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
('870609595', 'UV0000238', 'UV0000238', 'UT01', 'Utah County Medical Associates', 'Elizabeth', 'A', 'Dayton', 'MD', 'Family Practice', 'Obstetrics and Gynecology', '', NULL, 'O', '97 S Professional Way Ste 2', 'Payson', 'Utah', 'UT', '84651', '8014654896', NULL, '97 S Professional Way Ste 2', 'Payson', 'Utah', 'UT', '84651', '8014654896', '', 'WUUVPN10', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 3, '2006-01-01', '2010-07-14', 0, 0, 0, 'Mountain View Hospital', '', '', '', 'HCFA|UB|', '1598799421', 0, 'N', 0, '2014-05-28', NULL, NULL, 0, 0, NULL, NULL),
('870609595', 'UV0000239', 'UV0000239', 'UT01', 'Utah County Medical Associates', 'David', 'S', 'Devenport', 'MD', 'Pediatrics', '', '', NULL, 'O', '269 E 400 S Ste 2', 'Springville', 'Utah', 'UT', '84663', '8014919883', NULL, '269 E 400 S Ste 2', 'Springville', 'Utah', 'UT', '84663', '8014919883', '          ', 'WUUVPN10', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 3, '2006-01-01', '2009-11-30', 0, 0, 0, 'Mountain View Hospital', '', '', '', 'HCFA|UB|', '1245258425', 0, 'N', 0, '2013-06-19', NULL, NULL, 0, 0, NULL, NULL),
('870609595', 'UV0000240', 'UV0000240', 'UT01', 'Utah County Medical Associates', 'David', 'S', 'Devenport', 'MD', 'Pediatrics', NULL, NULL, NULL, 'B', '97 S Professional Way Ste 2', 'Payson', 'Utah', 'UT', '84651', '8014654899', NULL, '97 S Professional Way', 'payson', '', NULL, '84651', '', '', 'WUUVPN10', 'WUSTDHCPC5', NULL, '0.00', '35.00', NULL, 3, '2006-01-01', '2007-03-01', 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1245258425', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870609595', 'UV0000241', 'UV0000241', 'UT01', 'Utah County Medical Association', 'David', 'S', 'Devenport', 'MD', 'Pediatrics', NULL, NULL, NULL, 'O', '730 E 300 S ', 'Springville', 'Utah', 'UT', '84663', '8014919883', NULL, NULL, NULL, '', NULL, NULL, '', '', 'WUUVPN10', 'WUSTDHCPC5', NULL, '0.00', '35.00', NULL, 3, '2006-01-01', '2006-01-01', 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1245258425', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870609595', 'UV0000242', 'UV0000242', 'UT01', 'Utah County Medical Associates', 'David', 'S', 'Devenport', 'MD', 'Pediatrics', NULL, NULL, NULL, 'O', '97 S Professional Way Ste 2', 'Payson', 'Utah', 'UT', '84651', NULL, NULL, NULL, NULL, '', NULL, NULL, '', '', 'WUUVPN10', 'WUSTDHCPC5', NULL, '0.00', '35.00', NULL, 3, '2006-01-01', '2006-01-01', 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1245258425', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870609595', 'UV0000243', 'UV0000243', 'UT01', 'Utah County Medical Associates', 'Mark', 'A', 'Frazier', 'MD', 'Family Practice', '', '', NULL, 'O', '97 S Professional Way Ste 2', 'Payson', 'Utah', 'UT', '84651', '8014654896', '', '97 S Professional Way Ste 2', 'Payson', 'Utah', 'UT', '84651', '8014654896', '', 'WUUVPN10', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 3, '2006-01-01', '2009-04-01', 0, 0, 0, 'Castleview Hospital', 'Castleview Hospital', '', '', 'HCFA|UB|', '1801113147', 0, 'N', 0, '2014-07-25', NULL, NULL, 0, 0, NULL, NULL),
('870609595', 'UV0000244', 'UV0000244', 'UT01', 'Utah County Medical Associates', 'Mark', 'A', 'Frazier', 'MD', 'Family Practice', NULL, NULL, NULL, 'B', '97 S Professional Way Ste 2', 'Payson', 'Utah', 'UT', '84651', '8014654899', NULL, NULL, NULL, '', NULL, NULL, '', '', 'WUUVPN10', 'WUSTDHCPC5', NULL, '0.00', '35.00', NULL, 3, '2006-01-01', '2007-03-01', 0, NULL, 0, 'Castleview Hospital', 'Castleview Hospital-Pro Fees', NULL, NULL, 'HCFA|UB|', '1326066572', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870609595', 'UV0000245', 'UV0000245', 'UT01', 'Utah County Medical Associates', 'Ian', NULL, 'McMaster', 'MD', 'Family Practice', NULL, NULL, NULL, 'O', '97 S Professional Way Ste 2', 'Payson', 'Utah', 'UT', '84651', '4653209', NULL, NULL, NULL, '', NULL, NULL, '', '', 'WUUVPN10', 'WUSTDHCPC5', NULL, '0.00', '35.00', NULL, 3, '2006-01-01', '2007-03-01', 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1598799462', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870609595', 'UV0000246', 'UV0000246', 'UT01', 'Utah County Medical Associates', 'Ian', 'B', 'McMaster', 'MD', 'Family Practice', '', '', NULL, 'O', '269 E 400 S', 'Springville', 'Utah', 'UT', '84663', '8014919883', NULL, '269 E 400 S', 'Springville', 'Utah', 'UT', '84663', '8014919883', '', 'WUUVPN10', 'WUSTDHCPC5', NULL, '0.00', '35.00', '0.00', 3, '2006-01-01', '2009-11-30', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1598799462', 0, 'N', 0, '2011-02-03', NULL, NULL, 0, 0, NULL, NULL),
('870609595', 'UV0000247', 'UV0000247', 'UT01', 'Utah County Medical Associates', 'Ian', 'B', 'McMaster', 'MD', 'Family Practice', NULL, NULL, NULL, 'B', '97 S Professional Way Ste 2', 'Payson', 'Utah', 'UT', '84651', '8014654899', NULL, '97 S Professional Way', 'payson', '', NULL, '84651', '', '', 'WUUVPN10', 'WUSTDHCPC5', NULL, '0.00', '35.00', NULL, 3, '2006-01-01', '2006-01-01', 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1598799462', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870609595', 'UV0000248', 'UV0000248', 'UT01', 'Utah County Medical Associates', 'George', 'H', 'Michalek', 'MD', 'Pediatrics', '', '', NULL, 'O', '269 E 400 S', 'Springville', 'Utah', 'UT', '84663', '8014899883', NULL, '269 E 400 S', 'Springville', 'Utah', 'UT', '84663', '8014899883', '', 'WUUVPN10', 'WUSTDHCPC5', NULL, '0.00', '35.00', '0.00', 3, '2006-01-01', '2009-11-30', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1225062904', 0, 'N', 0, '2011-02-03', NULL, NULL, 0, 0, NULL, NULL),
('870609595', 'UV0000249', 'UV0000249', 'UT01', 'Utah County Medical Associates', 'George', 'H', 'Michalek', 'MD', 'Pediatrics', NULL, NULL, NULL, 'B', '97 S Professional Way Ste 2', 'Payson', 'Utah', 'UT', '84651', '8014654899', NULL, '97 S Professional Way', 'payson', '', NULL, '84651', '', '', 'WUUVPN10', 'WUSTDHCPC5', NULL, '0.00', '35.00', NULL, 3, '2006-01-01', '2007-03-01', 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1225062904', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870609595', 'UV0000250', 'UV0000250', 'UT01', 'Utah County Medical Associates', 'Nolan', 'B', 'Money', 'MD', 'Family Practice', '', '', NULL, 'O', '97 S Professional Way Ste 2', 'Payson', 'Utah', 'UT', '84651', '8014654896', NULL, '97 S Professional Way Ste 2', 'Payson', 'Utah', 'UT', '84651', '8014654896', '          ', 'WUUVPN10', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 3, '2006-01-01', '2010-07-14', 0, 0, 0, 'Mountain View Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1194759027', 0, 'N', 0, '2013-11-12', NULL, NULL, 0, 0, NULL, NULL),
('870609595', 'UV0000251', 'UV0000251', 'UT01', 'Utah County Medical Associates', 'David', 'J', 'Tipton', 'MD', 'Family Practice', '', '', NULL, 'O', '97 S Professional Way Ste 2', 'Payson', 'Utah', 'UT', '84651', '8014654896', NULL, '97 S Professional Way Ste 2', 'Payson', 'Utah', 'UT', '84651', '8014654896', '', 'WUUVPN10', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 3, '2006-01-01', '2010-07-14', 0, 0, 0, 'Mountain View Hospital', '', '', '', 'HCFA|UB|', '1811915051', 0, 'Y', 0, '2014-05-26', NULL, NULL, 0, 0, NULL, NULL),
('870621939', 'UV0000252', 'UV0000252', 'UT01', 'Alpine Womens Clinic', 'James', 'R', 'Nelson', 'MD', 'Obstetrics and Gynecology', '', '', NULL, 'O', '48 N 1100 E Ste A', 'American Fork', 'Utah', 'UT', '84003', '8017565826', NULL, '48 N 1100 E', 'American Fork', '', 'UT', '84003', '', '', 'WUUVPN10', 'WUSTDHCPC5', NULL, '0.00', '35.00', '0.00', 3, '2006-01-01', '2009-01-01', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1588646350', 0, 'N', 0, '2009-01-21', NULL, NULL, 0, 0, NULL, NULL),
('870629575', 'UV0000253', 'UV0000253', 'UT01', 'Central Utah Pathology', 'Stanley', 'L', 'Gibbon', 'MD', 'Pathology', '', '', NULL, 'O', '750 W 800 N', 'Orem', 'Utah', 'UT', '84057', '8017146061', NULL, '750 W 800 N', 'Orem', 'Utah', 'UT', '84057', '8017146061', '          ', 'WUUVPN10', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 3, '2006-01-01', '2010-07-14', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1104872621', 0, 'Y', 0, '2011-06-29', NULL, NULL, 0, 0, NULL, NULL),
('870629575', 'UV0000254', 'UV0000254', 'UT01', 'Central Utah Pathology', 'Stanley', 'L', 'Gibbon', 'MD', 'Pathology', '', '', NULL, 'B', 'PO Box 276', 'Midvale', 'Salt Lake', 'UT', '84047', '8012630810', NULL, 'PO Box 276', 'Midvale', 'Salt Lake', 'UT', '84047', '8012630810', '          ', 'WUUVPN10', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 3, '2006-01-01', '2010-07-14', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1104872621', 0, 'N', 0, '2011-06-29', NULL, NULL, 0, 0, NULL, NULL),
('870629575', 'UV0000255', 'UV0000255', 'UT01', 'Central Utah Pathology', 'Blair', 'F', 'McGirk', 'MD', 'Pathology', '', '', NULL, 'O', '750 W 800 N', 'Orem', 'Utah', 'UT', '84057', '8017146061', NULL, '750 W 800 N', 'Orem', 'Utah', 'UT', '84057', '8017146061', '          ', 'WUUVPN10', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 3, '2006-01-01', '2010-07-14', 0, 0, 0, 'Timpanogos Regional Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1093761595', 0, 'Y', 0, '2011-06-29', NULL, NULL, 0, 0, NULL, NULL),
('870629575', 'UV0000256', 'UV0000256', 'UT01', 'Central Utah Pathology', 'Blair', 'F', 'McGirk', 'MD', 'Pathology', '', '', NULL, 'B', 'PO Box 276', 'Midvale', 'Salt Lake', 'UT', '84047', '8012630810', NULL, 'PO Box 276', 'Midvale', 'Salt Lake', 'UT', '84047', '8012630810', '          ', 'WUUVPN10', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 3, '2006-01-01', '2010-07-14', 0, 0, 0, 'Timpanogos Regional Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1093761595', 0, 'N', 0, '2011-06-29', NULL, NULL, 0, 0, NULL, NULL),
('870629575', 'UV0000257', 'UV0000257', 'UT01', 'Central Utah Pathology', 'David', 'S', 'Mehr', 'MD', 'Pathology', '', '', NULL, 'O', '750 W 800 N', 'Orem', 'Utah', 'UT', '84057', '8017146061', NULL, '750 W 800 N', 'Orem', 'Utah', 'UT', '84057', '8017146061', '          ', 'WUUVPN10', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 3, '2006-01-01', '2010-07-14', 0, 0, 0, 'Timpanogos Regional Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1497795728', 0, 'Y', 0, '2011-06-29', NULL, NULL, 0, 0, NULL, NULL),
('870629575', 'UV0000258', 'UV0000258', 'UT01', 'Central Utah Pathology', 'David', 'S', 'Mehr', 'MD', 'Pathology', '', '', NULL, 'B', 'PO Box 276', 'Midvale', 'Salt Lake', 'UT', '84047', '8012630810', NULL, 'PO Box 276', 'Midvale', 'Salt Lake', 'UT', '84047', '8012630810', '          ', 'WUUVPN10', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 3, '2006-01-01', '2010-07-14', 0, 0, 0, 'Timpanogos Regional Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1497795728', 0, 'N', 0, '2011-06-29', NULL, NULL, 0, 0, NULL, NULL),
('870635422', 'UV0000259', 'UV0000259', 'UT01', 'Rocky Mountain Foot and Ankle', 'Kelly', 'A', 'Gomez', 'DPM', 'Podiatry', NULL, NULL, NULL, 'O', '777 N 500 W Ste 105', 'Provo', 'Utah', 'UT', '84604', '8013756677', NULL, 'PO Box 98', 'Springville', '', 'UT', '84663', '', '', 'WUUVPN10', 'WUSTDHCPC5', NULL, '0.00', '35.00', NULL, 3, '2006-04-03', '2007-12-31', 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1821021957', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870638632', 'UV0000260', 'UV0000260', 'UT01', 'Mountain Peaks Family Practice', 'Robert', 'G', 'Durrans', 'MD', 'Family Practice', '', '', NULL, 'O', '501E 770 N', 'Orem', 'Utah', 'UT', '84097', '8017249840', NULL, '501E 770 N', 'Orem', 'Utah', 'UT', '84097', '8017249840', '          ', 'WUUVPN10', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 3, '2006-01-01', '2010-07-14', 0, 0, 0, 'Timpanogos Regional Hospital', '', '', '', 'HCFA|UB|', '1447332465', 0, 'N', 0, '2014-02-24', NULL, NULL, 0, 0, NULL, NULL),
('870656465', 'UV0000261', 'UV0000261', 'UT01', 'Cascade Family Medicine', 'Steven', 'L', 'Berry', 'MD', 'Family Practice', '', '', NULL, 'O', '173 N 400 W Ste C11', 'Orem', 'Utah', 'UT', '84057', '8018027373', NULL, '173 N 400 W Ste C11', 'Orem', 'Utah', 'UT', '84057', '8018027373', '', 'WUUVPN10', 'WUSTDHCPC5', NULL, '0.00', '35.00', '0.00', 3, '2006-01-01', '2009-01-01', 0, 0, 0, 'Timpanogos Regional Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1528095312', 0, 'N', 0, '2012-03-20', NULL, NULL, 0, 0, NULL, NULL),
('870673378', 'UV0000262', 'UV0000262', 'UT01', 'Collins-Kronmiller Urologic', 'William', 'T', 'Collins', 'MD', 'Urology', NULL, NULL, NULL, 'O', '50 S Medical Dr Ste 5', 'Payson', 'Utah', 'UT', '84651', '8014652511', NULL, NULL, NULL, '', NULL, NULL, '', '', 'WUUVPN10', 'WUSTDHCPC5', NULL, '0.00', '35.00', NULL, 3, '2006-01-01', '2007-01-01', 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1851402572', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870673378', 'UV0000263', 'UV0000263', 'UT01', 'Collins-Kronmiller Urologic', 'Patrick', 'W', 'Kronmiller', 'MD', 'Urology', NULL, NULL, NULL, 'O', '50 S Medical Dr Ste 5', 'Payson', 'Utah', 'UT', '84651', '8014652511', NULL, NULL, NULL, '', NULL, NULL, '', '', 'WUUVPN10', 'WUSTDHCPC5', NULL, '0.00', '35.00', NULL, 3, '2006-01-01', '2007-01-01', 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1801907514', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('942747377', 'UV0000264', 'UV0000264', 'UT01', NULL, 'Henry', 'M', 'Yeates', 'MD', 'Allergy and Immunology', NULL, NULL, NULL, 'O', '159 N 400 W Ste B8', 'Orem', 'Utah', 'UT', '84057', '8012263600', NULL, '159 N 400 W Ste B8', 'Orem', 'Utah', 'UT', '84057', '8012263600', '', 'WUUVPN10', 'WUSTDHCPC5', NULL, '0.00', '35.00', '0.00', 3, '2006-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1649204033', 0, 'N', 0, '2011-03-16', NULL, NULL, 40.3, -111.705, NULL, NULL),
('954659390', 'UV0000265', 'UV0000265', 'UT01', '', 'Michael', 'D', 'Whiting', 'MD', 'Pediatrics', NULL, NULL, NULL, 'O', '48 N 1100 E Ste C', 'American Fork', 'Utah', 'UT', '84003', '8014924333', NULL, '48 N 1100 E Ste C', 'American Fork', 'Utah', 'UT', '84003', '8014924333', '          ', 'WUUVPN10', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 3, '2006-01-01', '2010-07-14', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1548220148', 0, 'N', 0, '2011-01-19', NULL, NULL, 0, 0, NULL, NULL),
('870622942', 'W11000001', 'W11000001', 'UT01', 'Utah Imaging Associates', 'Charles', '', 'Swallow', 'MD', 'Radiologist', '', '', NULL, 'B', 'PO Box 1369', 'Bountiful', 'Davis', 'UT', '84011', '8012962113', '8012961715', 'PO Box 1369', 'Bountiful', 'Davis', 'UT', '84011', '8012962113', '8012961715', 'WUUTIMAGE5', NULL, NULL, '0.00', '35.00', '0.00', 3, '2006-04-01', NULL, 0, 0, 0, 'Lakeview Hospital', 'St Marks Hospital', NULL, NULL, 'HCFA|UB|', '1497752448', 0, 'Y', 0, '2013-04-15', NULL, NULL, 0, 0, NULL, NULL),
('870622942', 'W11000002', 'W11000002', 'UT01', 'Utah Imaging Associates', 'K', 'Michael', 'Handlon', 'MD', 'Radiologist', '', '', NULL, 'B', 'PO Box 1369', 'Bountiful', 'Davis', 'UT', '84011', '8012962113', '8012961715', 'PO Box 1369', 'Bountiful', 'Davis', 'UT', '84011', '8012962113', '8012961715', 'WUUTIMAGE5', NULL, NULL, '0.00', '35.00', '0.00', 3, '2006-04-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '0000006559', 0, 'Y', 0, '2011-03-24', NULL, NULL, 0, 0, NULL, NULL),
('870622942', 'W11000003', 'W11000003', 'UT01', 'Utah Imaging Associates', 'Robert', '', 'Brinton', 'MD', 'Radiologist', '', '', NULL, 'B', 'PO Box 1369', 'Bountiful', 'Davis', 'UT', '84011', '8012962113', '8012961715', 'PO Box 1369', 'Bountiful', 'Davis', 'UT', '84011', '8012962113', '8012961715', 'WUUTIMAGE5', NULL, NULL, '0.00', '35.00', '0.00', 3, '2006-04-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1275530289', 0, 'Y', 0, '2011-03-24', NULL, NULL, 0, 0, NULL, NULL),
('870622942', 'W11000004', 'W11000004', 'UT01', 'Utah Imaging Associates', 'Richard', '', 'Holt', 'MD', 'Radiologist', '', '', NULL, 'B', 'PO Box 1369', 'Bountiful', 'Davis', 'UT', '84011', '8012962113', '8012961715', 'PO Box 1369', 'Bountiful', 'Davis', 'UT', '84011', '8012962113', '8012961715', 'WUUTIMAGE5', NULL, NULL, '0.00', '35.00', '0.00', 3, '2006-04-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1508863291', 0, 'Y', 0, '2013-04-15', NULL, NULL, 0, 0, NULL, NULL),
('870622942', 'W11000005', 'W11000005', 'UT01', 'Utah Imaging Associates', 'Jonathan', '', 'Naatz', 'MD', 'Radiologist', '', '', NULL, 'B', 'PO Box 1369', 'Bountiful', 'Davis', 'UT', '84011', '8012962113', '8012961715', 'PO Box 1369', 'Bountiful', 'Davis', 'UT', '84011', '8012962113', '8012961715', 'WUUTIMAGE5', NULL, NULL, '0.00', '35.00', '0.00', 3, '2006-04-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1255333886', 0, 'Y', 0, '2013-04-15', NULL, NULL, 0, 0, NULL, NULL),
('870501344', 'W11000006', 'W11000006', 'UT01', 'Pediatric Care', 'Jonathen', '', 'Bartholomew', 'DO', 'Pediatrics', '', '', NULL, 'O', '1675 N Freedom Blvd Bldg 3', 'Provo', 'Utah', 'UT', '84604', '8013778000', NULL, '1675 N Freedom Blvd Bldg 3', 'Provo', 'Utah', 'UT', '84604', '8013778000', '          ', 'WiseSTD', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 3, '2006-10-01', '2011-09-30', 0, 0, 0, 'Timpanogos Regional Hospital', '', '', '', 'HCFA|UB|', '1073672135', 0, 'N', 0, '2013-12-10', NULL, NULL, 0, 0, NULL, NULL),
