', 'USTDMULT', 'WUSTDHCPC5', NULL, '0.00', '35.00', '0.00', 8, '2008-01-01', '2008-11-05', 0, 0, 0, 'Valley View Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1457370868', 0, 'n', 0, '2010-01-12', NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W11003455', 'W11003455', 'UTIHCPHY', 'Sandy Clinic', 'Jeffrey', 'Cannon', 'Schmidt', 'MD', 'Pediatrics', NULL, NULL, NULL, 'o', '9500 S 1300 E', 'Sandy', 'Salt Lake', 'UT', '84094', '8015012100', NULL, NULL, NULL, '', NULL, NULL, '', '', 'USTDMULT', 'WUSTDHCPC5', NULL, '0.00', '35.00', '0.00', 8, '2008-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1811008790', 0, 'n', 0, '2008-05-14', NULL, NULL, 40.5787, -111.853, NULL, NULL),
('942854057', 'W11003456', 'W11003456', 'UTIHCPHY', 'Budge Clinic Pediatrics', 'Stephen', 'D', 'Schneider', 'MD', 'Pediatrics', '', '', NULL, 'o', '1350 N 500 E', 'Logan', 'Cache', 'UT', '84341', '4357921940', NULL, '1350 N 500 E', 'Logan', 'Cache', 'UT', '84341', '4357921940', '          ', 'USTDMULT', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 8, '2008-01-01', '2012-07-26', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1962412353', 0, 'N', 0, '2013-10-09', NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W11003457', 'W11003457', 'UTIHCPHY', 'Richfield Family Practice', 'Spencer', 'Lee', 'Scoville', 'DO', 'Family Practice', '', '', NULL, 'o', '460 N Main', 'Richfield', 'Sevier', 'UT', '84701', '4358965496', NULL, '460 N Main', 'Richfield', 'Sevier', 'UT', '84701', '4358965496', '          ', 'USTDMULT', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 8, '2008-01-01', '2012-12-31', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1821192436', 0, 'N', 0, '2012-05-04', NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W11003458', 'W11003458', 'UTIHCPHY', 'Cedar City Clinic', 'Julie', 'L', 'Smallwood', 'MD', 'Internal Medicine', '', '', NULL, 'o', '1303 N Main #3C', 'Cedar City', 'Iron', 'UT', '84720', '4358685500', NULL, '1303 N Main #3C', 'Cedar City', 'Iron', 'UT', '84720', '4358685500', '', 'USTDMULT', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 8, '2008-01-01', '2013-07-29', 0, 0, 0, 'St Marks Hospital', '', '', '', 'HCFA|UB|', '1689697146', 0, 'N', 0, '2014-04-10', NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W11003459', 'W11003459', 'UTIHCPHY', 'Cedar City Clinic', 'Philip', 'E', 'Smith', 'MD', 'Internal Medicine', NULL, NULL, NULL, 'o', '1303 N Main #3C', 'Cedar City', 'Iron', 'UT', '84720', '4358685500', NULL, NULL, NULL, '', NULL, NULL, '', '', 'USTDMULT', 'WUSTDHCPC5', NULL, '0.00', '35.00', '0.00', 8, '2008-01-01', NULL, 0, 0, 0, 'Valley View Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1134142698', 0, 'n', 0, '2008-05-14', NULL, NULL, 37.6711, -113.103, NULL, NULL),
('942854057', 'W11003460', 'W11003460', 'UTIHCPHY', 'River Road Internal Medicine', 'Gordon', 'L', 'Smith', 'MD', 'Internal Medicine', NULL, NULL, NULL, 'o', '577 S River Road', 'St George', 'Washington', 'UT', '84790', '4356886200', NULL, NULL, NULL, '', NULL, NULL, '', '', 'USTDMULT', 'WUSTDHCPC5', NULL, '0.00', '35.00', '0.00', 8, '2008-01-01', NULL, 0, 0, 0, 'Dixie Regional Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1255354718', 0, 'n', 0, '2008-05-14', NULL, NULL, 37.0986, -113.557, NULL, NULL),
('942854057', 'W11003461', 'W11003461', 'UTIHCPHY', 'Redrock Pediatrics', 'Kerri', 'N', 'Smith', 'MD', 'Pediatrics', NULL, NULL, NULL, 'o', '1380 E Medical Ctr Dr Ste 3100', 'St George', 'Washington', 'UT', '84790', '4352512740', NULL, NULL, NULL, '', NULL, NULL, '', '', 'USTDMULT', 'WUSTDHCPC5', NULL, '0.00', '35.00', '0.00', 8, '2008-01-01', NULL, 0, 0, 0, 'Dixie Regional Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1528086865', 0, 'n', 0, '2010-02-05', NULL, NULL, 37.0998, -113.554, NULL, NULL),
('942854057', 'W11003462', 'W11003462', 'UTIHCPHY', 'Rim Rock Orthopaedics', 'Scott', 'M', 'Smith', 'MD', 'Orthopedic Surgery', '', '', NULL, 'o', '652 S Medical Ctr Dr Ste 120', 'St George', 'Washington', 'UT', '84790', '4352513600', NULL, '652 S Medical Center Dr Ste 120', 'St George', 'Washington', 'UT', '84790', '4352513600', '', 'USTDMULT', 'WUSTDHCPC5', NULL, '0.00', '35.00', '0.00', 8, '2008-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1588698997', 0, 'n', 0, '2010-08-25', NULL, NULL, 37.0498, -113.574, NULL, NULL),