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('870501344', 'W11000008', 'W11000008', 'UT01', 'Pediatric Care', 'Michelle', NULL, 'Smith', 'MD', 'Pediatrics', NULL, NULL, NULL, 'O', '1675 N Freedom Blvd Bldg 3', 'Provo', 'Utah', 'UT', '84604', '8013778000', NULL, '1675 N Freedom Blvd', 'Provo', '', 'UT', '84604', '', '', 'WiseSTD', 'WUSTDHCPC5', NULL, '0.00', '35.00', '0.00', 3, '2006-10-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1538234158', 0, 'N', 0, '2009-01-13', NULL, NULL, 40.257, -111.662, NULL, NULL),
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('870567695', 'W11000038', 'W11000038', 'UT01', 'Logan Radiology', NULL, NULL, 'Bear Lake Memorial', 'GROUP', 'Radiologist', NULL, NULL, NULL, 'O', '164 S 5th St', 'Montpelier', 'Bear Lake', 'ID', '83254', '2088471630', NULL, 'PO Box 1108', 'Bountiful', '', 'UT', '84011', '', '', 'WUSTDRAD5', 'WUSTDHCPC5', NULL, '0.00', '35.00', '0.00', 3, '2007-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '0000005235', 0, 'Y', 0, '2007-03-26', NULL, NULL, 42.3165, -111.301, NULL, NULL),
('870567695', 'W11000039', 'W11000039', 'UT01', 'Logan Radiology', NULL, NULL, 'Franklin County  Medical Center', 'GROUP', 'Radiologist', NULL, NULL, NULL, 'O', '44 N 1st E', 'Preston', 'Franklin', 'ID', '83263', '2088520137', NULL, 'PO Box 1108', 'Bountiful', '', 'UT', '84011', '', '', 'WUSTDRAD5', 'WUSTDHCPC5', NULL, '0.00', '35.00', '0.00', 3, '2007-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '0000006302', 0, 'Y', 0, '2007-03-26', NULL, NULL, 42.0971, -111.874, NULL, NULL),
('201428952', 'W11000040', 'W11000040', 'UT01', 'Western Anesthesia Associates', 'Blake', 'J', 'Brown', 'MD', 'Anesthesiology', '', '', NULL, 'B', '1954 E Fort Union Blvd Ste 121', 'Salt Lake City', 'Salt Lake', 'UT', '84110', '8012992160', NULL, '1954 E Fort Union Blvd Ste 121', 'Salt Lake City', 'Salt Lake', 'UT', '84110', '8012992160', '', '', NULL, '1000', '48.50', '35.00', '0.00', 3, '2006-06-01', '2008-06-30', 0, 12, 0, '', '', '', '', 'HCFA|UB|', '1427060912', 0, 'Y', 0, '2012-06-21', NULL, NULL, 0, 0, NULL, NULL),
('201428952', 'W11000041', 'W11000041', 'UT01', 'Western Anesthesia Associates ', 'Anthony', NULL, 'Faber', 'MD', 'Anesthesiology', NULL, NULL, NULL, 'B', '1954 E Fort Union Blvd Ste 121', 'Salt Lake City', 'Salt Lake', 'UT', '84110', '8012992160', NULL, '1030 Woodmoor Dr', 'Bountiful', '', 'UT', '84010', '', '', '', NULL, '1000', '48.50', '35.00', '0.00', 3, '2006-06-01', NULL, 1, 12, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1083626303', 0, 'Y', 0, '2007-01-05', NULL, NULL, 0, 0, NULL, NULL),
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INSERT INTO `providers_new` (`Provider_Tax_ID`, `Provider_Suffix`, `Provider_Network_ID`, `Provider_Region`, `Provider_Name`, `Provider_Doctor_First_Name`, `Provider_Doctor_Middle_Name`, `Provider_Doctor_Last_Name`, `Provider_Doctor_Degree`, `Provider_Specialty_1`, `Provider_Specialty_2`, `Provider_Specialty_3`, `Provider_Specialty_4`, `Provider_Address_Type`, `Provider_Address`, `Provider_City`, `Provider_County`, `Provider_State`, `Provider_Zip`, `Provider_Phone`, `Provider_Fax`, `Provider_Mailing_Address`, `Provider_Mailing_City`, `Provider_Mailing_County`, `Provider_Mailing_State`, `Provider_Mailing_Zip`, `Provider_Mailing_Phone`, `Provider_Mailing_Fax`, `Provider_Primary_Schedule`, `Provider_Secondary_Schedule`, `Provider_Rate_Sheet`, `Provider_Anes_Rate`, `Provider_Default_Rate`, `Provider_Max_DOS`, `Provider_Min_Match_Value`, `Provider_Effective_Date`, `Provider_Term_Date`, `Provider_Pend`, `Provider_Anes_Minutes`, `Provider_PPO`, `Provider_Hospital_1`, `Provider_Hospital_2`, `Provider_Hospital_3`, `Provider_Hospital_4`, `Provider_Type`, `Provider_NPI`, `Provider_Check_Override`, `Exclude_Dir`, `Audit_Status`, `Last_Change_Date`, `Medicare_ID`, `Provider_Lang`, `Provider_Latitude`, `Provider_Longitude`, `Provider_school`, `Provider_cert`) VALUES
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('870428249', 'W11000074', 'W11000074', 'UT01', 'Kamas Health Center', 'Lisa', 'M', 'Saturnino', 'MD', 'Family Practice', '', '', NULL, 'O', '155 W 200 S', 'Kamas', 'Summit', 'UT', '84036', '4357834385', '4353365570', '155 W 200 S', 'Kamas', 'Summit', 'UT', '84036', '4357834385', '4353365570', 'WiseSTD', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 3, '2006-09-01', '2011-10-17', 0, 0, 0, 'Salt Lake Regional Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1336362490', 0, 'N', 0, '2013-05-23', NULL, NULL, 0, 0, NULL, NULL),
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('208407470', 'W11000149', 'W11000149', 'UT01', 'Urology Clinic of Utah Valley', 'Ronald', 'I', 'Oldroyd', 'MD', 'Urology', NULL, NULL, NULL, 'B', 'PO Box 12', 'Salt Lake City', 'Salt Lake', 'UT', '84110', '8013577530', NULL, 'PO Box 12', 'Salt Lake City', 'Salt Lake', 'UT', '84110', '8013577530', '', 'WiseSTD', 'WUSTDHCPC5', NULL, '0.00', '35.00', '0.00', 3, '2007-04-01', NULL, 0, 0, 0, 'Timpanogos Regional Hospital', '', '', '', 'HCFA|UB|', '1043240989', 0, 'y', 0, '2013-08-16', NULL, NULL, 0, 0, NULL, NULL),
('208407470', 'W11000150', 'W11000150', 'UT01', 'Urology Clinic of Utah Valley', 'Craig', 'A', 'Ensign', 'PA-C', 'Urology', 'Physician Assistant', '', NULL, 'B', 'PO Box 12', 'Salt Lake City', 'Salt Lake', 'UT', '84110', '8013577530', NULL, 'PO Box 12', 'Salt Lake City', 'Salt Lake', 'UT', '84110', '8013577530', '', 'WiseSTD', 'WUSTDHCPC5', NULL, '0.00', '35.00', '0.00', 3, '2007-04-01', NULL, 0, 0, 0, 'University Health Care University Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1760412605', 0, 'y', 0, '2011-11-30', NULL, NULL, 0, 0, NULL, NULL),
('208407470', 'W11000151', 'W11000151', 'UT01', 'Urology Clinic of Utah Valley', NULL, NULL, 'Urology Clinic of Utah Valley', 'GROUP', 'Urology', NULL, NULL, NULL, 'B', 'PO Box 12', 'Salt Lake City', 'Salt Lake', 'UT', '84110', '8013577530', NULL, 'PO Box 000012', 'Salt Lake City', '', 'UT', '84110', '', '', 'WiseSTD', 'WUSTDHCPC5', NULL, '0.00', '35.00', '0.00', 3, '2007-04-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1639211972', 0, 'y', 0, '2007-03-27', NULL, NULL, 0, 0, NULL, NULL),
('870667680', 'W11000152', 'W11000152', 'UT01', 'Oasis Family Medicine', 'Jay', 'Myron', 'Spector', 'MD', 'Family Practice', NULL, NULL, NULL, 'O', '196 E 2000 N Ste 100', 'Tooele', 'Tooele', 'UT', '84074', '4358330229', '4358330231', '196 E 2000 N', 'Tooele', '', 'UT', '84074', '', '', 'WiseSTD', 'WUSTDHCPC5', NULL, '0.00', '35.00', NULL, 3, '2006-11-01', '2006-11-01', 0, NULL, 0, 'Mountain West Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1386630259', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('202475777', 'W11000153', 'W11000153', 'UT01', 'Mountain View Foot & Ankle Specialists', 'Spencer', 'B', 'Heninger', 'DPM', 'Podiatry', '', '', NULL, 'O', '44 N 1st E', 'Preston', 'Franklin', 'ID', '83263', '4357872000', '4357871858', '44 N 1st E', 'Preston', 'Franklin', 'ID', '83263', '4357872000', '4357871858', 'WiseSTD', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 3, '2006-09-01', '2009-05-31', 0, 0, 0, 'Brigham City Community Hospital', 'Logan Regional Hospital', 'Franklin County Medical Center ', '', 'HCFA|UB|', '1790781292', 0, 'N', 0, '2014-07-25', NULL, NULL, 0, 0, NULL, NULL),
('900188420', 'W11000154', 'W11000154', 'UT01', 'Gynecology Affiliates', 'Jacolin', 'A', 'Shifrar', 'NP, CNM', 'Gynecology', '', '', NULL, 'O', '1140 E 3900 S Ste 300', 'Salt Lake City', 'Salt Lake', 'UT', '84124', '8012688222', '8012689926', '1140 E 3900 S Ste 300', 'Salt Lake City', 'Salt Lake', 'UT', '84124', '8012688222', '8012689926', 'WiseSTD', 'WUSTDHCPC5', NULL, '0.00', '35.00', '0.00', 3, '2006-10-01', NULL, 0, 0, 0, 'Jordan Valley Medical Center', 'St Marks Hospital', NULL, NULL, 'HCFA|UB|', '1134261209', 0, 'N', 0, '2010-09-02', NULL, NULL, 40.6871, -111.859, NULL, NULL),
('870396036', 'W11000155', 'W11000155', 'UT01', 'Enterprise Valley Medical Clinic', 'Greg', 'E', 'Halliday', 'PA-C', 'Family Practice', '', '', NULL, 'B', 'PO Box 370', 'Enterprise', 'Washington', 'UT', '84725', '4358782281', NULL, 'PO Box 370', 'Enterprise', 'Washington', 'UT', '84725', '4358782281', '          ', 'WiseSTD', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 3, '2006-12-01', '2011-11-01', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1366431918', 0, 'N', 0, '2013-10-23', NULL, NULL, 0, 0, NULL, NULL),
('870396036', 'W11000156', 'W11000156', 'UT01', 'Enterprise Valley Medical Clinic', 'Greg', 'E', 'Halliday', 'PA-C', 'Family Practice', '', '', NULL, 'O', '223 S 200 E', 'Enterprise', 'Washington', 'UT', '84725', '4358782281', NULL, '223 S 200 E', 'Enterprise', 'Washington', 'UT', '84725', '4358782281', '          ', 'WiseSTD', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 3, '2006-12-01', '2011-11-01', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1366431918', 0, 'N', 0, '2013-10-23', NULL, NULL, 0, 0, NULL, NULL),
('352163112', 'W11000157', 'W11000157', 'UT01', 'Southwest Utah Community Health', 'Norman', 'Jose', 'Brito-Dellan', 'MD', 'Internal Medicine', 'Hospitalist', '', NULL, 'O', '168 N 100 E', 'St George', 'Washington', 'UT', '84770', '4359862565', NULL, '168 N 100 E', 'St George', 'Washington', 'UT', '84770', '4359862565', '', 'WiseSTD', 'WUSTDHCPC5', NULL, '0.00', '35.00', '0.00', 3, '2006-09-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1164409553', 0, 'N', 0, '2011-03-01', NULL, NULL, 37.1111, -113.581, NULL, NULL),
('352163112', 'W11000158', 'W11000158', 'UT01', 'Southwest Utah Community Health', 'Ari', NULL, 'Mendez', 'LCSW', 'Mental Health', NULL, NULL, NULL, 'O', '168 N 100 E', 'St George', 'Washington', 'UT', '84770', '4359862565', NULL, '168 N 100 E', 'St George', '', 'UT', '847702893', '', '', 'WiseSTD', 'WUSTDHCPC5', NULL, '0.00', '35.00', '0.00', 3, '2006-09-01', '2008-04-01', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1134219892', 0, 'N', 0, '2006-11-07', NULL, NULL, 0, 0, NULL, NULL),
('352163112', 'W11000159', 'W11000159', 'UT01', 'Southwest Utah Community Health', 'Shauna', '', 'McBride', 'PA-C', 'Family Practice', '', '', NULL, 'O', '168 N 100 E', 'St George', 'Washington', 'UT', '84770', '4359862565', NULL, '168 N 100 E', 'St George', 'Washington', 'UT', '84770', '4359862565', '          ', 'WiseSTD', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 3, '2006-09-01', '2011-11-06', 0, 0, 0, 'Dixie Regional Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1457330532', 0, 'N', 0, '2011-11-17', NULL, NULL, 0, 0, NULL, NULL),
('352163112', 'W11000160', 'W11000160', 'UT01', 'Southwest Utah Community Health', 'Jayme (Jay)', '', 'Lott', 'PA-C', 'Family Practice', '', '', NULL, 'O', '168 N 100 E', 'St George', 'Washington', 'UT', '84770', '4359862565', NULL, '168 N 100 E', 'St George', 'Washington', 'UT', '84770', '4359862565', '          ', 'WiseSTD', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 3, '2006-09-01', '2011-11-07', 0, 0, 0, 'Dixie Regional Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1619970647', 0, 'N', 0, '2011-11-17', NULL, NULL, 0, 0, NULL, NULL),
('203908830', 'W11000161', 'W11000161', 'UT01', 'Clear Vue', 'Michael', 'T', 'Griffeth', 'MD', 'Ophthalmology', '', '', NULL, 'B', 'PO Box 1140', 'Tooele', 'Tooele', 'UT', '84074', '4358438333', '4358438334', 'PO Box 1140', 'Tooele', 'Tooele', 'UT', '84074', '4358438333', '4358438334', 'WISESTD', 'WUSTDHCPC5', NULL, '0.00', '35.00', '0.00', 6, '2006-10-01', '2009-08-01', 0, 0, 0, 'Mountain West Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1891799839', 0, 'Y', 0, '2014-01-17', 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
('460468660', 'W11000162', 'W11000162', 'UT01', 'Foot and Ankle Institute of Utah', 'Jason', 'B', 'Dickerson', 'DPM', 'Podiatry', NULL, NULL, NULL, 'B', 'PO Box 573625', 'Salt Lake City', 'Salt Lake', 'UT', '84157', '8012650600', NULL, 'PO Box 573625', 'Salt Lake City', 'Salt Lake', 'UT', '84157', '8012650600', '', 'WiseSTD', 'WUSTDHCPC5', NULL, '0.00', '35.00', '0.00', 3, '2006-09-01', NULL, 0, 0, 0, 'St Marks Hospital', '', '', '', 'HCFA|UB|', '1528039377', 0, 'y', 0, '2011-08-29', NULL, NULL, 0, 0, NULL, NULL),
('841407804', 'W11000163', 'W11000163', 'UT01', NULL, 'Christine', 'A', 'Cheng', 'MD', 'Plastic Surgery', NULL, NULL, NULL, 'B', 'PO Box 1512', 'Layton', 'Davis', 'UT', '84041', '8012989774', '8015939626', 'PO Box 1512', 'Layton', 'Davis', 'UT', '84041', '8012989774', '8015939626', 'WUSTDPLAS5', 'WUSTDHCPC5', NULL, '0.00', '35.00', '0.00', 3, '2007-01-01', NULL, 0, 0, 0, 'Lakeview Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1306848338', 0, 'y', 0, '2011-08-30', NULL, NULL, 0, 0, NULL, NULL),
('202781181', 'W11000164', 'W11000164', 'UT01', NULL, 'Danny', 'L', 'Cole', 'CRNA', 'Nurse Anesthetist', NULL, NULL, NULL, 'B', 'PO Box 210', 'Roy', 'Weber', 'UT', '84067', '8018254700', NULL, 'PO Box 210', 'Roy', '', 'UT', '84067', '', '', '', NULL, '1000', '40.90', '0.00', '0.00', 3, '2007-01-01', NULL, 1, 12, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1376553065', 0, 'Y', 0, '2007-01-10', NULL, NULL, 0, 0, NULL, NULL),
('760739760', 'W11000165', 'W11000165', 'UT01', 'Dixie Anesthesia', 'Gaylen', 'S', 'Gurr', 'MD', 'Anesthesiology', NULL, NULL, NULL, 'B', 'PO Box 911928', 'St George', 'Washington', 'UT', '84791', '4356529127', '4356747339', 'PO Box 911928', 'St George', '', 'UT', '84791', '', '', '', NULL, '1000', '45.00', '0.00', '0.00', 3, '2007-01-01', NULL, 1, 12, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1275693731', 0, 'Y', 0, '2007-01-10', NULL, NULL, 0, 0, NULL, NULL),
('760739760', 'W11000166', 'W11000166', 'UT01', 'Dixie Anesthesia', 'C', 'Michael', 'Reece', 'MD', 'Anesthesiology', NULL, NULL, NULL, 'B', 'PO Box 911928', 'St George', 'Washington', 'UT', '84791', '4356529127', '4356747339', 'PO Box 911928', 'St George', '', 'UT', '84791', '', '', '', NULL, '1000', '45.00', '0.00', '0.00', 3, '2007-01-01', NULL, 1, 12, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '0000008346', 0, 'Y', 0, '2007-01-10', NULL, NULL, 0, 0, NULL, NULL),
('760739760', 'W11000167', 'W11000167', 'UT01', 'Dixie Anesthesia', 'Bruce', 'M', 'Carter', 'MD', 'Anesthesiology', NULL, NULL, NULL, 'B', 'PO Box 911928', 'St George', 'Washington', 'UT', '84791', '4356529127', '4356747339', 'PO Box 911928', 'St George', '', 'UT', '84791', '', '', '', NULL, '1000', '45.00', '0.00', '0.00', 3, '2007-01-01', NULL, 1, 12, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1225198799', 0, 'Y', 0, '2007-01-10', NULL, NULL, 0, 0, NULL, NULL),
('870518374', 'W11000168', 'W11000168', 'UT01', 'ENT Specialists', 'Nancy', 'J', 'Stevenson', 'PA', 'Ear, Nose and Throat', '', '', NULL, 'O', '4000 S 700 E Ste 10', 'Murray', 'Salt Lake', 'UT', '84107', '8012684141', NULL, '4000 S 700 E Ste 10', 'Murray', 'Salt Lake', 'UT', '84107', '8012684141', '', 'WiseSTD', 'WUSTDHCPC5', NULL, '0.00', '35.00', '0.00', 3, '2007-01-01', NULL, 0, 0, 0, 'Mountain West Medical Center', 'St Marks Hospital', NULL, NULL, 'HCFA|UB|', '1215997655', 0, 'N', 0, '2010-08-25', NULL, NULL, 40.6857, -111.871, NULL, NULL),
('330766827', 'W11000169', 'W11000169', 'UT01', 'Park City Dermatology', 'Steven', 'M', 'Kern', 'MD', 'Dermatology', '', '', NULL, 'B', 'PO Box 932', 'Sandy', 'Salt Lake', 'UT', '84091', '4356581013', '4356583513', 'PO Box 932', 'Sandy', 'Salt Lake', 'UT', '84091', '4356581013', '4356583513', 'WiseSTD', 'WUSTDHCPC5', NULL, '0.00', '35.00', '0.00', 3, '2006-09-01', '2008-04-01', 0, 0, 0, 'Heber Valley Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1104814102', 0, 'y', 0, '2011-10-19', NULL, NULL, 0, 0, NULL, NULL),
('870651355', 'W11000170', 'W11000170', 'UT01', 'Utah Valley Obstetrics & Gynecology', 'Krissy', NULL, 'Rosser', 'NP', 'Obstetrics and Gynecology', NULL, NULL, NULL, 'O', '1055 N 300 W Ste 303', 'Provo', 'Utah', 'UT', '84604', '8013577377', NULL, '1055 N 300 W', 'Provo', '', 'UT', '84604', '', '', 'WiseSTD', 'WUSTDHCPC5', NULL, '0.00', '35.00', '0.00', 3, '2006-12-01', '2010-03-01', NULL, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '0000008489', 0, 'N', 0, '2006-11-17', NULL, NULL, 0, 0, NULL, NULL),
('562485184', 'W11000171', 'W11000171', 'UT01', 'Hyperbaric Medicine Physicians', 'Terri', 'A', 'DeJohn', 'MD', 'Emergency Medicine', NULL, NULL, NULL, 'B', 'PO Box 96398', 'Oklahoma City', 'Oklahoma', 'OK', '73143', '8009623303', '8015824269', 'PO Box 96398', 'Oklahoma City', '', 'OK', '731436398', '', '', 'WUEPIC5', 'WUSTDHCPC5', NULL, '0.00', '30.00', '0.00', 3, '2007-01-01', NULL, 0, 0, 0, 'Salt Lake Regional Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1598734386', 0, 'Y', 0, '2007-01-05', NULL, NULL, 0, 0, NULL, NULL),
('562485184', 'W11000172', 'W11000172', 'UT01', 'Hyperbaric Medicine Physicians', 'Scott', 'E', 'McIntosh', 'MD', 'Emergency Medicine', NULL, NULL, NULL, 'B', 'PO Box 96398', 'Oklahoma City', 'Oklahoma', 'OK', '73143', '8009623303', '8015824269', 'PO Box 96398', 'Oklahoma City', 'Oklahoma', 'OK', '73143', '8009623303', '8015824269', 'WUEPIC5', 'WUSTDHCPC5', NULL, '0.00', '30.00', '0.00', 3, '2007-01-01', NULL, 0, 0, 0, 'Salt Lake Regional Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1255427738', 0, 'Y', 0, '2012-09-19', NULL, NULL, 0, 0, NULL, NULL),
('562485184', 'W11000173', 'W11000173', 'UT01', 'Hyperbaric Medicine Physicians', 'Cathey', 'A', 'Putnam', 'MD', 'Emergency Medicine', NULL, NULL, NULL, 'B', 'PO Box 96398', 'Oklahoma City', 'Oklahoma', 'OK', '73143', '8009623303', '8015824269', 'PO Box 96398', 'Oklahoma City', '', 'OK', '731436398', '', '', 'WUEPIC5', 'WUSTDHCPC5', NULL, '0.00', '30.00', '0.00', 3, '2007-01-01', NULL, 0, 0, 0, 'Salt Lake Regional Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1437110368', 0, 'Y', 0, '2007-01-05', NULL, NULL, 0, 0, NULL, NULL),
('562485184', 'W11000174', 'W11000174', 'UT01', 'Hyperbaric Medicine Physicians', 'Cathey', 'A', 'Putnam', 'MD', 'Emergency Medicine', NULL, NULL, NULL, 'O', '540 Arapeen Dr Ste 110', 'Salt Lake City', 'Salt Lake', 'UT', '84108', '8015824268', '8015824269', 'PO Box 96398', 'Oklahoma City', '', 'OK', '731436398', '', '', 'WUEPIC5', 'WUSTDHCPC5', NULL, '0.00', '30.00', '0.00', 3, '2007-01-01', NULL, 0, 0, 0, 'Salt Lake Regional Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1437110368', 0, 'Y', 0, '2007-01-05', NULL, NULL, 40.757, -111.829, NULL, NULL),
('562485184', 'W11000175', 'W11000175', 'UT01', 'Hyperbaric Medicine Physicians', 'Scott', 'E', 'McIntosh', 'MD', 'Emergency Medicine', NULL, NULL, NULL, 'O', '540 Arapeen Dr Ste 110', 'Salt Lake City', 'Salt Lake', 'UT', '84108', '8015824268', '8015824269', '540 Arapeen Dr Ste 110', 'Salt Lake City', 'Salt Lake', 'UT', '84108', '8015824268', '8015824269', 'WUEPIC5', 'WUSTDHCPC5', NULL, '0.00', '30.00', '0.00', 3, '2007-01-01', NULL, 0, 0, 0, 'Salt Lake Regional Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1255427738', 0, 'Y', 0, '2012-09-19', NULL, NULL, 40.757, -111.829, NULL, NULL),
('562485184', 'W11000176', 'W11000176', 'UT01', 'Hyperbaric Medicine Physicians', 'Terri', 'A', 'DeJohn', 'MD', 'Emergency Medicine', NULL, NULL, NULL, 'O', '540 Arapeen Dr Ste 110', 'Salt Lake City', 'Salt Lake', 'UT', '84108', '8015824268', '8015824269', 'PO Box 96398', 'Oklahoma City', '', 'OK', '731436398', '', '', 'WUEPIC5', 'WUSTDHCPC5', NULL, '0.00', '30.00', '0.00', 3, '2007-01-01', NULL, 0, 0, 0, 'Salt Lake Regional Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1598734386', 0, 'Y', 0, '2007-01-05', NULL, NULL, 40.757, -111.829, NULL, NULL),
('870563433', 'W11000177', 'W11000177', 'UT01', 'Alpine Home Medical', '', '', 'Alpine Home Medical', 'GROUP', 'Durable Medical Equipment', '', '', NULL, 'O', '1071 E 100 S Ste 134', 'St George', 'Washington', 'UT', '84770', '8006867993', '8014754727', '1071 E 100 S Ste 134', 'St George', 'Washington', 'UT', '84770', '8006867993', '8014754727', 'WUDME5', 'WUSTDHCPC5', NULL, '0.00', '35.00', '0.00', 3, '2007-01-01', '2010-01-14', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '0000000420', 0, 'N', 0, '2014-01-20', NULL, NULL, 0, 0, NULL, NULL),
('521486235', 'W11000178', 'W11000178', 'WY01', 'Hanger Prosthetics & Orthotics Inc', '', '', 'Hanger Prosthetics & Orthotics Inc', 'GROUP', 'Durable Medical Equipment', '', '', NULL, 'o', '557 Broadway', 'Sheridan', 'Sheridan', 'WY', '82801', '3076720497', '3076720480', '557 Broadway', 'Sheridan', 'Sheridan', 'WY', '82801', '3076720497', '3076720480', 'WUDME5', '', '', '0.00', '35.00', '0.00', 3, '2006-10-01', '2012-03-31', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '0000006560', 0, 'N', 0, '2014-05-13', NULL, NULL, 0, 0, NULL, NULL),
('521486235', 'W11000179', 'W11000179', 'WY01', 'Hanger Prosthetics & Orthotics Inc', '', '', 'Hanger Prosthetics & Orthotics Inc', 'GROUP', 'Durable Medical Equipment', '', '', NULL, 'o', '148 E Arapaho Box 168', 'Thermopolis', 'Hot Springs', 'WY', '82443', '3078645530', '3078643281', '148 E Arapaho Box 168', 'Thermopolis', 'Hot Springs', 'WY', '82443', '3078645530', '3078643281', 'WUDME5', '', '', '0.00', '35.00', '0.00', 3, '2006-10-01', '2012-03-31', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '0000006560', 0, 'N', 0, '2014-05-13', NULL, NULL, 0, 0, NULL, NULL),
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('870550275', 'W11000181', 'W11000181', 'UT01', 'Cottonwood Pediatrics', 'Pamela', 'J', 'Hildebrand', 'MD', 'Pediatrics', '', '', NULL, 'B', 'PO Box 71550', 'Salt Lake City', 'Salt Lake', 'UT', '84171', '8012952888', NULL, 'PO Box 71550', 'Salt Lake City', 'Salt Lake', 'UT', '84171', '8012952888', '', 'WiseSTD', 'WUSTDHCPC5', NULL, '0.00', '35.00', '0.00', 3, '2006-06-01', NULL, 0, 0, 0, 'Lakeview Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1376568352', 0, 'Y', 0, '2013-12-30', NULL, NULL, 0, 0, NULL, NULL),
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('870519691', 'W11000250', 'W11000250', 'UT01', 'Utah Cancer Specialists', 'Jason', 'M', 'Stinnett', 'MD', 'Hematology and Oncology', 'Oncology', '', NULL, 'O', '1492 W Antelope Ste 125', 'Layton', 'Davis', 'UT', '84041', '8015253022', NULL, '1492 W Antelope Ste 125', 'Layton', 'Davis', 'UT', '84041', '8015253022', '', 'WUSTDONC5', 'WUSTDHCPC5', NULL, '0.00', '35.00', '0.00', 3, '2006-11-01', NULL, 0, 0, 0, 'Davis Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1861501694', 0, 'N', 0, '2012-01-27', NULL, NULL, 41.0893, -111.993, NULL, NULL),
('870519691', 'W11000251', 'W11000251', 'UT01', 'Utah Cancer Specialists', 'Jason', 'M', 'Stinnett', 'MD', 'Hematology and Oncology', 'Oncology', '', NULL, 'O', '520 E Medical Dr Ste 340', 'Bountiful', 'Davis', 'UT', '84010', '8012966665', NULL, '520 E Medical Dr Ste 340', 'Bountiful', 'Davis', 'UT', '84010', '8012966665', '          ', 'WUSTDONC5', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 3, '2006-11-01', NULL, 0, 0, 0, 'Davis Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1861501694', 0, 'N', 0, '2012-01-27', NULL, NULL, 40.8873, -111.87, NULL, NULL),
('870414618', 'W11000252', 'W11000252', 'UT01', 'Foot And Ankle Institute', NULL, NULL, 'Foot And Ankle Institute', 'GROUP', NULL, NULL, NULL, NULL, 'O', '52 S 850 W Ste 101', 'Hurricane', 'Washington', 'UT', '84737', '4356354609', NULL, '754 S Main St', 'St George', '', 'UT', '84770', '', '', 'WURURAL10', 'WUSTDHCPC5', NULL, '0.00', '35.00', '0.00', 3, '2007-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '0000006278', 0, 'Y', 0, '2006-12-21', NULL, NULL, 37.1756, -113.305, NULL, NULL),
('870414618', 'W11000253', 'W11000253', 'UT01', 'Foot And Ankle Institute', NULL, NULL, 'Foot And Ankle Institute', 'GROUP', NULL, NULL, NULL, NULL, 'O', '272 E Ctr St Ste 101', 'Ivins', 'Washington', 'UT', '84738', '4356564477', NULL, '754 S Main St', 'St George', '', 'UT', '84770', '', '', 'WURURAL10', 'WUSTDHCPC5', NULL, '0.00', '35.00', '0.00', 3, '2007-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '0000006278', 0, 'Y', 0, '2006-12-21', NULL, NULL, 37.1684, -113.673, 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
('870414618', 'W11000254', 'W11000254', 'UT01', 'Foot And Ankle Institute', NULL, NULL, 'Foot And Ankle Institute', 'GROUP', NULL, NULL, NULL, NULL, 'O', '340 Falconridge Pkwy Ste 300 A', 'Mesquite', 'Clark', 'NV', '89027', '7023467678', NULL, '754 S Main St', 'St George', '', 'UT', '84770', '', '', 'WURURAL10', 'WUSTDHCPC5', NULL, '0.00', '35.00', '0.00', 3, '2007-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '0000006278', 0, 'Y', 0, '2006-12-21', NULL, NULL, 36.8077, -114.113, NULL, NULL),
('202616136', 'W11000255', 'W11000255', 'UT01', 'Wasatch Audiology', 'Gary', 'C', 'Daniels', 'AUD', 'Audiology', '', '', NULL, 'O', '280 W River Park Ste 350', 'Provo', 'Utah', 'UT', '84604', '8013731108', NULL, '280 W River Park Ste 350', 'Provo', 'Utah', 'UT', '84604', '8013731108', '', 'WiseSTD', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 3, '2006-09-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1518079235', 0, 'N', 0, '2014-06-04', NULL, NULL, 40.3037, -111.662, NULL, NULL),
('202616136', 'W11000256', 'W11000256', 'UT01', 'Wasatch Audiology', 'Gary', 'C', 'Daniels', 'AUD', 'Audiology', '', '', NULL, 'O', '190 N Main', 'Heber City', 'Wasatch', 'UT', '84032', '8013731108', NULL, '190 N Main', 'Heber City', 'Wasatch', 'UT', '84032', '8013731108', '', 'WiseSTD', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 3, '2006-09-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1518079235', 0, 'N', 0, '2014-06-04', NULL, NULL, 40.5102, -111.413, NULL, NULL),
('870414618', 'W11000257', 'W11000257', 'UT01', 'Foot and Ankle Institute', 'Leon', 'K', 'Reber', 'DPM', 'Podiatry', '', '', NULL, 'O', '52 S 850 W Ste 101', 'Hurricane', 'Washington', 'UT', '84737', '4356354609', NULL, '52 S 850 W Ste 101', 'Hurricane', 'Washington', 'UT', '84737', '4356354609', '', 'WURURAL10', 'WUSTDHCPC5', NULL, '0.00', '35.00', '0.00', 3, '2007-01-01', NULL, 0, 0, 0, 'Dixie Regional Medical Center', 'Valley View Medical Center', NULL, NULL, 'HCFA|UB|', '1336179886', 0, 'N', 0, '2011-12-16', NULL, NULL, 37.1756, -113.305, NULL, NULL),
('870414618', 'W11000258', 'W11000258', 'UT01', 'Foot and Ankle Institute', 'Leon', 'K', 'Reber', 'DPM', 'Podiatry', '', '', NULL, 'O', '272 E Ctr St Ste 101', 'Ivins', 'Washington', 'UT', '84738', '4356564477', NULL, '272 E Ctr St Ste 101', 'Ivins', 'Washington', 'UT', '84738', '4356564477', '', 'WURURAL10', 'WUSTDHCPC5', NULL, '0.00', '35.00', '0.00', 3, '2007-01-01', NULL, 0, 0, 0, 'Dixie Regional Medical Center', 'Valley View Medical Center', NULL, NULL, 'HCFA|UB|', '1336179886', 0, 'N', 0, '2011-12-16', NULL, NULL, 37.1684, -113.673, NULL, NULL),
('870414618', 'W11000259', 'W11000259', 'UT01', 'Foot and Ankle Institute', 'Leon', 'K', 'Reber', 'DPM', 'Podiatry', '', '', NULL, 'O', '340 Falconridge Pkwy Ste 300 A', 'Mesquite', 'Clark', 'NV', '89027', '7023467678', NULL, '340 Falconridge Pkwy Ste 300 A', 'Mesquite', 'Clark', 'NV', '89027', '7023467678', '', 'WURURAL10', 'WUSTDHCPC5', NULL, '0.00', '35.00', '0.00', 3, '2007-01-01', NULL, 0, 0, 0, 'Dixie Regional Medical Center', 'Valley View Medical Center', NULL, NULL, 'HCFA|UB|', '1336179886', 0, 'N', 0, '2011-12-16', NULL, NULL, 36.8077, -114.113, NULL, NULL),
('870414618', 'W11000260', 'W11000260', 'UT01', 'Foot and Ankle Institute', 'Leon', 'K', 'Reber', 'DPM', 'Podiatry', '', '', NULL, 'O', '415 N Main St Ste 204', 'Cedar City', 'Iron', 'UT', '84720', '4358651943', NULL, '415 N Main St Ste 204', 'Cedar City', 'Iron', 'UT', '84720', '4358651943', '          ', 'WURURAL10', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 3, '2007-01-01', '2011-09-20', 0, 0, 0, 'Dixie Regional Medical Center', 'Valley View Medical Center', NULL, NULL, 'HCFA|UB|', '1336179886', 0, 'N', 0, '2011-12-16', NULL, NULL, 0, 0, NULL, NULL),
('870649259', 'W11000261', 'W11000261', 'UT01', 'Alpine Orthopaedic Specialists', 'Gregory', 'J', 'Hicken', 'MD', 'Orthopedic Surgery', '', '', NULL, 'O', '296 S 3rd W Ste B', 'Soda Springs', 'Caribou', 'ID', '83276', '4357872000', NULL, '296 S 3rd W Ste B', 'Soda Springs', 'Caribou', 'ID', '83276', '4357872000', '', 'WiseSTD', 'WUSTDHCPC5', NULL, '0.00', '35.00', '0.00', 3, '2006-11-01', NULL, 0, 0, 0, 'Brigham City Community Hospital', 'Logan Regional Hospital', 'Franklin County Medical Center ', NULL, 'HCFA|UB|', '1225027931', 0, 'N', 0, '2011-05-18', NULL, NULL, 42.6526, -111.613, NULL, NULL),
('870649259', 'W11000262', 'W11000262', 'UT01', 'Bear Lake Community Health Center', 'Kevin', 'R', 'Kellogg', 'PA-C', 'Orthopedic Surgery', NULL, NULL, NULL, 'O', '325 W Logan Hwy Ste 3', 'Tremonton', 'Box Elder', 'UT', '84337', '4357872000', NULL, 'PO Box 6250', 'Logan', '', 'UT', '84341', '', '', 'WiseSTD', 'WUSTDHCPC5', NULL, '0.00', '35.00', NULL, 3, '2006-11-01', '2007-06-01', 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1003899493', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870649259', 'W11000263', 'W11000263', 'UT01', 'Alpine Orthopaedic Specialists', 'Kevin', 'R', 'Kellogg', 'PA-C', 'Orthopedic Surgery', NULL, NULL, NULL, 'O', '2310 N 400 E Ste A', 'Logan', 'Cache', 'UT', '84341', '4357872000', NULL, 'PO Box 6250', 'Logan', '', 'UT', '84341', '', '', 'WiseSTD', 'WUSTDHCPC5', NULL, '0.00', '35.00', NULL, 3, '2006-11-01', '2007-06-01', 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1003899493', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870649259', 'W11000264', 'W11000264', 'UT01', 'Alpine Orthopaedic Specialists', 'Kevin', 'R', 'Kellogg', 'PA-C', 'Orthopedic Surgery', NULL, NULL, NULL, 'O', '296 S 3rd W Ste B', 'Soda Springs', 'Caribou', 'ID', '83276', '4357872000', NULL, 'PO Box 6250', 'Logan', '', 'UT', '84341', '', '', 'WiseSTD', 'WUSTDHCPC5', NULL, '0.00', '35.00', NULL, 3, '2006-11-01', '2007-06-01', 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1003899493', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('680562677', 'W11000265', 'W11000265', 'UT01', 'Intermountain Ear Nose and Throat Specialists', 'Timothy', 'L', 'Pefaur', 'PA', 'Family Practice', 'Ear, Nose and Throat', '', NULL, 'O', '7138 S 2000 E Ste 213 A', 'Sandy', 'Salt Lake', 'UT', '84121', '8013282522', NULL, '7138 S 2000 E Ste 213 A', 'Sandy', 'Salt Lake', 'UT', '84121', '8013282522', '          ', 'WiseOrtho', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 3, '2006-09-01', '2011-11-30', 0, 0, 0, 'Salt Lake Regional Medical Center', '', '', '', 'HCFA|UB|', '1871628404', 0, 'N', 0, '2013-09-19', NULL, NULL, 0, 0, NULL, NULL),
('680562677', 'W11000266', 'W11000266', 'UT01', 'Intermountain Ear Nose and Throat Specialists', 'Steven', 'K', 'Miller', 'MD', 'Ear, Nose and Throat', NULL, NULL, NULL, 'O', '1473 S Hwy 40 Ste E', 'Heber City', 'Wasatch', 'UT', '84032', '8005438964', NULL, '1473 S Hwy 40 Ste E', 'Heber City', 'Wasatch', 'UT', '84032', '8005438964', '', 'WiseOrtho', 'WUSTDHCPC5', NULL, '0.00', '35.00', '0.00', 3, '2006-09-01', NULL, 0, 0, 0, 'Primary Childrens Medical Center', '', '', '', 'HCFA|UB|', '1942313796', 0, 'N', 0, '2013-10-04', NULL, NULL, 40.4893, -111.409, NULL, NULL),
('680562677', 'W11000267', 'W11000267', 'UT01', 'Intermountain Ear Nose and Throat Specialists', 'Bryan', 'C', 'Tagge', 'MD', 'Ear, Nose and Throat', '', '', NULL, 'O', '22 S 900 E', 'Salt Lake City', 'Salt Lake', 'UT', '84102', '8013282522', NULL, '22 S 900 E', 'Salt Lake City', 'Salt Lake', 'UT', '84102', '8013282522', '', 'WiseOrtho', 'WUSTDHCPC5', NULL, '0.00', '35.00', '0.00', 3, '2006-09-01', NULL, 0, 0, 0, 'Salt Lake Regional Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1164557583', 0, 'N', 0, '2013-12-11', NULL, NULL, 40.7689, -111.865, NULL, NULL),
('680562677', 'W11000268', 'W11000268', 'UT01', 'Intermountain Ear Nose and Throat Specialists', 'Bryan', 'C', 'Tagge', 'MD', 'Ear, Nose and Throat', '', '', NULL, 'O', '1777 Sun Peak Dr', 'Park City', 'Summit', 'UT', '84098', '4356450800', NULL, '1777 Sun Peak Dr', 'Park City', 'Summit', 'UT', '84098', '4356450800', '', 'WiseOrtho', 'WUSTDHCPC5', NULL, '0.00', '35.00', '0.00', 3, '2006-09-01', NULL, 0, 0, 0, 'Salt Lake Regional Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1164557583', 0, 'N', 0, '2013-12-11', NULL, NULL, 40.6924, -111.545, NULL, NULL),
('680562677', 'W11000269', 'W11000269', 'UT01', 'Intermountain Ear Nose and Throat Specialists', 'Bryan', 'C', 'Tagge', 'MD', 'Ear, Nose and Throat', '', '', NULL, 'O', '7138 Highland Dr', 'Sandy', 'Salt Lake', 'UT', '84121', '8013282522', NULL, '7138 Highland Dr', 'Sandy', 'Salt Lake', 'UT', '84121', '8013282522', '', 'WiseOrtho', 'WUSTDHCPC5', NULL, '0.00', '35.00', '0.00', 3, '2006-09-01', NULL, 0, 0, 0, 'Salt Lake Regional Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1164557583', 0, 'N', 0, '2013-12-11', NULL, NULL, 40.6215, -111.834, NULL, NULL),
('680562677', 'W11000270', 'W11000270', 'UT01', 'Intermountain Ear Nose and Throat Specialists', 'Steven', 'K', 'Miller', 'MD', 'Ear, Nose and Throat', NULL, NULL, NULL, 'O', '1777 Sun Peak Dr', 'Park City', 'Summit', 'UT', '84098', '4356450800', NULL, '1777 Sun Peak Dr', 'Park City', 'Summit', 'UT', '84098', '4356450800', '', 'WiseOrtho', 'WUSTDHCPC5', NULL, '0.00', '35.00', '0.00', 3, '2006-09-01', NULL, 0, 0, 0, 'Primary Childrens Medical Center', '', '', '', 'HCFA|UB|', '1942313796', 0, 'N', 0, '2013-10-04', NULL, NULL, 40.6924, -111.545, NULL, NULL),
('680562677', 'W11000271', 'W11000271', 'UT01', 'Intermountain Ear Nose and Throat Specialists', 'Steven', 'K', 'Miller', 'MD', 'Ear, Nose and Throat', NULL, NULL, NULL, 'O', '7138 S 2000 E Ste 213 A', 'Sandy', 'Salt Lake', 'UT', '84121', '8013282522', NULL, '7138 S 2000 E Ste 213 A', 'Sandy', 'Salt Lake', 'UT', '84121', '8013282522', '', 'WiseOrtho', 'WUSTDHCPC5', NULL, '0.00', '35.00', '0.00', 3, '2006-09-01', NULL, 0, 0, 0, 'Primary Childrens Medical Center', '', '', '', 'HCFA|UB|', '1942313796', 0, 'N', 0, '2013-10-04', NULL, NULL, 40.6215, -111.834, NULL, NULL),
('680562677', 'W11000272', 'W11000272', 'UT01', 'Intermountain Ear Nose and Throat Specialists', 'Steven', 'K', 'Miller', 'MD', 'Ear, Nose and Throat', NULL, NULL, NULL, 'O', '22 S 900 E', 'Salt Lake City', 'Salt Lake', 'UT', '84102', '8013282522', NULL, '22 S 900 E', 'Salt Lake City', 'Salt Lake', 'UT', '84102', '8013282522', '', 'WiseOrtho', 'WUSTDHCPC5', NULL, '0.00', '35.00', '0.00', 3, '2006-09-01', NULL, 0, 0, 0, 'Primary Childrens Medical Center', '', '', '', 'HCFA|UB|', '1942313796', 0, 'N', 0, '2013-10-04', NULL, NULL, 40.7689, -111.865, NULL, NULL),
('870643872', 'W11000273', 'W11000273', 'UT01', 'Intermountain Neurology Clinic', 'Jamal', '', 'Horani', 'MD', 'Internal Medicine', 'Infectious Disease', '', NULL, 'B', '6112 S 1515 E Ste 200', 'Ogden', 'Weber', 'UT', '84405', '8017768080', NULL, '6112 S 1515 E Ste 200', 'Ogden', 'Weber', 'UT', '84405', '8017768080', '', 'WiseSTD', 'WUSTDHCPC5', NULL, '0.00', '35.00', '0.00', 3, '2006-10-01', NULL, 0, 0, 0, 'Jordan Valley Medical Center', '', '', '', 'HCFA|UB|', '1770585564', 0, 'Y', 0, '2012-07-31', NULL, NULL, 0, 0, NULL, NULL),