('942854057', 'W11003463', 'W11003463', 'UTIHCPHY', 'Sandy Clinic', 'Tanya', 'S', 'Jackson', 'MD', 'Pediatrics', NULL, NULL, NULL, 'o', '9500 S 1300 E', 'Sandy', 'Salt Lake', 'UT', '84094', '8015012100', NULL, NULL, NULL, '', NULL, NULL, '', '', 'USTDMULT', 'WUSTDHCPC5', NULL, '0.00', '35.00', '0.00', 8, '2008-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1255445383', 0, 'n', 0, '2008-05-14', NULL, NULL, 40.5787, -111.853, NULL, NULL),
('942854057', 'W11003464', 'W11003464', 'UTIHCPHY', 'Logan InstaCare', 'Chad', 'Brent', 'Speth', 'APRN', 'Family Practice', '', '', NULL, 'B', '235 E 400 N', 'Logan', 'Cache', 'UT', '84321', '4357521010', NULL, '235 E 400 N', 'Logan', 'Cache', 'UT', '84321', '4357521010', '', 'USTDMULT', 'WUSTDHCPC5', NULL, '0.00', '35.00', '0.00', 8, '2008-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1851301246', 0, 'n', 0, '2011-05-20', NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W11003465', 'W11003465', 'UTIHCPHY', 'Bear River Specialists', 'Stephen', 'E', 'Starr', 'MD', 'Obstetrics and Gynecology', '', '', NULL, 'o', '935 N 1000 W', 'Tremonton', 'Box Elder', 'UT', '84337', '4352074800', NULL, '935 N 1000 W', 'Tremonton', 'Box Elder', 'UT', '84337', '4352074800', '', 'USTDMULT', 'WUSTDHCPC5', NULL, '0.00', '35.00', '0.00', 8, '2008-01-01', '2008-12-31', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1043220445', 0, 'n', 0, '2012-12-12', NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W11003466', 'W11003466', 'UTIHCPHY', 'Budge Clinic Internal Medicine', 'Michael', 'John', 'Stones', 'MD', 'Internal Medicine', '', '', NULL, 'o', '1350 N 500 E', 'Logan', 'Cache', 'UT', '84341', '4357921980', NULL, '1350 N 500 E', 'Logan', 'Cache', 'UT', '84341', '4357921980', '          ', 'USTDMULT', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 8, '2008-01-01', '2012-05-31', 0, 0, 0, 'Logan Regional Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1689684094', 0, 'N', 0, '2012-09-10', NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W11003467', 'W11003467', 'UTIHCPHY', 'Layton Clinic', 'Catherine', 'A', 'Strasser', 'MD', 'Pediatrics', NULL, NULL, NULL, 'o', '2075 N 1200 W', 'Layton', 'Davis', 'UT', '84041', '8017796200', NULL, NULL, NULL, '', NULL, NULL, '', '', 'USTDMULT', 'WUSTDHCPC5', NULL, '0.00', '35.00', '0.00', 8, '2008-01-01', '2008-11-05', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1609984798', 0, 'n', 0, '2008-05-14', NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W11003468', 'W11003468', 'UTIHCPHY', 'Budge Clinic Internal Medicine', 'Jeffrey', 'S', 'Strong', 'MD', 'Hospitalist', '', '', NULL, 'o', '1350 N 500 E', 'Logan', 'Cache', 'UT', '84341', '4357921980', NULL, '1350 N 500 E', 'Logan', 'Cache', 'UT', '84341', '4357921980', '          ', 'USTDMULT', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 8, '2008-01-01', '2014-01-31', 0, 0, 0, 'Logan Regional Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1023028438', 0, 'N', 0, '2013-12-30', NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W11003469', 'W11003469', 'UTIHCPHY', 'Mountain View Pediatrics', 'Richard', 'K', 'Strong', 'MD', 'Pediatrics', NULL, NULL, NULL, 'o', '9720 S 1300 E #100', 'Sandy', 'Salt Lake', 'UT', '84094', '8015718550', NULL, NULL, NULL, '', NULL, NULL, '', '', 'USTDMULT', 'WUSTDHCPC5', NULL, '0.00', '35.00', '0.00', 8, '2008-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1083636435', 0, 'n', 0, '2008-05-14', NULL, NULL, 40.5739, -111.853, NULL, NULL),
('942854057', 'W11003470', 'W11003470', 'UTIHCPHY', 'Southern Utah Surgical Associates', 'Michael', 'G', 'Stults', 'MD', 'General Surgery', '', '', NULL, 'o', '166 W 1325 N #350', 'Cedar City', 'Iron', 'UT', '84720', '4355868192', NULL, '166 W 1325 N #350', 'Cedar City', 'Iron', 'UT', '84720', '4355868192', '', 'USTDMULT', 'WUSTDHCPC5', NULL, '0.00', '35.00', '0.00', 8, '2008-01-01', NULL, 0, 0, 0, 'Valley View Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1528087236', 0, 'n', 0, '2012-05-01', NULL, NULL, 37.7011, -113.065, NULL, NULL),
('942854057', 'W11003471', 'W11003471', 'UTIHCPHY', 'Sandy Clinic', 'Jane', 'E', 'Sturtevant', 'APRN', 'Pediatrics', NULL, NULL, NULL, 'o', '9500 S 1300 E', 'Sandy', 'Salt Lake', 'UT', '84094', '8015012100', NULL, NULL, NULL, 'Salt Lake', NULL, NULL, '8015012100', '          ', 'USTDMULT', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 8, '2008-01-01', '2009-07-31', NULL, 0, NULL, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1699886580', 0, 'N', 0, '2008-05-14', NULL, NULL, 0, 0, NULL, NULL);