('870643872', 'W11000274', 'W11000274', 'UT01', 'Intermountain Neurology Clinic', 'Ahmad', 'N', 'Al-Sadat', 'MD', 'Neurology', 'Neurophysiology', '', NULL, 'B', '6112 S 1515 E Ste 200', 'Ogden', 'Weber', 'UT', '84405', '8017768080', NULL, '6112 S 1515 E Ste 200', 'Ogden', 'Weber', 'UT', '84405', '8017768080', '', 'WiseSTD', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 3, '2006-10-01', '2009-02-01', 0, 0, 0, 'Ogden Regional Medical Center', '', '', '', 'HCFA|UB|', '1104828987', 0, 'Y', 0, '2014-07-08', NULL, NULL, 0, 0, NULL, NULL),
('870643872', 'W11000275', 'W11000275', 'UT01', 'Intermountain Neurology Clinic', 'Khaldoun', 'M', 'Al-Rayess', 'MD', 'Endocrinology', 'Internal Medicine', '', NULL, 'B', '6112 S 1515 E Ste 200', 'Ogden', 'Weber', 'UT', '84405', '8017768080', NULL, '6112 S 1515 E Ste 200', 'Ogden', 'Weber', 'UT', '84405', '8017768080', '', 'WiseSTD', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 3, '2006-10-01', NULL, 0, 0, 0, 'Davis Hospital', '', '', '', 'HCFA|UB|', '1003808122', 0, 'Y', 0, '2014-06-17', NULL, NULL, 0, 0, NULL, NULL),
('621795214', 'W11000276', 'W11000276', 'UT01', 'Salt Lake Senior Clinic', 'James', 'C', 'Stringham', 'MD', 'Cardiovascular Disease', 'Pulmonary', NULL, NULL, 'O', '24 S 1100 E Ste 304', 'Salt Lake City', 'Salt Lake', 'UT', '84102', '8017464440', '8012664174', '24 S 1100 E Ste 304', 'Salt Lake City', 'Salt Lake', 'UT', '84102', '8017464440', '8012664174', 'WUSTDSURG5', 'WUSTDHCPC5', NULL, '0.00', '35.00', '0.00', 6, '2006-09-01', '2008-07-20', 0, 0, 0, 'Salt Lake Regional Medical Center', NULL, NULL, NULL, 'HCFA|', '1538182449', 0, 'N', 0, '2012-10-12', NULL, NULL, 0, 0, NULL, NULL),
('870354442', 'W11000277', 'W11000277', 'UT01', 'Rocky Mountain Womens Health Center', 'Erica', NULL, 'Brown', 'RT', 'Obstetrics and Gynecology', NULL, NULL, NULL, 'B', '1580 W Antelope Dr Ste 290', 'Layton', 'Davis', 'UT', '84041', '8017760880', NULL, '1580 W Antelope Dr', 'Layton', '', 'UT', '84041', '', '', 'WRYMTWOM', 'WUSTDHCPC5', NULL, '0.00', '35.00', NULL, 3, '2000-01-01', '2000-01-01', 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '0000005439', 0, 'y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870354442', 'W11000278', 'W11000278', 'UT01', 'Rocky Mountain Womens Health Center', 'Cindy', '', 'Clampitt', 'RT', 'Obstetrics and Gynecology', '', '', NULL, 'B', '1580 W Antelope Dr Ste 290', 'Layton', 'Davis', 'UT', '84041', '8017760880', NULL, '1580 W Antelope Dr Ste 290', 'Layton', 'Davis', 'UT', '84041', '8017760880', '', 'WRYMTWOM', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 3, '2007-01-01', '2014-04-30', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '0000005721', 0, 'Y', 0, '2014-05-27', NULL, NULL, 0, 0, NULL, NULL),
('870354442', 'W11000279', 'W11000279', 'UT01', 'Rocky Mountain Womens Health Center', 'Jody', NULL, 'Brown', 'MD', 'Obstetrics and Gynecology', NULL, NULL, NULL, 'B', '1580 W Antelope Dr Ste 290', 'Layton', 'Davis', 'UT', '84041', '8017760880', NULL, '1580 W Antelope Dr', 'Layton', '', 'UT', '84041', '', '', 'WRYMTWOM', 'WUSTDHCPC5', NULL, '0.00', '35.00', NULL, 3, '2000-01-01', '2000-01-01', 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '0000005444', 0, 'y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
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('870525682', 'W11000314', 'W11000314', 'UT01', 'Retina Associates of Utah', 'James', 'G', 'Howard', 'MD', 'Ophthalmology', '', '', NULL, 'O', '5169 S Cottonwood St Bldg B Ste 630', 'Murray', 'Salt Lake', 'UT', '84107', '8013122020', '8013122022', '5169 S Cottonwood St Bldg B Ste 630', 'Murray', 'Salt Lake', 'UT', '84107', '8013122020', '8013122022', 'WUUVPN10', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 3, '2006-06-01', '2010-07-14', 0, 0, 0, 'St Marks Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1033110119', 0, 'N', 0, '2013-08-01', NULL, NULL, 0, 0, NULL, NULL),
('870525682', 'W11000315', 'W11000315', 'UT01', 'Retina Associates of Utah', 'James', 'G', 'Howard', 'MD', 'Ophthalmology', '', '', NULL, 'O', '1055 N 300 W Ste 420', 'Provo', 'Utah', 'UT', '84604', '8013577999', '8013577020', '1055 N 300 W Ste 420', 'Provo', 'Utah', 'UT', '84604', '8013577999', '8013577020', 'WUUVPN10', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 3, '2006-06-01', '2010-07-14', 0, 0, 0, 'St Marks Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1033110119', 0, 'N', 0, '2013-08-01', NULL, NULL, 0, 0, NULL, NULL),
('870525682', 'W11000316', 'W11000316', 'UT01', 'Retina Associates of Utah', 'James', 'G', 'Howard', 'MD', 'Ophthalmology', '', '', NULL, 'O', '1660 W Antelope Dr Ste 325', 'Layton', 'Davis', 'UT', '84041', '8017558222', '8017758223', '1660 W Antelope Dr Ste 325', 'Layton', 'Davis', 'UT', '84041', '8017558222', '8017758223', 'WUUVPN10', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 3, '2006-06-01', '2010-07-14', 0, 0, 0, 'St Marks Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1033110119', 0, 'N', 0, '2013-08-01', NULL, NULL, 0, 0, NULL, NULL),
('870525682', 'W11000317', 'W11000317', 'UT01', 'Retina Associates of Utah', 'James', 'G', 'Howard', 'MD', 'Ophthalmology', '', '', NULL, 'O', '272 1/2 N Main St', 'Logan', 'Cache', 'UT', '84321', '8013122020', '8013122022', '272 1/2 N Main St', 'Logan', 'Cache', 'UT', '84321', '8013122020', '8013122022', 'WUUVPN10', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 3, '2006-06-01', '2010-07-14', 0, 0, 0, 'St Marks Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1033110119', 0, 'N', 0, '2013-08-01', NULL, NULL, 0, 0, NULL, NULL),
('870560763', 'W11000318', 'W11000318', 'UT01', 'Blanding Family Practice', 'Janel', '', 'Arbon', 'RD', 'Dietician', '', '', NULL, 'B', '799 S 200 W', 'Blanding', 'San Juan', 'UT', '84511', '4356783601', NULL, '799 S 200 W', 'Blanding', 'San Juan', 'UT', '84511', '4356783601', '          ', 'WiseSTD', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 6, '2006-12-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1336143924', 0, 'Y', 0, '2013-08-23', NULL, NULL, 0, 0, NULL, NULL),
('870560763', 'W11000319', 'W11000319', 'UT01', 'Montezuma Creek Community Health Center', 'Nelladee', '', 'Street', 'NP', 'Family Practice', '', '', NULL, 'O', 'East Hwy 262', 'Montezuma Creek', 'San Juan', 'UT', '84534', '4357273241', NULL, 'East Hwy 262', 'Montezuma Creek', 'San Juan', 'UT', '84534', '4357273241', '', 'WiseSTD', 'WUSTDHCPC5', NULL, '0.00', '35.00', '0.00', 6, '2006-12-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1588646665', 0, 'N', 0, '2011-10-19', NULL, NULL, 37.2619, -109.306, NULL, NULL),
('870560763', 'W11000320', 'W11000320', 'UT01', 'Montezuma Creek', 'Kimberly', '', 'Fairley', 'MD', 'Family Practice', '', '', NULL, 'B', 'PO Box 130', 'Montezuma Creek', 'San Juan', 'UT', '84534', '4357273241', NULL, 'PO Box 130', 'Montezuma Creek', 'San Juan', 'UT', '84534', '4357273241', '', 'WiseSTD', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 6, '2006-12-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1235214289', 0, 'Y', 0, '2014-06-04', NULL, NULL, 0, 0, NULL, NULL),
('870560763', 'W11000321', 'W11000321', 'UT01', 'Montezuma Creek', 'Anna', '', 'Day', 'NP', 'Family Practice', '', '', NULL, 'B', 'PO Box 130', 'Montezuma Creek', 'San Juan', 'UT', '84534', '4357273241', NULL, 'PO Box 130', 'Montezuma Creek', 'San Juan', 'UT', '84534', '4357273241', '', 'WiseSTD', 'WUSTDHCPC5', NULL, '0.00', '35.00', '0.00', 6, '2006-12-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1114002151', 0, 'Y', 0, '2014-04-22', NULL, NULL, 0, 0, NULL, NULL),
('870560763', 'W11000322', 'W11000322', 'UT01', 'Montezuma Creek', 'Deirdre', '', 'Piotrowski', 'LCSW', 'Mental Health', 'Social Worker', '', NULL, 'B', 'PO Box 130', 'Montezuma Creek', 'San Juan', 'UT', '84534', '4357273241', NULL, 'PO Box 130', 'Montezuma Creek', 'San Juan', 'UT', '84534', '4357273241', '', 'ma', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 6, '2006-12-01', '2013-02-14', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1609879998', 0, 'Y', 0, '2014-05-12', NULL, NULL, 0, 0, NULL, NULL),
('870560763', 'W11000323', 'W11000323', 'UT01', 'Montezuma Creek', 'Roselyn', '', 'Maryboy', 'LCSW', 'Mental Health', '', '', NULL, 'B', 'PO Box 130', 'Montezuma Creek', 'San Juan', 'UT', '84534', '4357273241', NULL, 'PO Box 130', 'Montezuma Creek', 'San Juan', 'UT', '84534', '4357273241', '', 'MA', 'WUSTDHCPC5', NULL, '0.00', '35.00', '0.00', 6, '2006-12-01', '2013-02-14', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1053324665', 0, 'Y', 0, '2013-02-27', NULL, NULL, 0, 0, NULL, NULL),
('870560763', 'W11000324', 'W11000324', 'UT01', 'Montezuma Creek', 'Jane', NULL, 'Palmer', 'NP', 'Family Practice', NULL, NULL, NULL, 'B', 'PO Box 130', 'Montezuma Creek', 'San Juan', 'UT', '84534', '4357273241', NULL, 'PO Box 130', 'Montezuma Creek', '', 'UT', '84534', '', '', 'WiseSTD', 'WUSTDHCPC5', NULL, '0.00', '35.00', NULL, 6, '2006-12-01', '2007-08-03', 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1154314169', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870560763', 'W11000325', 'W11000325', 'UT01', 'Montezuma Creek', 'Mahana', 'S', 'Fisher', 'MD', 'Family Practice', '', '', NULL, 'B', 'PO Box 130', 'Montezuma Creek', 'San Juan', 'UT', '84534', '4357273241', NULL, 'PO Box 130', 'Montezuma Creek', 'San Juan', 'UT', '84534', '4357273241', '', 'WiseSTD', 'WUSTDHCPC5', NULL, '0.00', '35.00', '0.00', 6, '2006-12-01', NULL, 0, 0, 0, 'Blue mountain hospital', '', '', '', 'HCFA|UB|', '1700878949', 0, 'Y', 0, '2014-01-17', NULL, NULL, 0, 0, NULL, NULL),
('870560763', 'W11000326', 'W11000326', 'UT01', 'Monument Valley Community Health Center', 'Anna', '', 'Day', 'NP', 'Family Practice', '', '', NULL, 'O', 'Four Rock Door Canyon', 'Monument Valley', 'San Juan', 'UT', '84536', '4357273000', NULL, 'Four Rock Door Canyon', 'Monument Valley', 'San Juan', 'UT', '84536', '4357273000', '', 'WiseSTD', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 6, '2006-12-01', '2011-10-17', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1114002151', 0, 'N', 0, '2014-04-22', NULL, NULL, 0, 0, NULL, NULL),
('870560763', 'W11000327', 'W11000327', 'UT01', 'Blanding Family Practice', 'Nelladee', '', 'Street', 'NP', 'Family Practice', '', '', NULL, 'O', '799 S 200 W', 'Blanding', 'San Juan', 'UT', '84511', '4356783601', NULL, '799 S 200 W', 'Blanding', 'San Juan', 'UT', '84511', '4356783601', '          ', 'WiseSTD', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 6, '2006-12-01', '2011-10-16', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1588646665', 0, 'N', 0, '2011-10-19', NULL, NULL, 0, 0, NULL, NULL),
('870560763', 'W11000328', 'W11000328', 'UT01', 'Montezuma Creek', 'Nelladee', '', 'Street', 'NP', 'Family Practice', '', '', NULL, 'B', 'PO Box 130', 'Montezuma Creek', 'San Juan', 'UT', '84534', '4357273241', NULL, 'PO Box 130', 'Montezuma Creek', 'San Juan', 'UT', '84534', '4357273241', '', 'WiseSTD', 'WUSTDHCPC5', NULL, '0.00', '35.00', '0.00', 6, '2006-12-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1588646665', 0, 'Y', 0, '2011-10-19', NULL, NULL, 0, 0, NULL, NULL),
('870560763', 'W11000329', 'W11000329', 'UT01', 'Montezuma Creek Community Health Center', 'Janel', '', 'Arbon', 'RD', 'Dietician', '', '', NULL, 'B', 'E Hwy 262', 'Montezuma Creek', 'San Juan', 'UT', '84534', '4357273241', NULL, 'E Hwy 262', 'Montezuma Creek', 'San Juan', 'UT', '84534', '4357273241', '', 'WiseSTD', 'WUSTDHCPC5', NULL, '0.00', '35.00', '0.00', 6, '2006-12-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1336143924', 0, 'Y', 0, '2013-08-23', NULL, NULL, 0, 0, NULL, NULL),
('870560763', 'W11000330', 'W11000330', 'UT01', 'Montezuma Creek', 'Janel', '', 'Arbon', 'RD', 'Dietician', '', '', NULL, 'B', 'PO Box 130', 'Montezuma Creek', 'San Juan', 'UT', '84534', '4357273241', NULL, 'PO Box 130', 'Montezuma Creek', 'San Juan', 'UT', '84534', '4357273241', '', 'WiseSTD', 'WUSTDHCPC5', NULL, '0.00', '35.00', '0.00', 6, '2006-12-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1336143924', 0, 'Y', 0, '2013-08-23', NULL, NULL, 0, 0, NULL, NULL),
('870347187', 'W11000331', 'W11000331', 'UT01', 'Utah Valley Eye Center', 'Loran', 'D', 'Cook', 'MD', 'Ophthalmology', '', '', NULL, 'O', '1055 N 300 W Ste 204', 'Provo', 'Utah', 'UT', '84604', '8013577373', NULL, '1055 N 300 W Ste 204', 'Provo', 'Utah', 'UT', '84604', '8013577373', '          ', 'WUUVPN10', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 3, '2006-01-01', '2010-07-14', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1396741948', 0, 'N', 0, '2013-08-05', NULL, NULL, 0, 0, NULL, NULL),
('870560471', 'W11000332', 'W11000332', 'UT01', 'Aspen Womens Center', 'Gregory', NULL, 'Gordon', 'MD', 'Family Practice', NULL, NULL, NULL, 'O', '1355 N University Ave Ste 110', 'Provo', 'Utah', 'UT', '84604', '8013745000', NULL, '1355 N Universitiy Ave', 'Provo', '', 'UT', '84604', '', '', 'WUUVPN10', 'WUSTDHCPC5', NULL, '0.00', '35.00', '0.00', 3, '2006-01-01', '2008-04-01', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '0000006454', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870543342', 'W11000333', 'W11000333', 'UT01', 'Moab Regional Medical Clinic', 'Rebecca', '', 'Love', 'MD', 'Emergency Medicine', '', '', NULL, 'B', 'PO Box 998', 'Moab', 'Grand', 'UT', '84532', '4352597191', NULL, 'PO Box 998', 'Moab', 'Grand', 'UT', '84532', '4352597191', '          ', '', '', '', '0.00', '10.00', '0.00', 6, '2006-11-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1073628798', 0, 'Y', 0, '2012-01-03', NULL, NULL, 0, 0, NULL, NULL),
('870543342', 'W11000334', 'W11000334', 'UT01', 'Moab Regional Medical Clinic', 'James', '', 'Rohan', 'MD', 'Radiologist', '', '', NULL, 'B', 'PO Box 998', 'Moab', 'Grand', 'UT', '84532', '4352597191', NULL, 'PO Box 998', 'Moab', 'Grand', 'UT', '84532', '4352597191', '          ', '', '', '', '0.00', '10.00', '0.00', 6, '2006-11-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1144290347', 0, 'Y', 0, '2012-04-17', NULL, NULL, 0, 0, NULL, NULL),
('870543342', 'W11000335', 'W11000335', 'UT01', 'Allen Memorial Physician Services', 'Patrick', 'M', 'Scherer', 'MD', 'Emergency Medicine', '', '', NULL, 'O', '719 W 400 N', 'Moab', 'Grand', 'UT', '84532', '4352597191', NULL, '719 W 400 N', 'Moab', 'Grand', 'UT', '84532', '4352597191', '          ', '', '', '', '0.00', '10.00', '0.00', 6, '2006-11-01', '2011-02-13', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1457435513', 0, 'Y', 0, '2012-04-17', NULL, NULL, 0, 0, NULL, NULL),
('870543342', 'W11000336', 'W11000336', 'UT01', 'Allen Memorial Physician Services', 'Rebecca', '', 'Love', 'MD', 'Emergency Medicine', '', '', NULL, 'O', '719 W 400 N', 'Moab', 'Grand', 'UT', '84532', '4352597191', NULL, '719 W 400 N', 'Moab', 'Grand', 'UT', '84532', '4352597191', '          ', '', '', '', '0.00', '10.00', '0.00', 6, '2006-11-01', '2011-02-13', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1073628798', 0, 'Y', 0, '2012-01-03', NULL, NULL, 0, 0, NULL, NULL),
('870543342', 'W11000337', 'W11000337', 'UT01', 'Allen Memorial Physician Services', 'James', '', 'Rohan', 'MD', 'Radiologist', '', '', NULL, 'O', '719 W 400 N', 'Moab', 'Grand', 'UT', '84532', '4352597191', NULL, '719 W 400 N', 'Moab', 'Grand', 'UT', '84532', '4352597191', '          ', '', '', '', '0.00', '10.00', '0.00', 6, '2006-11-01', '2011-02-14', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1144290347', 0, 'Y', 0, '2012-04-17', NULL, NULL, 0, 0, NULL, NULL),
('870543342', 'W11000338', 'W11000338', 'UT01', 'Moab Regional Medical Clinic', 'Patrick', 'M', 'Scherer', 'MD', 'Emergency Medicine', '', '', NULL, 'B', 'PO Box 998', 'Moab', 'Grand', 'UT', '84532', '4352597191', NULL, 'PO Box 998', 'Moab', 'Grand', 'UT', '84532', '4352597191', '          ', '', '', '', '0.00', '10.00', '0.00', 6, '2006-11-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1457435513', 0, 'Y', 0, '2012-04-17', NULL, NULL, 0, 0, NULL, NULL),
('621762357', 'W11000339', 'W11000339', 'UT01', 'Emery Medical Center', 'Lowell', '', 'Morris', 'PA', 'Family Practice', '', '', NULL, 'O', '90 W Main St', 'Castle Dale', 'Emery', 'UT', '84513', '4353812305', NULL, '90 W Main St', 'Castle Dale', 'Emery', 'UT', '84513', '4353812305', '', 'WURURAL5', 'WUSTDHCPC5', NULL, '0.00', '35.00', '0.00', 6, '2006-11-01', NULL, 0, 0, 0, 'Castleview Hospital', 'Castleview Hospital', NULL, NULL, 'HCFA|', '1346387305', 0, 'N', 0, '2012-11-09', NULL, NULL, 39.2109, -111.02, NULL, NULL),
('621762357', 'W11000340', 'W11000340', 'UT01', 'Emery Medical Center', 'Christine', '', 'Bardsley', 'NP', 'Family Practice', '', '', NULL, 'B', '90 W Main St', 'Castle Dale', 'Emery', 'UT', '84513', '4353812305', NULL, '90 W Main St', 'Castle Dale', 'Emery', 'UT', '84513', '4353812305', '', 'WURURAL5', 'WUSTDHCPC5', NULL, '0.00', '35.00', '0.00', 6, '2006-11-01', '2009-07-23', 0, 0, 0, '', '', '', '', 'HCFA|', '1285771220', 0, 'y', 0, '2012-11-09', NULL, NULL, 0, 0, NULL, NULL),
('621762357', 'W11000341', 'W11000341', 'UT01', 'Emery Medical Center', 'Lowell', '', 'Morris', 'PA', 'Family Practice', '', '', NULL, 'B', 'PO Box 607', 'Castle Dale', 'Emery', 'UT', '84513', '4353812305', '4353815010', 'PO Box 607', 'Castle Dale', 'Emery', 'UT', '84513', '4353812305', '4353815010', 'WURURAL5', 'WUSTDHCPC5', NULL, '0.00', '35.00', '0.00', 6, '2006-11-01', NULL, 0, 0, 0, 'Castleview Hospital', 'Castleview Hospital', NULL, NULL, 'HCFA|', '1346387305', 0, 'Y', 0, '2012-11-09', NULL, NULL, 0, 0, NULL, NULL),
('621762357', 'W11000342', 'W11000342', 'UT01', 'Emery Medical Center', 'Christine', '', 'Bardsley', 'NP', 'Family Practice', '', '', NULL, 'B', 'PO Box 607', 'Castle Dale', 'Emery', 'UT', '84513', '4353812305', '4353815010', 'PO Box 607', 'Castle Dale', 'Emery', 'UT', '84513', '4353812305', '4353815010', 'WURURAL5', 'WUSTDHCPC5', NULL, '0.00', '35.00', '0.00', 6, '2006-11-01', '2009-07-23', 0, 0, 0, '', '', '', '', 'HCFA|', '1285771220', 0, 'Y', 0, '2012-11-09', NULL, NULL, 0, 0, NULL, NULL),
('870543342', 'W11000343', 'W11000343', 'UT01', 'Allen Memorial Physician Services', 'Lowell', 'D', 'Barrows', 'MD', 'Emergency Medicine', '', '', NULL, 'O', '719 W 400 N', 'Moab', 'Grand', 'UT', '84532', '4352597191', NULL, '719 W 400 N', 'Moab', 'Grand', 'UT', '84532', '4352597191', '          ', '', '', '', '0.00', '10.00', '0.00', 6, '2006-11-01', '2011-02-13', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '0000005204', 0, 'Y', 0, '2012-01-03', NULL, NULL, 0, 0, NULL, NULL),
('870609595', 'W11000344', 'W11000344', 'UT01', 'Utah County Medical Associates', 'George', 'M', 'Baker', 'PA', 'Family Practice', '', '', NULL, 'O', '97 S Professional Way Ste 2', 'Payson', 'Utah', 'UT', '84651', '8014654896', NULL, '97 S Professional Way Ste 2', 'Payson', 'Utah', 'UT', '84651', '8014654896', '', 'WUUVPN10', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 3, '2006-01-01', '2010-07-14', 0, 0, 0, 'Mountain View Hospital', '', '', '', 'HCFA|UB|', '1124046370', 0, 'Y', 0, '2014-07-16', NULL, NULL, 0, 0, NULL, NULL),
('870609595', 'W11000345', 'W11000345', 'UT01', 'Utah County Medical Associates', 'Deborah', 'A', 'Hill', 'NP', 'Pediatrics', '', '', NULL, 'O', '269 E 400 S', 'Springville', 'Utah', 'UT', '84663', '8014919883', NULL, '97 S Professional Way', 'Payson', '', NULL, '84651', '', '', 'WUUVPN10', 'WUSTDHCPC5', NULL, '0.00', '35.00', '0.00', 3, '2006-01-01', '2009-11-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1821016015', 0, 'N', 0, '2009-09-25', NULL, NULL, 0, 0, NULL, NULL),
('870546501', 'W11000346', 'W11000346', 'UT01', 'Alpine Pediatrics', 'Jefferey', 'H', 'Abram', 'PA', 'Pediatrics', '', '', NULL, 'O', '3231 N 1120 E', 'Lehi', 'Utah', 'UT', '84043', '8014921999', NULL, '3231 N 1120 E', 'Lehi', 'Utah', 'UT', '84043', '8014921999', '', 'WUUVPN10', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 3, '2006-01-01', '2010-07-14', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1003855768', 0, 'N', 0, '2014-07-16', NULL, NULL, 0, 0, NULL, NULL),
('870546501', 'W11000347', 'W11000347', 'UT01', 'Alpine Pediatrics', 'Heather', 'N', 'Benally', 'PA', 'Pediatrics', NULL, NULL, NULL, 'O', '3231 N 1120 E', 'Lehi', 'Utah', 'UT', '84043', '8014921999', NULL, '3231 N 1120 E', 'Lehi', 'Utah', 'UT', '84043', '8014921999', '          ', 'WUUVPN10', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 3, '2006-01-01', '2010-07-14', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1659327153', 0, 'N', 0, '2011-10-27', NULL, NULL, 0, 0, NULL, NULL);
INSERT INTO `providers_new` (`Provider_Tax_ID`, `Provider_Suffix`, `Provider_Network_ID`, `Provider_Region`, `Provider_Name`, `Provider_Doctor_First_Name`, `Provider_Doctor_Middle_Name`, `Provider_Doctor_Last_Name`, `Provider_Doctor_Degree`, `Provider_Specialty_1`, `Provider_Specialty_2`, `Provider_Specialty_3`, `Provider_Specialty_4`, `Provider_Address_Type`, `Provider_Address`, `Provider_City`, `Provider_County`, `Provider_State`, `Provider_Zip`, `Provider_Phone`, `Provider_Fax`, `Provider_Mailing_Address`, `Provider_Mailing_City`, `Provider_Mailing_County`, `Provider_Mailing_State`, `Provider_Mailing_Zip`, `Provider_Mailing_Phone`, `Provider_Mailing_Fax`, `Provider_Primary_Schedule`, `Provider_Secondary_Schedule`, `Provider_Rate_Sheet`, `Provider_Anes_Rate`, `Provider_Default_Rate`, `Provider_Max_DOS`, `Provider_Min_Match_Value`, `Provider_Effective_Date`, `Provider_Term_Date`, `Provider_Pend`, `Provider_Anes_Minutes`, `Provider_PPO`, `Provider_Hospital_1`, `Provider_Hospital_2`, `Provider_Hospital_3`, `Provider_Hospital_4`, `Provider_Type`, `Provider_NPI`, `Provider_Check_Override`, `Exclude_Dir`, `Audit_Status`, `Last_Change_Date`, `Medicare_ID`, `Provider_Lang`, `Provider_Latitude`, `Provider_Longitude`, `Provider_school`, `Provider_cert`) VALUES
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('841384124', 'W11000363', 'W11000363', 'UT01', 'Southern Utah MRI', 'Randy', '', 'Delcore', 'MD', 'Orthopedic Surgery', '', '', NULL, 'O', '1335 Northfield Rd Ste 100', 'Cedar City', 'Iron', 'UT', '84720', '4355861003', '4358679848', '1335 Northfield Rd Ste 100', 'Cedar City', 'Iron', 'UT', '84720', '4355861003', '4358679848', 'WiseSTD', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 3, '2006-11-01', NULL, 0, 0, 0, 'Valley View Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1205926748', 0, 'Y', 0, '2013-09-23', NULL, NULL, 37.7013, -113.068, NULL, NULL),
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('870360395', 'W11000382', 'W11000382', 'UT01', NULL, 'Walter', 'M', 'Snihurowych', 'MD', 'Urology', '', '', NULL, 'O', '70 E 1100 N', 'Richfield', 'Sevier', 'UT', '84701', '4358930225', NULL, '70 E 1100 N', 'Richfield', 'Sevier', 'UT', '84701', '4358930225', '', 'WEUHP', 'WUSTDHCPC5', NULL, '0.00', '20.00', '0.00', 3, '2006-10-01', NULL, 0, 0, 0, 'Castleview Hospital', 'Castleview Hospital', 'Uintah Basin Medical Center', NULL, 'HCFA|UB|', '1669428736', 0, 'N', 0, '2014-01-20', NULL, NULL, 38.782, -112.083, NULL, NULL),
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('870373083', 'W11000421', 'W11000421', 'UT01', 'Heart And Lung Institute', 'Robert', 'F', 'Sprung', 'MD', 'Cardiovascular Disease', NULL, NULL, NULL, 'O', '3570 W 9000 S Ste 110', 'West Jordan', 'Salt Lake', 'UT', '84088', '8012330140', '8012633887', '5979 S Fashion Blvd', 'Murray', '', 'UT', '84107', '', '', 'WUSTDCARD5', 'WUSTDHCPC5', NULL, '0.00', '35.00', NULL, 3, '2006-10-01', '2006-10-01', 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1255314837', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870373083', 'W11000422', 'W11000422', 'UT01', 'Heart And Lung Institute', 'Ali', NULL, 'Ahmed', 'MD', 'Pulmonary', 'Critical Care', NULL, NULL, 'O', '3570 W 9000 S Ste 110', 'West Jordan', 'Salt Lake', 'UT', '84088', '8012330140', NULL, '5979 S Fashion Blvd', 'Murray', '', 'UT', '84107', '', '', 'WUSTDCARD5', 'WUSTDHCPC5', NULL, '0.00', '35.00', NULL, 3, '2006-10-01', '2007-03-01', 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1013994813', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870373083', 'W11000423', 'W11000423', 'UT01', 'Heart and Lung Institute', 'Gerald', 'Ira', 'Polukoff', 'MD', 'Cardiovascular Disease', '', '', NULL, 'O', '3570 W 9000 S Ste 110', 'West Jordan', 'Salt Lake', 'UT', '84088', '8012330140', NULL, '3570 W 9000 S Ste 110', 'West Jordan', 'Salt Lake', 'UT', '84088', '8012330140', '', 'WUSTDCARD5', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 3, '2006-10-01', '2009-01-08', 0, 0, 0, 'Logan Regional Hospital', '', '', '', 'HCFA|UB|', '1215020045', 0, 'N', 0, '2014-05-22', NULL, NULL, 0, 0, NULL, NULL),
('870373083', 'W11000424', 'W11000424', 'UT01', 'Heart and Lung Institute', 'Gerald', 'Ira', 'Polukoff', 'MD', 'Cardiovascular Disease', '', '', NULL, 'O', '5979 S Fashion Blvd', 'Murray', 'Salt Lake', 'UT', '84107', '8012632370', NULL, '5979 S Fashion Blvd', 'Murray', 'Salt Lake', 'UT', '84107', '8012632370', '', 'WUSTDCARD5', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 3, '2006-10-01', '2009-01-08', 0, 0, 0, 'Logan Regional Hospital', '', '', '', 'HCFA|UB|', '1215020045', 0, 'N', 0, '2014-05-22', NULL, NULL, 0, 0, NULL, NULL),
('870373083', 'W11000425', 'W11000425', 'UT01', 'Heart And Lung Institute', 'Gerald', 'Ira', 'Polukoff', 'MD', 'Cardiovascular Disease', NULL, NULL, NULL, 'O', '5979 S Fashion Blvd', 'West Jordan', 'Salt Lake', 'UT', '84088', '8012632370', NULL, '5979 S Fashion Blvd', 'Murray', '', 'UT', '84107', '', '', 'WUSTDCARD5', 'WUSTDHCPC5', NULL, '0.00', '35.00', NULL, 3, '2006-10-01', '2006-10-01', 0, NULL, 0, 'Logan Regional Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1215020045', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('954893928', 'W11000426', 'W11000426', 'UT01', 'Exodus Healthcare Network', 'Jill', 'D', 'McBride', 'MD', 'Family Practice', '', '', NULL, 'O', '8211 W 3500 S', 'Magna', 'Salt Lake', 'UT', '84044', '8012509638', '8012503204', '8211 W 3500 S', 'Magna', 'Salt Lake', 'UT', '84044', '8012509638', '8012503204', 'WiseSTD', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 3, '2006-08-01', '2011-09-01', 0, 0, 0, 'Pioneer Valley Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1992718902', 0, 'N', 0, '2011-09-30', NULL, NULL, 0, 0, NULL, NULL),
('954893928', 'W11000427', 'W11000427', 'UT01', 'Exodus Healthcare Network', 'Jason', 'V', 'Church', 'MD', 'Pediatrics', NULL, NULL, NULL, 'O', '8211 W 3500 S', 'Magna', 'Salt Lake', 'UT', '84044', '8012509638', '8012503204', '8211 W 3500 S', 'Magna', '', 'UT', '84044', '', '', 'WiseSTD', 'WUSTDHCPC5', NULL, '0.00', '35.00', NULL, 3, '2006-08-01', '2007-09-13', 0, NULL, 0, 'Ogden Regional Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1992859607', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('954893928', 'W11000428', 'W11000428', 'UT01', 'Exodus Healthcare Network', 'Jill', 'D', 'McBride', 'MD', 'Family Practice', '', '', NULL, 'O', '3336 Pioneer Pkwy Ste 201', 'Salt Lake City', 'Salt Lake', 'UT', '84044', '8012509638', '8012503204', '3336 Pioneer Pkwy Ste 201', 'Salt Lake City', 'Salt Lake', 'UT', '84044', '8012509638', '8012503204', 'WiseSTD', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 3, '2006-08-01', '2014-05-30', 0, 0, 0, 'Pioneer Valley Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1992718902', 0, 'N', 0, '2014-05-30', NULL, NULL, 40.6991, -111.99, NULL, NULL),
('954893928', 'W11000429', 'W11000429', 'UT01', 'Exodus Healthcare Network', 'Jason', 'V', 'Church', 'MD', 'Pediatrics', NULL, NULL, NULL, 'O', '3336 Pioneer Pkwy Ste 201', 'Salt Lake City', 'Salt Lake', 'UT', '84044', '8012509638', '8012503204', '8211 W 3500 S', 'Magna', '', 'UT', '84044', '', '', 'WiseSTD', 'WUSTDHCPC5', NULL, '0.00', '35.00', NULL, 3, '2006-08-01', '2007-09-13', 0, NULL, 0, 'Ogden Regional Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1992859607', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('954893928', 'W11000430', 'W11000430', 'UT01', 'Exodus Healthcare Network', 'Adriana', 'I', 'Rojoas', 'MD', 'Internal Medicine', NULL, NULL, NULL, 'O', '3336 Pioneer Pkwy Ste 201', 'Salt Lake City', 'Salt Lake', 'UT', '84044', '8012509638', '8012503204', '8211 W 3500 S', 'Magna', '', 'UT', '84044', '', '', 'WiseSTD', 'WUSTDHCPC5', NULL, '0.00', '35.00', '0.00', 3, '2006-08-01', '2008-04-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1467554196', 0, 'N', 0, '2006-10-19', NULL, NULL, 0, 0, NULL, NULL),
('954893928', 'W11000431', 'W11000431', 'UT01', 'Exodus Healthcare Network', 'Rodolfo', '', 'Martinez-Ferrate', 'MD', 'Family Practice', '', '', NULL, 'O', '3336 Pioneer Pkwy Ste 201', 'Salt Lake City', 'Salt Lake', 'UT', '84044', '8012509638', '8012503204', '3336 Pioneer Pkwy Ste 201', 'Salt Lake City', 'Salt Lake', 'UT', '84044', '8012509638', '8012503204', 'WiseSTD', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 3, '2006-08-01', '2014-05-30', 0, 0, 0, 'Pioneer Valley Hospital', '', '', '', 'HCFA|UB|', '1598738270', 0, 'N', 0, '2014-06-30', NULL, NULL, 40.6991, -111.99, NULL, NULL),
('841411398', 'W11000432', 'W11000432', 'UT01', 'Foothill Family Clinic', 'Robert', 'F', 'Sprung', 'MD', 'Cardiovascular Disease', NULL, NULL, NULL, 'O', '2295 Foothill Dr', 'Salt Lake City', 'Salt Lake', 'UT', '84109', '8014863021', '8014856339', '6360 S 3000 E', 'Salt Lake City', '', 'UT', '84121', '', '', 'WUFOOTHIL5', 'WUSTDHCPC5', NULL, '0.00', '35.00', '0.00', 3, '2007-01-01', '2008-07-03', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1255314837', 0, 'N', 0, '2007-11-06', NULL, NULL, 0, 0, NULL, NULL),
('841411398', 'W11000433', 'W11000433', 'UT01', 'Foothill Family Clinic', 'Mark', 'A', 'Rosen', 'MD', 'Orthopedic Surgery', NULL, NULL, NULL, 'O', '2295 Foothill Dr', 'Salt Lake City', 'Salt Lake', 'UT', '84109', '8014863021', '8014856339', '2295 Foothill Dr', 'Salt Lake City', 'Salt Lake', 'UT', '84109', '8014863021', '8014856339', 'WUFOOTHIL5', 'WUSTDHCPC5', NULL, '0.00', '35.00', '0.00', 3, '2007-01-01', NULL, 0, 0, 0, 'St Marks Hospital', 'St Marks Hospital', '', '', 'HCFA|UB|', '1609823426', 0, 'N', 0, '2013-02-19', NULL, NULL, 40.7206, -111.811, NULL, NULL),
('841411398', 'W11000434', 'W11000434', 'UT01', 'Foothill Family Clinic', 'Bruce', NULL, 'Callister', 'PA-C', 'Family Practice', NULL, NULL, NULL, 'B', '2295 Foothill Dr', 'Salt Lake City', 'Salt Lake', 'UT', '84109', '8014863021', '8014856339', '6360 S 3000 E', 'Salt Lake City', '', 'UT', '84121', '', '', 'WUFOOTHIL5', 'WUSTDHCPC5', NULL, '0.00', '35.00', '0.00', 3, '2007-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '0000005540', 0, 'Y', 0, '2006-12-21', NULL, NULL, 0, 0, NULL, NULL),
('841411398', 'W11000435', 'W11000435', 'UT01', 'Foothill Family Clinic', 'Jerry', NULL, 'Kelty', 'PA-C', 'Family Practice', NULL, NULL, NULL, 'B', '2295 Foothill Dr', 'Salt Lake City', 'Salt Lake', 'UT', '84109', '8014863021', '8014856339', '6360 S 3000 E', 'Salt Lake City', '', 'UT', '84121', '', '', 'WUFOOTHIL5', 'WUSTDHCPC5', NULL, '0.00', '35.00', '0.00', 3, '2007-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '0000007061', 0, 'Y', 0, '2006-12-21', NULL, NULL, 0, 0, NULL, NULL),
('841411398', 'W11000436', 'W11000436', 'UT01', 'Foothill Family Clinic', 'Shirley', NULL, 'Ala', 'PA-C', 'Family Practice', NULL, NULL, NULL, 'O', '2295 Foothill Dr', 'Salt Lake City', 'Salt Lake', 'UT', '84109', '8014863021', '8014856339', '6360 S 3000 E', 'Salt Lake City', '', 'UT', '84121', '', '', 'WUFOOTHIL5', 'WUSTDHCPC5', NULL, '0.00', '35.00', '0.00', 3, '2007-01-01', '2008-08-01', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1619909017', 0, 'N', 0, '2006-12-21', NULL, NULL, 0, 0, NULL, NULL),
('841411398', 'W11000437', 'W11000437', 'UT01', 'Foothill Family Clinic', 'Karen', NULL, 'Sasaki-Black', 'MD', 'Family Practice', NULL, NULL, NULL, 'O', '6360 S 3000 E Ste 100', 'Salt Lake City', 'Salt Lake', 'UT', '84121', '8013651032', '8013651033', '6360 S 3000 E', 'Salt Lake City', '', 'UT', '84121', '', '', 'WUFOOTHIL5', 'WUSTDHCPC5', NULL, '0.00', '35.00', '0.00', 3, '2007-01-01', '2008-08-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '0000008595', 0, 'N', 0, '2006-12-21', NULL, NULL, 0, 0, NULL, NULL),
('841411398', 'W11000438', 'W11000438', 'UT01', 'Foothill Family Clinic', 'Bruce', NULL, 'Callister', 'PA-C', 'Family Practice', NULL, NULL, NULL, 'B', '6360 S 3000 E Ste 100', 'Salt Lake City', 'Salt Lake', 'UT', '84121', '8013651032', '8013651033', '6360 S 3000 E', 'Salt Lake City', '', 'UT', '84121', '', '', 'WUFOOTHIL5', 'WUSTDHCPC5', NULL, '0.00', '35.00', '0.00', 3, '2007-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '0000005540', 0, 'Y', 0, '2006-12-21', NULL, NULL, 0, 0, NULL, NULL),
('841411398', 'W11000439', 'W11000439', 'UT01', 'Foothill Family Clinic', 'Jerry', NULL, 'Kelty', 'PA-C', 'Family Practice', NULL, NULL, NULL, 'B', '6360 S 3000 E Ste 100', 'Salt Lake City', 'Salt Lake', 'UT', '84121', '8013651032', '8013651033', '6360 S 3000 E', 'Salt Lake City', '', 'UT', '84121', '', '', 'WUFOOTHIL5', 'WUSTDHCPC5', NULL, '0.00', '35.00', '0.00', 3, '2007-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '0000007061', 0, 'Y', 0, '2006-12-21', NULL, NULL, 0, 0, NULL, NULL),
('841411398', 'W11000440', 'W11000440', 'UT01', 'Foothill Family Clinic', 'Joe', '', 'Food', 'PA-C', 'Family Practice', '', '', NULL, 'O', '6360 S 3000 E Ste 100', 'Salt Lake City', 'Salt Lake', 'UT', '84121', '8013651032', '8013651033', '6360 S 3000 E Ste 100', 'Salt Lake City', 'Salt Lake', 'UT', '84121', '8013651032', '8013651033', 'WUFOOTHIL5', 'WUSTDHCPC5', NULL, '0.00', '35.00', '0.00', 3, '2007-01-01', '2009-10-07', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '0000006276', 0, 'N', 0, '2013-01-11', NULL, NULL, 0, 0, NULL, NULL),
('841411398', 'W11000441', 'W11000441', 'UT01', 'Foothill Family Clinic', 'Timothy', 'L', 'Pefaur', 'PA', 'Family Practice', 'Ear, Nose and Throat', '', NULL, 'B', '6360 S 3000 E Ste 100', 'Salt Lake City', 'Salt Lake', 'UT', '84121', '8013651032', '8013651033', '6360 S 3000 E Ste 100', 'Salt Lake City', 'Salt Lake', 'UT', '84121', '8013651032', '8013651033', 'WUFOOTHIL5', 'WUSTDHCPC5', NULL, '0.00', '35.00', '0.00', 3, '2007-01-01', NULL, 0, 0, 0, 'Salt Lake Regional Medical Center', '', '', '', 'HCFA|UB|', '1871628404', 0, 'Y', 0, '2013-09-19', NULL, NULL, 0, 0, NULL, NULL),
('870284475', 'W11000442', 'W11000442', 'UT01', 'Granger Medical Clinic', 'Robert', 'E', 'Burr', 'MD', 'Endocrinology', 'Diabetes', '', NULL, 'B', 'PO Box 70658', 'West Valley', 'Salt Lake', 'UT', '84170', NULL, NULL, 'PO Box 70658', 'West Valley', 'Salt Lake', 'UT', '84170', '', '', 'WUGRANGER5', 'WUSTDHCPC5', NULL, '0.00', '35.00', '0.00', 3, '2006-08-01', NULL, 0, 0, 0, 'Salt Lake Regional Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1770533788', 0, 'Y', 0, '2011-09-21', NULL, NULL, 0, 0, NULL, NULL);
INSERT INTO `providers_new` (`Provider_Tax_ID`, `Provider_Suffix`, `Provider_Network_ID`, `Provider_Region`, `Provider_Name`, `Provider_Doctor_First_Name`, `Provider_Doctor_Middle_Name`, `Provider_Doctor_Last_Name`, `Provider_Doctor_Degree`, `Provider_Specialty_1`, `Provider_Specialty_2`, `Provider_Specialty_3`, `Provider_Specialty_4`, `Provider_Address_Type`, `Provider_Address`, `Provider_City`, `Provider_County`, `Provider_State`, `Provider_Zip`, `Provider_Phone`, `Provider_Fax`, `Provider_Mailing_Address`, `Provider_Mailing_City`, `Provider_Mailing_County`, `Provider_Mailing_State`, `Provider_Mailing_Zip`, `Provider_Mailing_Phone`, `Provider_Mailing_Fax`, `Provider_Primary_Schedule`, `Provider_Secondary_Schedule`, `Provider_Rate_Sheet`, `Provider_Anes_Rate`, `Provider_Default_Rate`, `Provider_Max_DOS`, `Provider_Min_Match_Value`, `Provider_Effective_Date`, `Provider_Term_Date`, `Provider_Pend`, `Provider_Anes_Minutes`, `Provider_PPO`, `Provider_Hospital_1`, `Provider_Hospital_2`, `Provider_Hospital_3`, `Provider_Hospital_4`, `Provider_Type`, `Provider_NPI`, `Provider_Check_Override`, `Exclude_Dir`, `Audit_Status`, `Last_Change_Date`, `Medicare_ID`, `Provider_Lang`, `Provider_Latitude`, `Provider_Longitude`, `Provider_school`, `Provider_cert`) VALUES
('870284475', 'W11000443', 'W11000443', 'UT01', 'Granger Medical Clinic', 'Robert', 'E', 'Burr', 'MD', 'Endocrinology', 'Diabetes', '', NULL, 'O', '3725 W 4100 S', 'West Valley', 'Salt Lake', 'UT', '84120', '8019653600', NULL, '3725 W 4100 S', 'West Valley', 'Salt Lake', 'UT', '84120', '8019653600', '', 'WUGRANGER5', 'WUSTDHCPC5', NULL, '0.00', '35.00', '0.00', 3, '2006-08-01', NULL, 0, 0, 0, 'Salt Lake Regional Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1770533788', 0, 'N', 0, '2011-09-21', NULL, NULL, 40.682, -111.979, NULL, NULL),
('954893928', 'W11000444', 'W11000444', 'UT01', 'Exodus Healthcare Network', 'Mary', '', 'Dodge', 'FNP', 'Family Practice', '', '', NULL, 'O', '3336 Pioneer Pkwy Ste 201', 'Salt Lake City', 'Salt Lake', 'UT', '84044', '8012509638', '8012503204', '3336 Pioneer Pkwy Ste 201', 'Salt Lake City', 'Salt Lake', 'UT', '84044', '8012509638', '8012503204', 'WiseSTD', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 3, '2006-08-01', '2007-04-01', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1730252636', 0, 'N', 0, '2010-09-08', NULL, NULL, 0, 0, NULL, NULL),
('954893928', 'W11000445', 'W11000445', 'UT01', 'Exodus Healthcare Network', 'Mary', '', 'Dodge', 'FNP', 'Family Practice', '', '', NULL, 'B', '8211 W 3500 S', 'Magna', 'Salt Lake', 'UT', '84044', '8012509638', '8012503204', '8211 W 3500 S', 'Magna', 'Salt Lake', 'UT', '84044', '8012509638', '8012503204', 'WiseSTD', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 3, '2006-08-01', '2007-04-01', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1730252636', 0, 'Y', 0, '2010-09-08', NULL, NULL, 0, 0, NULL, NULL),
('870179340', 'W11000446', 'W11000446', 'UT01', 'Standard Optical', 'Dustin', 'D', 'Harlin', 'OD', 'Optometry', NULL, NULL, NULL, 'O', '1200 Provo Town Center Ste 1060', 'Provo', 'Utah', 'UT', '84601', '8013732254', NULL, '1901 W Pkwy Blvd', 'Salt Lake City', '', 'UT', '84119', '', '', 'WUTALBERT5', 'WUSTDHCPC5', NULL, '0.00', '35.00', '0.00', 6, '2006-10-01', '2009-07-29', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1891733424', 0, 'N', 0, '2006-10-02', NULL, NULL, 0, 0, NULL, NULL),
('870179340', 'W11000447', 'W11000447', 'UT01', 'Standard Optical', 'Bruce', 'L', 'Lundin', 'OD', 'Optometry', '', '', NULL, 'O', '1153 N Main St Ste A 120', 'Logan', 'Cache', 'UT', '84341', '4357522092', NULL, '1153 N Main St Ste A 120', 'Logan', 'Cache', 'UT', '84341', '4357522092', '', 'WUTALBERT5', 'WUSTDHCPC5', NULL, '0.00', '35.00', '0.00', 6, '2006-10-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1750336152', 0, 'N', 0, '2012-03-14', NULL, NULL, 41.753, -111.834, NULL, NULL),
('870179340', 'W11000448', 'W11000448', 'UT01', 'Standard Optical', 'Bruce', 'L', 'Lundin', 'OD', 'Optometry', '', '', NULL, 'O', '4305 S Harrison Blvd Ste 9111', 'Ogden', 'Weber', 'UT', '84403', '8014795060', NULL, '4305 S Harrison Blvd Ste 9111', 'Ogden', 'Weber', 'UT', '84403', '8014795060', '          ', 'WUTALBERT5', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 6, '2006-10-01', '2013-03-03', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1750336152', 0, 'N', 0, '2013-03-15', NULL, NULL, 0, 0, NULL, NULL),
('043687810', 'W11000449', 'W11000449', 'UT01', 'Alpine Hospice Inc', NULL, NULL, 'Alpine Hospice Inc', 'GROUP', 'Hospice', NULL, NULL, NULL, 'O', '1172 E 100 N Ste D', 'Payson', 'Utah', 'UT', '84058', '4354654401', NULL, 'PO Box 65788', 'Salt Lake City', '', 'UT', '84165', '', '', '', NULL, '3', '0.00', '35.00', '0.00', 3, '2006-10-01', NULL, 1, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1265430573', 0, 'N', 0, '2006-10-19', NULL, NULL, 40.0451, -111.713, NULL, NULL),
('841411398', 'W11000450', 'W11000450', 'UT01', 'Foothill Family Clinic', 'Melora', NULL, 'Smith', 'PA-C', 'Family Practice', NULL, NULL, NULL, 'B', '6360 S 3000 E Ste 100', 'Salt Lake City', 'Salt Lake', 'UT', '84121', '8013651032', '8013651033', '6360 S 3000 E', 'Salt Lake City', '', 'UT', '84121', '', '', 'WUFOOTHIL5', 'WUSTDHCPC5', NULL, '0.00', '35.00', '0.00', 3, '2007-01-01', '2010-02-19', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '0000008771', 0, 'Y', 0, '2006-12-21', NULL, NULL, 0, 0, NULL, NULL),
('870618776', 'W11000451', 'W11000451', 'UT01', 'Gamma West Brachytherapy ', '', '', 'Gamma West Brachytherapy LLC', 'GROUP', 'Radiation Oncology', '', '', NULL, 'o', '24 S 1100 E Ste 306', 'Salt Lake City', 'Salt Lake', 'UT', '84102', '8013508400', NULL, '24 S 1100 E Ste 306', 'Salt Lake City', 'Salt Lake', 'UT', '84102', '8013508400', '', 'WUSTDRONC5', 'WUSTDHCPC5', NULL, '0.00', '35.00', '0.00', 3, '2006-10-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '0000006352', 0, 'Y', 0, '2013-01-16', NULL, NULL, 40.7689, -111.86, NULL, NULL),
('870618776', 'W11000452', 'W11000452', 'UT01', 'Gamma West Brachytherapy ', '', '', 'Gamma West Brachytherapy LLC', 'GROUP', 'Radiation Oncology', '', '', NULL, 'B', 'PO Box 25213', 'Salt Lake City', 'Salt Lake', 'UT', '84125', '8018520210', NULL, 'PO Box 25213', 'Salt Lake City', 'Salt Lake', 'UT', '84125', '8018520210', '', 'WUSTDRONC5', 'WUSTDHCPC5', NULL, '0.00', '35.00', '0.00', 3, '2006-10-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '0000006352', 0, 'Y', 0, '2013-01-16', NULL, NULL, 0, 0, NULL, NULL),
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('450467418', 'W11000523', 'W11000523', 'UT01', 'Apria Healthcare LLC', '', '', 'Apria Healthcare LLC', 'GROUP', 'Durable Medical Equipment', '', '', NULL, 'O', '203 E 6100 S', 'Salt Lake City', 'Salt Lake', 'UT', '84107', '8012617174', NULL, '203 E 6100 S', 'Salt Lake City', 'Salt Lake', 'UT', '84107', '8012617174', '          ', 'Wpraxair', '', '', '0.00', '20.00', '0.00', 3, '2006-05-01', '2011-10-04', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '0000008248', 0, 'Y', 0, '2014-01-24', NULL, NULL, 0, 0, NULL, NULL),
('450467418', 'W11000524', 'W11000524', 'UT01', 'Apria Healthcare LLC', '', '', 'Apria Healthcare LLC', 'GROUP', 'Durable Medical Equipment', '', '', NULL, 'O', '1395 Greg St Ste 108', 'Sparks', 'Washoe', 'NV', '89431', '7753559696', NULL, '1395 Greg St Ste 108', 'Sparks', 'Washoe', 'NV', '89431', '7753559696', '          ', 'Wpraxair', '', '', '0.00', '20.00', '0.00', 3, '2006-05-01', '2014-01-24', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '0000008248', 0, 'Y', 0, '2014-01-24', NULL, NULL, 0, 0, NULL, NULL),
('870293873', 'W11000525', 'W11000525', 'UT01', 'Tri City Medical Clinic', 'Joseph', 'B', 'Liddle', 'MD', 'Family Practice', NULL, NULL, NULL, 'O', '487 E 1000 S Ste A', 'Pleasant Grove', 'Utah', 'UT', '84062', '8017961333', NULL, '487 E 1000 S Ste A', 'Pleasant Grove', 'Utah', 'UT', '84062', '8017961333', '          ', 'WUUVPN10', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 3, '2006-06-01', '2010-07-14', 0, 0, 0, 'Timpanogos Regional Hospital', '', '', '', 'HCFA|UB|', '1427166701', 0, 'N', 0, '2013-11-11', NULL, NULL, 0, 0, NULL, NULL),
('870293873', 'W11000526', 'W11000526', 'UT01', 'Tri City Medical Clinic', 'Scott', 'L', 'Smith', 'MD', 'Family Practice', NULL, NULL, NULL, 'O', '487 E 1000 S Ste A', 'Pleasant Grove', 'Utah', 'UT', '84062', '8017961333', NULL, '487 E 1000 S Ste A', 'Pleasant Grove', 'Utah', 'UT', '84062', '8017961333', '          ', 'WUUVPN10', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 3, '2006-06-01', '2010-07-14', 0, 0, 0, 'Timpanogos Regional Hospital', '', '', '', 'HCFA|UB|', '1336257617', 0, 'N', 0, '2013-11-25', NULL, NULL, 0, 0, NULL, NULL),
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('870293873', 'W11000528', 'W11000528', 'UT01', 'Tri City Medical Clinic', 'Melinda', 'M', 'Midgley', 'MD', 'Family Practice', '', '', NULL, 'O', '487 E 1000 S Ste A', 'Pleasant Grove', 'Utah', 'UT', '84062', '8017961333', NULL, '487 E 1000 S Ste A', 'Pleasant Grove', 'Utah', 'UT', '84062', '8017961333', '          ', 'WUUVPN10', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 3, '2006-06-01', '2010-07-14', 0, 0, 0, 'Timpanogos Regional Hospital', '', '', '', 'HCFA|UB|', '1760587653', 0, 'N', 0, '2013-11-04', NULL, NULL, 0, 0, NULL, NULL),
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('061725406', 'W11000533', 'W11000533', 'WA01', 'Gentiva Rehab Without Walls ', '', '', 'Gentiva Rehab Without Walls LLC', 'GROUP', 'Home Health Agency', '', '', NULL, 'O', '6912 220th SW Ste 301', 'Mountlake Terrace', 'Snohomish', 'WA', '98043', '4256729219', NULL, '6912 220th SW Ste 301', 'Mountlake Terrace', 'Snohomish', 'WA', '98043', '4256729219', '', '', NULL, '4', '0.00', '100.00', '0.00', 3, '2007-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '0000833759', 0, 'N', 0, '2012-04-25', NULL, NULL, 0, 0, NULL, NULL),
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('061725406', 'W11000535', 'W11000535', 'UT01', 'Gentiva Rehab Without Walls ', '', '', 'Gentiva Rehab Without Walls LLC', 'GROUP', 'Home Health Agency', '', '', NULL, 'O', '4010 Moorpark Ave Ste 112', 'San Jose', 'Santa Clara', 'CA', '95117', '4085560420', NULL, '4010 Moorpark Ave Ste 112', 'San Jose', 'Santa Clara', 'CA', '95117', '4085560420', '', '', NULL, '4', '0.00', '100.00', '0.00', 3, '2007-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '0000833759', 0, 'N', 0, '2012-04-25', NULL, NULL, 0, 0, NULL, NULL),
('061725406', 'W11000536', 'W11000536', 'UT01', 'Gentiva Rehab Without Walls ', '', '', 'Gentiva Rehab Without Walls LLC', 'GROUP', 'Home Health Agency', '', '', NULL, 'O', '1485 Response Rd Ste 220', 'Sacramento', 'Sacramento', 'CA', '95815', '9165671244', NULL, '1485 Response Rd Ste 220', 'Sacramento', 'Sacramento', 'CA', '95815', '9165671244', '', '', NULL, '4', '0.00', '100.00', '0.00', 3, '2007-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '0000833759', 0, 'N', 0, '2012-04-25', NULL, NULL, 0, 0, NULL, NULL),
('061725406', 'W11000537', 'W11000537', 'UT01', 'Gentiva Rehab Without Walls ', '', '', 'Gentiva Rehab Without Walls LLC', 'GROUP', 'Home Health Agency', '', '', NULL, 'O', '1501 W Cameron Ave Ste 210', 'West Covina', 'Los Angeles', 'CA', '91790', '6263384884', NULL, '1501 W Cameron Ave Ste 210', 'West Covina', 'Los Angeles', 'CA', '91790', '6263384884', '', '', NULL, '4', '0.00', '100.00', '0.00', 3, '2007-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '0000833759', 0, 'N', 0, '2012-04-25', 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
('061725406', 'W11000538', 'W11000538', 'UT01', 'Gentiva Rehab Without Walls ', '', '', 'Gentiva Rehab Without Walls LLC', 'GROUP', 'Home Health Agency', '', '', NULL, 'O', '2525 Camino Del Rio S Ste 210', 'San Diego', 'San Diego', 'CA', '92108', '6197189960', NULL, '2525 Camino Del Rio S Ste 210', 'San Diego', 'San Diego', 'CA', '92108', '6197189960', '', '', NULL, '4', '0.00', '100.00', '0.00', 3, '2007-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '0000833759', 0, 'N', 0, '2012-04-25', NULL, NULL, 0, 0, NULL, NULL),
('061725406', 'W11000539', 'W11000539', 'UT01', 'Gentiva Rehab Without Walls ', '', '', 'Gentiva Rehab Without Walls LLC', 'GROUP', 'Home Health Agency', '', '', NULL, 'O', '4500 N State Rd 7 Bldg 1 Ste 105', 'Ft Lauderdale', 'Broward', 'FL', '33319', '9544849550', NULL, '4500 N State Rd 7 Bldg 1 Ste 105', 'Ft Lauderdale', 'Broward', 'FL', '33319', '9544849550', '', '', NULL, '4', '0.00', '100.00', '0.00', 3, '2007-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '0000833759', 0, 'N', 0, '2012-04-25', NULL, NULL, 0, 0, NULL, NULL),
('061725406', 'W11000540', 'W11000540', 'UT01', 'Gentiva Rehab Without Walls ', '', '', 'Gentiva Rehab Without Walls LLC', 'GROUP', 'Home Health Agency', '', '', NULL, 'O', '2311 10th Ave Ste 5', 'Palm Beach', 'Palm Beach', 'FL', '33461', '5615475111', NULL, '2311 10th Ave Ste 5', 'Palm Beach', 'Palm Beach', 'FL', '33461', '5615475111', '', '', NULL, '4', '0.00', '100.00', '0.00', 3, '2007-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '0000833759', 0, 'N', 0, '2012-04-25', NULL, NULL, 0, 0, NULL, NULL),
('061725406', 'W11000541', 'W11000541', 'UT01', 'Gentiva Rehab Without Walls ', '', '', 'Gentiva Rehab Without Walls LLC', 'GROUP', 'Home Health Agency', '', '', NULL, 'O', '3 Hawthorne Pkwy Ste 250', 'Vernon Hills', 'Lake', 'IL', '60061', '8475491473', NULL, '3 Hawthorne Pkwy Ste 250', 'Vernon Hills', 'Lake', 'IL', '60061', '8475491473', '', '', NULL, '4', '0.00', '100.00', '0.00', 3, '2007-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '0000833759', 0, 'N', 0, '2012-04-25', NULL, NULL, 0, 0, NULL, NULL),
('061725406', 'W11000542', 'W11000542', 'UT01', 'Gentiva Rehab Without Walls ', '', '', 'Gentiva Rehab Without Walls LLC', 'GROUP', 'Home Health Agency', '', '', NULL, 'O', '6105 W St Joseph Ste 211', 'Lansing', 'Eaton', 'MI', '48917', '5173231124', NULL, '6105 W St Joseph Ste 211', 'Lansing', 'Eaton', 'MI', '48917', '5173231124', '', '', NULL, '4', '0.00', '100.00', '0.00', 3, '2007-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '0000833759', 0, 'N', 0, '2012-04-25', NULL, NULL, 0, 0, NULL, NULL),
('061725406', 'W11000543', 'W11000543', 'UT01', 'Gentiva Rehab Without Walls ', '', '', 'Gentiva Rehab Without Walls LLC', 'GROUP', 'Home Health Agency', '', '', NULL, 'O', '29836 Telegraph Rd', 'Southfield', 'Oakland', 'MI', '48034', '5173231124', NULL, '29836 Telegraph Rd', 'Southfield', 'Oakland', 'MI', '48034', '5173231124', '', '', NULL, '4', '0.00', '100.00', '0.00', 3, '2007-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '0000833759', 0, 'N', 0, '2012-04-25', NULL, NULL, 0, 0, NULL, NULL),
('061725406', 'W11000544', 'W11000544', 'UT01', 'Gentiva Rehab Without Walls ', '', '', 'Gentiva Rehab Without Walls LLC', 'GROUP', 'Home Health Agency', '', '', NULL, 'O', '505 E Capovilla Ave Ste 105', 'Las Vegas', 'Clark', 'NV', '89119', '7022607329', NULL, '505 E Capovilla Ave Ste 105', 'Las Vegas', 'Clark', 'NV', '89119', '7022607329', '', '', NULL, '4', '0.00', '100.00', '0.00', 3, '2007-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '0000833759', 0, 'N', 0, '2012-04-25', NULL, NULL, 0, 0, NULL, NULL),
('061725406', 'W11000545', 'W11000545', 'UT01', 'Gentiva Rehab Without Walls ', '', '', 'Gentiva Rehab Without Walls LLC', 'GROUP', 'Home Health Agency', '', '', NULL, 'O', '4900 Mill St Ste 1', 'Reno', 'Washoe', 'NV', '89502', '7758581912', NULL, '4900 Mill St Ste 1', 'Reno', 'Washoe', 'NV', '89502', '7758581912', '', '', NULL, '4', '0.00', '100.00', '0.00', 3, '2007-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '0000833759', 0, 'N', 0, '2012-04-25', NULL, NULL, 0, 0, NULL, NULL),
('061725406', 'W11000546', 'W11000546', 'TX01', 'Gentiva Rehab Without Walls ', '', '', 'Gentiva Rehab Without Walls LLC', 'GROUP', 'Home Health Agency', '', '', NULL, 'B', '7801 Mesquite Bend Blvd Ste 106A', 'Irving', 'Dallas', 'TX', '75063', '9728692415', NULL, '7801 Mesquite Bend Blvd Ste 106A', 'Irving', 'Dallas', 'TX', '75063', '9728692415', '', '', NULL, '4', '0.00', '100.00', '0.00', 3, '2007-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '0000833759', 0, 'Y', 0, '2012-04-25', NULL, NULL, 0, 0, NULL, NULL),
('202299593', 'W11000547', 'W11000547', 'WY01', 'Wyoming Range Medical', 'William', 'D', 'Burnett', 'MD', 'Family Practice', '', '', NULL, 'B', 'PO Box 130', 'Big Piney', 'Sublette', 'WY', '83113', '3073823064', NULL, 'PO Box 130', 'Big Piney', 'Sublette', 'WY', '83113', '3073823064', '', '', '', '', '0.00', '7.50', '0.00', 3, '2007-01-01', '2011-09-22', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1760579023', 0, 'Y', 0, '2014-04-01', NULL, NULL, 0, 0, NULL, NULL),
('202299593', 'W11000548', 'W11000548', 'WY01', 'Wyoming Range Medical', 'Darcy', '', 'Turner', 'MD', 'Family Practice', '', '', NULL, 'B', 'PO Box 130', 'Big Piney', 'Sublette', 'WY', '83113', '3073823064', NULL, 'PO Box 130', 'Big Piney', 'Sublette', 'WY', '83113', '3073823064', '', '', NULL, '', '0.00', '7.50', '0.00', 3, '2007-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1487741658', 0, 'Y', 0, '2014-06-25', NULL, NULL, 0, 0, NULL, NULL),
('204011364', 'W11000549', 'W11000549', 'WY01', 'Independent Family Practice', 'Donald', 'J', 'Kirk', 'MD', 'Family Practice', '', '', NULL, 'O', '110 Hospital Ln Bldg 2 Ste 1', 'Afton', 'Lincoln', 'WY', '83110', '3078854437', '', '110 Hospital Ln Bldg 2 Ste 1', 'Afton', 'Lincoln', 'WY', '83110', '3078854437', '', 'wystd', 'wyhcpcs', '', '0.00', '35.00', '0.00', 3, '2006-12-01', NULL, 0, 0, 0, 'Star Valley Medical Center', '', '', '', 'HCFA|UB|', '1861447971', 0, 'N', 0, '2014-07-25', NULL, NULL, 42.7162, -110.931, NULL, NULL),
('204011364', 'W11000550', 'W11000550', 'WY01', 'Independent Family Practice', 'Scott', NULL, 'Bennett', 'DO', 'Family Practice', NULL, NULL, NULL, 'O', '110 Hospital Ln Bldg 2 Ste 1', 'Afton', 'Lincoln', 'WY', '83110', '3078854437', NULL, '122 Peterson Pkwy', 'Thayne', '', 'WY', '83127', '', '', 'wystd', 'wyhcpcs', NULL, '0.00', '35.00', '0.00', 3, '2006-12-01', '2008-11-01', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '0000005261', 0, 'N', 0, '2007-01-11', NULL, NULL, 0, 0, NULL, NULL),
('204011364', 'W11000551', 'W11000551', 'WY01', 'Independent Family Practice', 'Edward', '', 'Henry', 'FNP', 'Family Practice', '', '', NULL, 'O', '110 Hospital Ln Bldg 2 Ste 1', 'Afton', 'Lincoln', 'WY', '83110', '3078854437', NULL, '110 Hospital Ln Bldg 2 Ste 1', 'Afton', 'Lincoln', 'WY', '83110', '3078854437', '          ', 'wystd', 'wyhcpcs', '', '0.00', '35.00', '0.00', 3, '2006-12-01', '2011-05-24', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '0000006675', 0, 'N', 0, '2011-05-24', NULL, NULL, 0, 0, NULL, NULL),
('870519691', 'W11000552', 'W11000552', 'UT01', 'Utah Cancer Specialists', 'Nasfat', 'J', 'Shehadeh', 'MD', 'Hematology and Oncology', 'Oncology', '', NULL, 'O', '82 S 1100 E Ste 403', 'Salt Lake City', 'Salt Lake', 'UT', '84103', '8013641006', NULL, '82 S 1100 E Ste 403', 'Salt Lake City', 'Salt Lake', 'UT', '84103', '8013641006', '          ', 'WUSTDONC5', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 3, '2006-11-01', '2011-06-30', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1538241369', 0, 'N', 0, '2012-06-13', NULL, NULL, 0, 0, NULL, NULL),
('870519691', 'W11000553', 'W11000553', 'UT01', 'Utah Cancer Specialists', 'Jane', 'E', 'MacPherson', 'MD', 'Family Practice', 'Hospice and Palliative Care', '', NULL, 'B', '1121 E 3900 S Bldg C Ste 240', 'Salt Lake City', 'Salt Lake', 'UT', '84124', '8012660878', '8012662074', '1121 E 3900 S Bldg C Ste 240', 'Salt Lake City', 'Salt Lake', 'UT', '84124', '8012660878', '8012662074', 'WUSTDONC5', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 3, '2006-11-01', NULL, 0, 0, 0, 'St Marks Hospital', '', '', '', 'HCFA|UB|', '1699869479', 0, 'Y', 0, '2014-06-16', NULL, NULL, 0, 0, NULL, NULL),
('870519691', 'W11000554', 'W11000554', 'UT01', 'Utah Cancer Specialists', 'Jane', 'E', 'MacPherson', 'MD', 'Family Practice', 'Hospice and Palliative Care', '', NULL, 'O', '5121 S Cottonwood St Bldg A Level 2', 'Murray', 'Salt Lake', 'UT', '84157', '8012633416', '8012662074', '5121 S Cottonwood St Bldg A Level 2', 'Murray', 'Salt Lake', 'UT', '84157', '8012633416', '8012662074', 'WUSTDONC5', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 3, '2006-11-01', '2006-11-01', 0, 0, 0, 'St Marks Hospital', '', '', '', 'HCFA|UB|', '1699869479', 0, 'N', 0, '2014-06-16', NULL, NULL, 0, 0, NULL, NULL),
('870519691', 'W11000555', 'W11000555', 'UT01', 'Utah Cancer Specialists', 'Jane', 'E', 'MacPherson', 'MD', 'Family Practice', 'Hospice and Palliative Care', '', NULL, 'O', '3838 S 700 E Ste 100', 'Salt Lake City', 'Salt Lake', 'UT', '84106', '8012690231', '8012662074', '3838 S 700 E Ste 100', 'Salt Lake City', 'Salt Lake', 'UT', '84106', '8012690231', '8012662074', 'WUSTDONC5', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 3, '2006-11-01', NULL, 0, 0, 0, 'St Marks Hospital', '', '', '', 'HCFA|UB|', '1699869479', 0, 'Y', 0, '2014-06-16', NULL, NULL, 40.6874, -111.871, NULL, NULL),
('621560557', 'W11000556', 'W11000556', 'UT01', 'Morgan Health Center', 'Smitha', '', 'Sadiq', 'MD', 'Internal Medicine', 'Pediatrics', 'Family Practice', NULL, 'B', 'PO Box 71128', 'Salt Lake City', 'Salt Lake', 'UT', '84121', '8018293426', NULL, 'PO Box 71128', 'Salt Lake City', 'Salt Lake', 'UT', '84121', '8018293426', '', 'WiseSTD', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 3, '2006-07-01', '2011-02-15', 0, 0, 0, 'Ogden Regional Medical Center', '', '', '', 'HCFA|UB|', '1962490201', 0, 'Y', 0, '2014-07-10', NULL, NULL, 0, 0, NULL, NULL),
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('237268471', 'W11000630', 'W11000630', 'UT01', 'University Radiology Associates', '', '', 'University Radiology Associates', 'GROUP', 'Diagnostic Radiology', '', '', 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, '2006-08-01', '2012-08-01', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '0000009332', 0, 'N', 0, '2012-08-02', NULL, NULL, 0, 0, NULL, NULL),
('621795211', 'W11000631', 'W11000631', 'UT01', 'Salt Lake Regional Physican', 'Jodie', 'K', 'Levitt', 'MD', 'Neurosurgery', NULL, NULL, NULL, 'O', '1060 E 100 S Ste 101', 'Salt Lake City', 'Salt Lake', 'UT', '84102', '8015981041', NULL, '1060 E 100 S Ste 101', 'Salt Lake City', 'Salt Lake', 'UT', '84102', '8015981041', '', 'WUSTDSURG5', 'WUSTDHCPC5', NULL, '0.00', '35.00', '0.00', 6, '2007-03-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1053325365', 0, 'N', 0, '2012-05-07', NULL, NULL, 40.7672, -111.861, NULL, NULL),
('621795211', 'W11000632', 'W11000632', 'UT01', 'Salt Lake Regional Physican', 'Jodie', 'K', 'Levitt', 'MD', 'Neurosurgery', NULL, NULL, NULL, 'B', 'PO Box 572528', 'Salt Lake City', 'Salt Lake', 'UT', '84157', '8015981041', NULL, 'PO Box 572528', 'Salt Lake City', 'Salt Lake', 'UT', '84157', '8015981041', '', 'WUSTDSURG5', 'WUSTDHCPC5', NULL, '0.00', '35.00', '0.00', 6, '2007-03-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1053325365', 0, 'Y', 0, '2012-05-07', NULL, NULL, 0, 0, NULL, NULL),
('061128081', 'W11000633', 'W11000633', 'NA01', 'Dianon Systems Inc', '', '', 'Dianon Systems Inc', 'GROUP', 'Laboratory', '', '', NULL, 'B', 'Phone Number Only', '', NULL, '', '', '8003282666', NULL, 'Phone Number Only', '', '', '', '', '8003282666', '', 'WDIANON', NULL, '', '0.00', '35.00', '0.00', 3, '2006-12-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1003819020', 0, 'Y', 0, '2014-06-03', '', NULL, 0, 0, NULL, NULL),
('870640775', 'W11000634', 'W11000634', 'UT01', 'University Health Care', 'Bruce', 'E', 'Bray', 'MD', 'Cardiovascular Disease', 'Internal Medicine', 'Echocardiography', NULL, 'o', '1743 W Redstone Ctr Ste 115', 'Park City', 'Summit', 'UT', '84098', '4356589200', NULL, NULL, NULL, '', NULL, NULL, '', '', 'WISESTD', 'WUSTDHCPC5', NULL, '0.00', '35.00', NULL, 3, '2006-08-01', '2007-07-31', 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1124118708', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('205050083', 'W11000635', 'W11000635', 'WY01', 'Wyoming Vision Center', 'Alison', 'A', 'Arrants', 'OD', 'Optometry', '', '', NULL, 'O', '2820 Foothill Blvd', 'Rock Springs', 'Sweetwater', 'WY', '82901', '3073824444', NULL, '2820 Foothill Blvd', 'Rock Springs', 'Sweetwater', 'WY', '82901', '3073824444', '', 'WYSTD', 'wyhcpcs', NULL, '0.00', '35.00', '0.00', 3, '2007-05-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1144270091', 0, 'N', 0, '2014-05-07', NULL, NULL, 41.5832, -109.256, 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
('205050083', 'W11000636', 'W11000636', 'WY01', 'Wyoming Vision Center', 'Alison', 'A', 'Arrants', 'OD', 'Optometry', '', '', NULL, 'B', 'PO Box 2250', 'Rock Springs', 'Sweetwater', 'WY', '82902', '3073824444', NULL, 'PO Box 2250', 'Rock Springs', 'Sweetwater', 'WY', '82902', '3073824444', '', 'WYSTD', 'wyhcpcs', NULL, '0.00', '35.00', '0.00', 3, '2007-05-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1144270091', 0, 'Y', 0, '2014-05-07', NULL, NULL, 0, 0, NULL, NULL),
('204844228', 'W11000637', 'W11000637', 'UT01', NULL, 'Janet', 'M', 'Balbierz', 'MD', 'Physical Medicine and Rehabilitation', 'Physical Medicine and Rehabilitation', NULL, NULL, 'O', '166 E 5900 S Ste B106', 'Murray', 'Salt Lake', 'UT', '84107', '8017436444', NULL, '166 E 5900 S Ste B106', 'Murray', 'Salt Lake', 'UT', '84107', '8017436444', '', 'WISESTD', 'WUSTDHCPC5', NULL, '0.00', '35.00', '0.00', 3, '2007-01-01', NULL, 0, 0, 0, 'St Marks Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1801829650', 0, 'N', 0, '2011-03-28', NULL, NULL, 40.6428, -111.886, NULL, NULL),
('204844228', 'W11000638', 'W11000638', 'UT01', NULL, 'Janet', 'M', 'Balbierz', 'MD', 'Physical Medicine and Rehabilitation', 'Physical Medicine and Rehabilitation', NULL, NULL, 'B', 'PO Box 27688', 'Salt Lake City', 'Salt Lake', 'UT', '84127', '8017436444', NULL, 'PO Box 27688', 'Salt Lake City', 'Salt Lake', 'UT', '84127', '8017436444', '', 'WISESTD', 'WUSTDHCPC5', NULL, '0.00', '35.00', '0.00', 3, '2007-01-01', NULL, 0, 0, 0, 'St Marks Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1801829650', 0, 'Y', 0, '2011-03-28', NULL, NULL, 0, 0, NULL, NULL),
('330892907', 'W11000639', 'W11000639', 'UT01', 'Nufactor', '', '', 'Nufactor', 'GROUP', 'Infusion Agency', '', '', NULL, 'O', 'Phone Number Only', '', '', '', '', '8003236832', '8002117418', 'Phone Number Only', '', '', '', '', '8003236832', '8002117418', '', '', '1001', '0.00', '0.00', '0.00', 3, '2006-12-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1861599540', 0, 'N', 0, '2013-06-18', NULL, NULL, 0, 0, NULL, NULL),
('562595369', 'W11000640', 'W11000640', 'UT01', NULL, 'Scott', '', 'Allen', 'OD', 'Optometry', '', '', NULL, 'O', '307 N 300 W Ste 302', 'Kaysville', 'Davis', 'UT', '84037', '8014449977', NULL, '307 N 300 W Ste 302', 'Kaysville', 'Davis', 'UT', '84037', '8014449977', '', 'WUTALBERT5', NULL, NULL, '0.00', '35.00', '0.00', 3, '2007-05-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1255442885', 0, 'N', 0, '2014-01-31', NULL, NULL, 41.0399, -111.944, NULL, NULL),
('841396314', 'W11000641', 'W11000641', 'UT01', 'Harmony Home Health and Hospice', NULL, NULL, 'Harmony Home Health and Hospice', 'GROUP', 'Home Health Agency', 'Hospice', NULL, NULL, 'O', '5660 S Green St', 'Murray', 'Salt Lake', 'UT', '84123', '8774633322', '8012663482', '5660 S Green St', 'Murray', '', 'UT', '84123', '', '', '', NULL, '4', '0.00', '30.00', '0.00', 3, '2007-04-01', NULL, 1, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1629025192', 0, 'N', 0, '2007-04-11', NULL, NULL, 0, 0, NULL, NULL),
('870617520', 'W11000642', 'W11000642', 'UT01', 'Infusion Innovations', NULL, NULL, 'Infusion Innovations', 'GROUP', 'Home IV Infusion Agency', NULL, NULL, NULL, 'O', ' ', '', NULL, '', '', '8003228695', NULL, '2446 S Progress Dr', 'Salt Lake City', '', 'UT', '84119', '', '', NULL, NULL, '1001', '0.00', '100.00', NULL, 3, '2006-10-01', '2007-07-31', 1, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1023192390', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('841396314', 'W11000643', 'W11000643', 'UT01', 'Harmony Home Health and Hospice', NULL, NULL, 'Harmony Home Health and Hospice', 'GROUP', 'Home Health Agency', 'Hospice', NULL, NULL, 'O', '1424 Legend Hills Dr Ste 110', 'Clearfield', 'Davis', 'UT', '84015', '8774633322', '8012663482', '5660 S Green St', 'Murray', '', 'UT', '84123', '', '', '', NULL, '4', '0.00', '30.00', '0.00', 3, '2007-04-01', NULL, 1, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1629025192', 0, 'N', 0, '2007-04-11', NULL, NULL, 41.099, -111.997, NULL, NULL),
('841396314', 'W11000644', 'W11000644', 'UT01', 'Harmony Home Health and Hospice', NULL, NULL, 'Harmony Home Health and Hospice', 'GROUP', 'Home Health Agency', 'Hospice', NULL, NULL, 'O', '1815 S State St Ste 120', 'Orem', 'Utah', 'UT', '84097', '8774633322', '8012663482', '5660 S Green St', 'Murray', '', 'UT', '84123', '', '', '', NULL, '4', '0.00', '30.00', '0.00', 3, '2007-04-01', NULL, 1, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1629025192', 0, 'N', 0, '2007-04-11', NULL, NULL, 0, 0, NULL, NULL),
('841396314', 'W11000645', 'W11000645', 'UT01', 'Harmony Home Health and Hospice', NULL, NULL, 'Harmony Home Health and Hospice', 'GROUP', 'Home Health Agency', 'Hospice', NULL, NULL, 'O', '1929 Aaron Dr Ste H', 'Tooele', 'Tooele', 'UT', '84074', '8774633322', '8012663482', '5660 S Green St', 'Murray', '', 'UT', '84123', '', '', '', NULL, '4', '0.00', '30.00', '0.00', 3, '2007-04-01', NULL, 1, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1629025192', 0, 'N', 0, '2007-04-11', NULL, NULL, 40.5651, -112.298, NULL, NULL),
('562609286', 'W11000646', 'W11000646', 'UT01', 'Wendover Eye Care', 'Lanny', 'F', 'Duclos', 'OD', 'Optometry', NULL, NULL, NULL, 'O', '479 E Wendover Blvd', 'Wendover', 'Tooele', 'UT', '84083', '4356657923', NULL, '479 E Wendover Blvd', 'Wendover', 'Tooele', 'UT', '84083', '4356657923', '          ', 'WUTALBERT5', '', '', '0.00', '35.00', '0.00', 3, '2007-04-01', '2011-09-12', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1508827262', 0, 'N', 0, '2012-03-13', NULL, NULL, 0, 0, NULL, NULL),
('562609286', 'W11000647', 'W11000647', 'UT01', 'Wendover Eye Care', 'Lanny', 'F', 'Duclos', 'OD', 'Optometry', NULL, NULL, NULL, 'B', '88 E 700 N Ste A', 'Tooele', 'Tooele', 'UT', '84074', '4356657923', NULL, '88 E 700 N Ste A', 'Tooele', 'Tooele', 'UT', '84074', '4356657923', '', 'WUTALBERT5', NULL, NULL, '0.00', '35.00', '0.00', 3, '2007-04-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1508827262', 0, 'Y', 0, '2012-03-13', NULL, NULL, 0, 0, NULL, NULL),
('870574267', 'W11000648', 'W11000648', 'UT01', 'The Er Group', 'Nolan', 'R', 'Brooksby', 'DO', 'Family Practice', 'Emergency Medicine', '', NULL, 'B', 'PO Box 96398', 'Oklahoma City', 'Oklahoma', 'OK', '73143', '4357893342', NULL, 'PO Box 96398', 'Oklahoma City', 'Oklahoma', 'OK', '73143', '4357893342', '', '', NULL, NULL, '0.00', '10.00', '0.00', 3, '2007-01-01', NULL, 0, 0, 0, 'Ashley Valley Regional Medical', '', '', '', 'HCFA|UB|', '1912949603', 0, 'Y', 0, '2013-01-14', NULL, NULL, 0, 0, NULL, NULL),
('870574267', 'W11000649', 'W11000649', 'UT01', 'The Er Group', 'Wallace', 'J', 'Salter', 'MD', 'Emergency Medicine', NULL, NULL, NULL, 'B', 'PO Box 96398', 'Oklahoma City', 'Oklahoma', 'OK', '73143', '4357893342', NULL, 'PO Box 96398', 'Oklahoma City', '', 'OK', '83143', '', '', '', NULL, NULL, '0.00', '10.00', '0.00', 3, '2007-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1851491070', 0, 'Y', 0, '2007-04-11', NULL, NULL, 0, 0, NULL, NULL),
('870574267', 'W11000650', 'W11000650', 'UT01', 'The Er Group', 'Hilary', 'J', 'Sarhatt', 'DO', 'Emergency Medicine', NULL, NULL, NULL, 'B', 'PO Box 96398', 'Oklahoma City', 'Oklahoma', 'OK', '73143', '4357893342', NULL, 'PO Box 96398', 'Oklahoma City', '', 'OK', '83143', '', '', '', NULL, NULL, '0.00', '10.00', '0.00', 3, '2007-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1174573679', 0, 'Y', 0, '2007-04-11', NULL, NULL, 0, 0, NULL, NULL),
('870574267', 'W11000651', 'W11000651', 'UT01', 'The Er Group', 'Nolan', 'R', 'Brooksby', 'DO', 'Family Practice', 'Emergency Medicine', '', NULL, 'O', '151 W 200 N', 'Vernal', 'Uintah', 'UT', '84078', '8002250953', NULL, '151 W 200 N', 'Vernal', 'Uintah', 'UT', '84078', '8002250953', '', '', NULL, NULL, '0.00', '10.00', '0.00', 3, '2007-01-01', NULL, 0, 0, 0, 'Ashley Valley Regional Medical', '', '', '', 'HCFA|UB|', '1912949603', 0, 'Y', 0, '2013-01-14', NULL, NULL, 40.4585, -109.531, NULL, NULL),
('870574267', 'W11000652', 'W11000652', 'UT01', 'The Er Group', 'Hilary', 'J', 'Sarhatt', 'DO', 'Emergency Medicine', NULL, NULL, NULL, 'O', '151 W 200 N', 'Vernal', 'Uintah', 'UT', '84078', '8002250953', NULL, 'PO Box 96398', 'Oklahoma City', '', 'OK', '83143', '', '', '', NULL, NULL, '0.00', '10.00', '0.00', 3, '2007-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1174573679', 0, 'Y', 0, '2007-04-11', NULL, NULL, 40.4585, -109.531, NULL, NULL),
('870574267', 'W11000653', 'W11000653', 'UT01', 'The Er Group', 'Wallace', 'J', 'Salter', 'MD', 'Emergency Medicine', NULL, NULL, NULL, 'O', '151 W 200 N', 'Vernal', 'Uintah', 'UT', '84078', '8002250953', NULL, 'PO Box 96398', 'Oklahoma City', '', 'OK', '83143', '', '', '', NULL, NULL, '0.00', '10.00', '0.00', 3, '2007-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1851491070', 0, 'Y', 0, '2007-04-11', NULL, NULL, 0, 0, NULL, NULL),
('870442129', 'W11000654', 'W11000654', 'UT01', 'U of U Department of Anesthesiology', 'Karen', NULL, 'Madigan', 'CRNA', 'Anesthesiology', NULL, NULL, NULL, 'B', 'Po Box 581053', 'Salt Lake City', 'Salt Lake', 'UT', '84158', '8012133800', NULL, NULL, NULL, '', NULL, NULL, '', '', NULL, NULL, '1000', '44.00', NULL, NULL, 3, '2007-05-01', '2007-07-31', 1, 12, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1740213602', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870442129', 'W11000655', 'W11000655', 'UT01', 'U of U Department of Anesthesiology', 'Karen', NULL, 'Madigan', 'CRNA', 'Anesthesiology', NULL, NULL, NULL, 'O', '50 N Medical Dr', 'Salt Lake City', 'Salt Lake', 'UT', '84132', '8015819393', NULL, NULL, NULL, '', NULL, NULL, '', '', NULL, NULL, '1000', '44.00', NULL, NULL, 3, '2007-05-01', '2007-07-31', 1, 12, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1740213602', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('411694999', 'W11000656', 'W11000656', 'NA01', 'Disetronic Medical Systems (Diabetic Equipment and Supplies)', NULL, NULL, 'Disetronic Medical Systems (Diabetic Equipment and Supplies)', 'GROUP', 'Durable Medical Equipment', NULL, NULL, NULL, 'O', 'Phone Number Only 8002807801', '', NULL, '', '', '8002807801', '8888100758', '11800 Exit 5 Pkwy', 'Fisher', '', 'IN', '46037', '', '', 'WDISETR', NULL, NULL, '0.00', '30.00', '0.00', 3, '2006-12-01', '2010-04-01', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1710980156', 0, 'Y', 0, '2008-10-08', NULL, NULL, 0, 0, NULL, NULL),
('043115329', 'W11000657', 'W11000657', 'UT01', 'Critical Care Systems ', '', '', 'Critical Care Systems ', 'GROUP', 'Infusion Agency', NULL, NULL, NULL, 'O', 'Phone Number Only', '', '', '', '', '8669789600', '8019780020', 'Phone Number Only 8669789600', '', '', '', '', '8669789600', '8019780020', '', '', '1001', '0.00', '100.00', '0.00', 3, '2007-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1588692164', 0, 'N', 0, '2012-02-13', NULL, NULL, 0, 0, NULL, NULL),
('522229954', 'W11000658', 'W11000658', 'UT01', 'Life Centre Physical Therapy', 'Quinn', NULL, 'Christensen', 'OT', 'Physical Therapy', NULL, NULL, NULL, 'B', 'PO Box 74125', 'Salt Lake City', 'Salt Lake', 'UT', '84171', '8019422729', NULL, NULL, NULL, '', NULL, NULL, '', '', 'WestRehab', 'WUSTDHCPC5', NULL, '0.00', NULL, '58.00', 3, '2006-05-01', '2006-05-01', 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1972691749', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('522229954', 'W11000659', 'W11000659', 'UT01', 'Life Centre Physical Therapy', 'Alan', 'Kenneth', 'Ward', 'PT', 'Physical Therapy', 'Occupational Therapy', NULL, NULL, 'B', 'PO Box 74125', 'Salt Lake City', 'Salt Lake', 'UT', '84171', '8019422729', NULL, NULL, NULL, '', NULL, NULL, '', '', 'WestRehab', 'WUSTDHCPC5', NULL, '0.00', NULL, '58.00', 3, '2006-05-01', '2006-05-01', 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1811965817', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('522229954', 'W11000660', 'W11000660', 'UT01', 'Mountain Land Rehabilitation', 'Quinn', NULL, 'Christensen', 'OT', 'Occupational Therapy', NULL, NULL, NULL, 'O', '1745 E 280 N', 'St George', 'Salt Lake', 'UT', '84171', '4356285701', NULL, '1745 E 280 N', 'St George', '', 'UT', '84171', '', '', 'WestRehab', 'WUSTDHCPC5', NULL, '0.00', NULL, '58.00', 3, '2006-05-01', '2006-05-01', 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1972691749', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('522229954', 'W11000661', 'W11000661', 'UT01', 'Mountain Land Rehabilitation', 'Alan', 'Kenneth', 'Ward', 'PT', 'Physical Therapy', 'Occupational Therapy', NULL, NULL, 'O', '364 W 100 N', 'St George', 'Salt Lake', 'UT', '84171', '4355872116', NULL, '364 W 100 N', 'St George', '', 'UT', '84171', '', '', 'WestRehab', 'WUSTDHCPC5', NULL, '0.00', NULL, '58.00', 3, '2006-05-01', '2006-05-01', 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1811965817', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('522229954', 'W11000662', 'W11000662', 'UT01', 'Mountain Land Rehabilitation', 'Alan', 'Kenneth', 'Ward', 'PT', 'Physical Therapy', 'Occupational Therapy', NULL, NULL, 'O', '818 N 400 W', 'St George', 'Salt Lake', 'UT', '84171', '4356783869', NULL, '818 N 400 W', 'St George', '', 'UT', '84171', '', '', 'WestRehab', 'WUSTDHCPC5', NULL, '0.00', NULL, '58.00', 3, '2006-05-01', '2006-05-01', 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1811965817', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('431850570', 'W11000663', 'W11000663', 'UT01', 'Caremark', '', '', 'Choice Source Therapeutics', 'GROUP', 'Infusion Agency', NULL, NULL, NULL, 'O', 'Phone Number Only', '', '', '', '', '8002372767', NULL, 'Phone Number Only 8002372767', '', '', '', '', '8002372767', '          ', '', '', '1001', '0.00', '0.00', '0.00', 3, '2007-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1164403069', 0, 'N', 0, '2011-09-20', NULL, NULL, 0, 0, NULL, NULL),
('870519172', 'W11000664', 'W11000664', 'UT01', 'Utah Heart Clinic', 'Ruben', 'Alberto', 'Zito', 'MD', 'Cardiovascular Disease', 'Internal Medicine', '', NULL, 'O', '9844 S 1300 E Ste 350', 'Salt Lake City', 'Salt Lake', 'UT', '84094', '8014083900', '8014083909', '9844 S 1300 E Ste 350', 'Salt Lake City', 'Salt Lake', 'UT', '84094', '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),
('743003947', 'W11000665', 'W11000665', 'TX01', 'The San Antonio Orthopaedic Group', 'Deborah', 'M', 'Egger', 'PA', 'Orthopedic Surgery', '', '', NULL, 'B', 'PO Box 2516', 'San Antonio', 'Bexar', 'TX', '78258', '8004454263', NULL, 'PO Box 2516', 'San Antonio', 'Bexar', 'TX', '78258', '8004454263', '', 'TXORTHO', 'TXHCPCS', NULL, '0.00', '50.00', '0.00', 3, '2007-01-01', '2012-08-19', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1669407441', 0, 'Y', 0, '2013-09-26', NULL, NULL, 0, 0, NULL, NULL),
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('870542403', 'W11000700', 'W11000700', 'UT01', 'Intermountain Anesthesia', '', '', 'Intermountain Anesthesia', 'GROUP', 'Anesthesiology', NULL, NULL, NULL, 'O', '3580 W 9000 S', 'West Jordan', 'Salt Lake', 'UT', '84088', '8019939506', NULL, '1954 E Fort Union Bvld', 'Salt Lake City', '', 'UT', '84121', '', '', '', NULL, '1000', '41.23', '0.00', '0.00', 6, '2007-12-01', NULL, 1, 12, 0, '', '', '', '', 'HCFA|UB|', '1205865029', 0, 'Y', 0, '2007-01-10', NULL, NULL, 40.5879, -111.975, NULL, NULL),
('203093502', 'W11000701', 'W11000701', 'UT01', NULL, 'Richard', 'E', 'Lambert', 'MD', 'Anesthesiology', NULL, NULL, NULL, 'B', '1954 Fort Union Blvd Ste 107', 'Salt Lake City', 'Salt Lake', 'UT', '84121', '8019939506', NULL, '1954 E Ft Union Blvd', 'Salt Lake City', '', 'UT', '84121', '', '', '', NULL, '1000', '48.50', '0.00', '0.00', 3, '2007-12-01', NULL, 1, 12, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1154435485', 0, 'Y', 0, '2007-03-23', NULL, NULL, 0, 0, NULL, NULL),
('203093502', 'W11000702', 'W11000702', 'UT01', NULL, 'Richard', 'E', 'Lambert', 'MD', 'Anesthesiology', NULL, NULL, NULL, 'O', '3580 W 9000 S', 'West Jordan', 'Salt Lake', 'UT', '84088', '8019939506', NULL, '1954 E Ft Union Blvd', 'Salt Lake City', '', 'UT', '84121', '', '', '', NULL, '1000', '48.50', '0.00', '0.00', 3, '2007-12-01', NULL, 1, 12, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1154435485', 0, 'Y', 0, '2007-03-23', NULL, NULL, 40.5879, -111.975, NULL, NULL),
('562609286', 'W11000703', 'W11000703', 'UT01', 'Wendover Eye Care', 'Scott', '', 'Allen', 'OD', 'Optometry', '', '', NULL, 'O', '479 E Wendover Blvd', 'Wendover', 'Tooele', 'UT', '84083', '4356657923', NULL, '479 E Wendover Blvd', 'Wendover', 'Tooele', 'UT', '84083', '4356657923', '', 'WUTALBERT5', NULL, NULL, '0.00', '35.00', '0.00', 3, '2007-04-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1255442885', 0, 'N', 0, '2014-01-31', NULL, NULL, 40.7372, -114.037, NULL, NULL),
('562609286', 'W11000704', 'W11000704', 'UT01', 'Wendover Eye Care', 'Scott', '', 'Allen', 'OD', 'Optometry', '', '', NULL, 'B', '88 E 700 N Ste A', 'Tooele', 'Tooele', 'UT', '84074', '4356657923', NULL, '88 E 700 N Ste A', 'Tooele', 'Tooele', 'UT', '84074', '4356657923', '', 'WUTALBERT5', NULL, NULL, '0.00', '35.00', '0.00', 3, '2007-04-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1255442885', 0, 'Y', 0, '2014-01-31', NULL, NULL, 0, 0, NULL, NULL),
('870661635', 'W11000705', 'W11000705', 'UT01', NULL, 'Joseph', 'E', 'Morgan', 'MD', 'Anesthesiology', NULL, NULL, NULL, 'O', '3580 W 9000 S', 'West Jordan', 'Salt Lake', 'UT', '84088', '8019939506', NULL, '1954 E Ft Union Blvd', 'Salt Lake City', '', 'UT', '84121', '', '', '', NULL, '1000', '48.50', '0.00', '0.00', 3, '2007-12-01', NULL, 1, 12, 0, 'Jordan Valley Medical Center', 'Pioneer Valley Hospital', NULL, NULL, 'HCFA|UB|', '1023121464', 0, 'Y', 0, '2007-03-23', NULL, NULL, 40.5879, -111.975, NULL, NULL),
('870661635', 'W11000706', 'W11000706', 'UT01', NULL, 'Joseph', 'E', 'Morgan', 'MD', 'Anesthesiology', NULL, NULL, NULL, 'B', '1954 Fort Union Blvd Ste 107', 'Salt Lake City', 'Salt Lake', 'UT', '84121', '8019939506', NULL, '1954 E Ft Union Blvd', 'Salt Lake City', '', 'UT', '84121', '', '', '', NULL, '1000', '48.50', '0.00', '0.00', 3, '2007-12-01', NULL, 1, 12, 0, 'Jordan Valley Medical Center', 'Pioneer Valley Hospital', NULL, NULL, 'HCFA|UB|', '1023121464', 0, 'Y', 0, '2007-03-23', NULL, NULL, 0, 0, NULL, NULL),
('870533611', 'W11000707', 'W11000707', 'UT01', 'North Davis Anesthesiology', 'Mark', 'E', 'Rush', 'MD', 'Pain Management', 'Anesthesiology', '', NULL, 'B', 'PO Box 160354', 'Clearfield', 'Davis', 'UT', '84016', '8017748992', NULL, 'PO Box 160354', 'Clearfield', '', 'UT', '84016', '', '', '', NULL, '1000', '48.00', '0.00', '0.00', 6, '2007-01-01', '2008-06-30', 1, 12, 0, 'Davis Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1801840806', 0, 'Y', 0, '2008-06-30', NULL, NULL, 0, 0, NULL, NULL),
('870533611', 'W11000708', 'W11000708', 'UT01', 'North Davis Anesthesiology', 'Mark', 'R', 'Gillis', 'MD', 'Anesthesiology', '', '', NULL, 'B', 'PO Box 160354', 'Clearfield', 'Davis', 'UT', '84016', '8017748992', NULL, 'PO Box 160354', 'Clearfield', '', 'UT', '84016', '', '', '', NULL, '1000', '48.00', '0.00', '0.00', 6, '2007-01-01', '2008-06-30', 1, 12, 0, 'Davis Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1154390177', 0, 'Y', 0, '2008-06-30', NULL, NULL, 0, 0, NULL, NULL),
('870533611', 'W11000709', 'W11000709', 'UT01', 'North Davis Anesthesiology', 'Brian', 'C', 'Hales', 'MD', 'Anesthesiology', '', '', NULL, 'B', 'PO Box 160354', 'Clearfield', 'Davis', 'UT', '84016', '8017748992', NULL, 'PO Box 160354', 'Clearfield', 'Davis', 'UT', '84016', '8017748992', '          ', '', '', '1000', '48.00', '0.00', '0.00', 6, '2007-01-01', '2008-06-30', 1, 12, 0, 'Davis Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1053396770', 0, 'Y', 0, '2012-06-13', NULL, NULL, 0, 0, NULL, NULL),
('870533611', 'W11000710', 'W11000710', 'UT01', 'North Davis Anesthesiology', '', '', 'North Davis Anesthesiology', 'GROUP', 'Anesthesiology', '', '', NULL, 'B', 'PO Box 160354', 'Clearfield', 'Davis', 'UT', '84016', '8017748992', NULL, 'PO Box 98', 'Farmington', '', 'UT', '84025', '', '', '', NULL, '1000', '48.00', '0.00', '0.00', 6, '2007-01-01', '2008-06-30', 1, 12, 0, '', '', '', '', 'HCFA|UB|', '1679525901', 0, 'Y', 0, '2008-06-30', NULL, NULL, 0, 0, NULL, NULL),
('870533611', 'W11000711', 'W11000711', 'UT01', 'North Davis Anesthesiology', 'Melvin', 'K', 'Richardson', 'MD', 'Anesthesiology', '', '', NULL, 'B', 'PO Box 160354', 'Clearfield', 'Davis', 'UT', '84016', '8017748992', NULL, 'PO Box 160354', 'Clearfield', '', 'UT', '84016', '', '', '', NULL, '1000', '48.00', '0.00', '0.00', 6, '2007-01-01', '2008-06-30', 1, 12, 0, 'Davis Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1467401737', 0, 'Y', 0, '2008-06-30', NULL, NULL, 0, 0, NULL, NULL),
('870533611', 'W11000712', 'W11000712', 'UT01', 'North Davis Anesthesiology', 'Clay', '', 'Richardson', 'DO', 'Anesthesiology', '', '', NULL, 'B', '1652 Wildcat Ln', 'Ogden', 'Weber', 'UT', '84403', '8013932249', NULL, '1652 Wildcat Ln', 'Ogden', '', 'UT', '84403', '', '', '', NULL, '1000', '48.00', '0.00', '0.00', 6, '2007-01-01', '2008-06-30', 1, 12, 0, 'Davis Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1295950731', 0, 'Y', 0, '2008-06-30', NULL, NULL, 0, 0, NULL, NULL),
('870533611', 'W11000713', 'W11000713', 'UT01', 'North Davis Anesthesiology', '', '', 'North Davis Anesthesiology', 'GROUP', 'Anesthesiology', '', '', NULL, 'O', '1652 Wildcat Ln Ste 1', 'Ogden', 'Weber', 'UT', '84403', '8013932249', NULL, 'PO Box 98', 'Farmington', '', 'UT', '84025', '', '', '', NULL, '1000', '45.00', '0.00', '0.00', 6, '2007-01-01', '2008-06-30', 1, 12, 0, '', '', '', '', 'HCFA|UB|', '1679525901', 0, 'Y', 0, '2008-06-30', NULL, NULL, 0, 0, NULL, NULL),
('870533611', 'W11000714', 'W11000714', 'UT01', 'North Davis Anesthesiology', '', '', 'North Davis Anesthesiology', 'GROUP', 'Anesthesiology', '', '', NULL, 'O', '1600 W Antelope Dr', 'Layton', 'Davis', 'UT', '84041', '8017748992', '8015250347', 'PO Box 98', 'Farmington', '', 'UT', '84025', '', '', '', NULL, '1000', '45.00', '0.00', '0.00', 6, '2007-01-01', '2008-06-30', 1, 12, 0, '', '', '', '', 'HCFA|UB|', '1679525901', 0, 'Y', 0, '2008-06-30', NULL, NULL, 0, 0, NULL, NULL),
('870571510', 'W11000715', 'W11000715', 'UT01', 'Layton Ambulatory Anesthesia', 'Bryan', 'G', 'Holbrook', 'MD', 'Pain Management', 'Anesthesiology', '', NULL, 'B', 'PO Box 160354', 'Clearfield', 'Davis', 'UT', '84016', '8017748992', '8015250347', 'PO Box 160354', 'Clearfield', '', 'UT', '84016', '', '', '', NULL, '1000', '48.00', '0.00', '0.00', 3, '2007-01-01', '2008-06-30', 1, 12, 0, 'Davis Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1427034081', 0, 'Y', 0, '2008-06-30', NULL, NULL, 0, 0, NULL, NULL),
('870571510', 'W11000716', 'W11000716', 'UT01', 'Layton Ambulatory Anesthesia', 'Earl', 'K', 'Leeman', 'MD', 'Anesthesiology', '', '', NULL, 'B', 'PO Box 160354', 'Clearfield', 'Davis', 'UT', '84016', '8017748992', '8015250347', 'PO Box 160354', 'Clearfield', '', 'UT', '84016', '', '', '', NULL, '1000', '48.00', '0.00', '0.00', 3, '2007-01-01', '2008-06-30', 1, 12, 0, '', '', '', '', 'HCFA|UB|', '1831174333', 0, 'Y', 0, '2008-06-30', NULL, NULL, 0, 0, NULL, NULL),
('870571510', 'W11000717', 'W11000717', 'UT01', 'Layton Ambulatory Anesthesia', 'Clark', 'E', 'Petersen', 'MD', 'Anesthesiology', '', '', NULL, 'B', 'PO Box 160354', 'Clearfield', 'Davis', 'UT', '84016', '8017748992', '8015250347', 'PO Box 160354', 'Clearfield', '', 'UT', '84016', '', '', '', NULL, '1000', '48.00', '0.00', '0.00', 3, '2007-01-01', '2008-06-30', 1, 12, 0, 'Davis Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1275519894', 0, 'Y', 0, '2008-06-30', NULL, NULL, 0, 0, NULL, NULL),
('870571510', 'W11000718', 'W11000718', 'UT01', 'Layton Ambulatory Anesthesia', 'Christopher', 'G', 'Reveley', 'MD', 'Anesthesiology', '', '', NULL, 'B', 'PO Box 160354', 'Clearfield', 'Davis', 'UT', '84016', '8017748992', '8015250347', 'PO Box 160354', 'Clearfield', '', 'UT', '84016', '', '', '', NULL, '1000', '48.00', '0.00', '0.00', 3, '2007-01-01', '2008-06-30', 1, 12, 0, '', '', '', '', 'HCFA|UB|', '1144206723', 0, 'Y', 0, '2008-06-30', NULL, NULL, 0, 0, NULL, NULL),
('870571510', 'W11000719', 'W11000719', 'UT01', 'Layton Ambulatory Anesthesia', 'Robert', 'M', 'Sorensen', 'MD', 'Anesthesiology', '', '', NULL, 'B', 'PO Box 160354', 'Clearfield', 'Davis', 'UT', '84016', '8017748992', '8015250347', 'PO Box 160354', 'Clearfield', '', 'UT', '84016', '', '', '', NULL, '1000', '48.00', '0.00', '0.00', 3, '2007-01-01', '2008-06-30', 1, 12, 0, '', '', '', '', 'HCFA|UB|', '1609852243', 0, 'Y', 0, '2008-06-30', NULL, NULL, 0, 0, NULL, NULL),
('870571510', 'W11000720', 'W11000720', 'UT01', 'Layton Ambulatory Anesthesia', 'Earl', 'K', 'Leeman', 'MD', 'Anesthesiology', '', '', NULL, 'O', '1544 W Antelope Dr', 'Layton', 'Davis', 'UT', '84041', '8017748992', '8015250347', 'PO Box 160354', 'Clearfield', '', 'UT', '84016', '', '', '', NULL, '1000', '48.00', '0.00', '0.00', 3, '2007-01-01', '2008-06-30', 1, 12, 0, '', '', '', '', 'HCFA|UB|', '1831174333', 0, 'Y', 0, '2008-06-30', NULL, NULL, 0, 0, NULL, NULL),
('870571510', 'W11000721', 'W11000721', 'UT01', 'Layton Ambulatory Anesthesia', 'Clark', 'E', 'Petersen', 'MD', 'Anesthesiology', '', '', NULL, 'O', '1544 W Antelope Dr', 'Layton', 'Davis', 'UT', '84041', '8017748992', '8015250347', 'PO Box 160354', 'Clearfield', '', 'UT', '84016', '', '', '', NULL, '1000', '48.00', '0.00', '0.00', 3, '2007-01-01', '2008-06-30', 1, 12, 0, 'Davis Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1275519894', 0, 'Y', 0, '2008-06-30', NULL, NULL, 0, 0, NULL, NULL),
('870571510', 'W11000722', 'W11000722', 'UT01', 'Layton Ambulatory Anesthesia', 'Christopher', 'G', 'Reveley', 'MD', 'Anesthesiology', '', '', NULL, 'O', '1544 W Antelope Dr', 'Layton', 'Davis', 'UT', '84041', '8017748992', '8015250347', '1544 W Antelope Dr', 'Layton', 'Davis', 'UT', '84041', '8017748992', '8015250347', '', '', '1000', '48.00', '0.00', '0.00', 3, '2007-01-01', '2008-06-30', 0, 12, 0, '', '', '', '', 'HCFA|UB|', '1144206723', 0, 'Y', 0, '2012-06-22', NULL, NULL, 0, 0, NULL, NULL),
('870571510', 'W11000723', 'W11000723', 'UT01', 'Layton Ambulatory Anesthesia', 'Robert', 'M', 'Sorensen', 'MD', 'Anesthesiology', '', '', NULL, 'O', '1544 W Antelope Dr', 'Layton', 'Davis', 'UT', '84041', '8017748992', '8015250347', 'PO Box 160354', 'Clearfield', '', 'UT', '84016', '', '', '', NULL, '1000', '48.00', '0.00', '0.00', 3, '2007-01-01', '2008-06-30', 1, 12, 0, '', '', '', '', 'HCFA|UB|', '1609852243', 0, 'Y', 0, '2008-06-30', NULL, NULL, 0, 0, NULL, NULL),
('870571510', 'W11000724', 'W11000724', 'UT01', 'Layton Ambulatory Anesthesia', 'Bryan', 'G', 'Holbrook', 'MD', 'Pain Management', 'Anesthesiology', '', NULL, 'O', '1544 W Antelope Dr', 'Layton', 'Davis', 'UT', '84041', '8017748992', '8015250347', 'PO Box 160354', 'Clearfield', '', 'UT', '84016', '', '', '', NULL, '1000', '48.00', '0.00', '0.00', 3, '2007-01-01', '2008-06-30', 1, 12, 0, 'Davis Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1427034081', 0, 'Y', 0, '2008-06-30', NULL, NULL, 0, 0, NULL, NULL),
('562302331', 'W11000725', 'W11000725', 'UT01', 'Central Utah Anesthesia', 'Jeffrey', 'G', 'Priest', 'MD', 'Anesthesiology', '', '', NULL, 'O', '1067 N 500 W', 'Provo', 'Utah', 'UT', '84604', '8013758049', NULL, '1067 N 500 W', 'Provo', 'Utah', 'UT', '84604', '8013758049', '          ', '', '', '1000', '48.00', '0.00', '0.00', 6, '2007-04-01', '2010-07-14', 1, 12, 0, 'Mountain View Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1710100011', 0, 'Y', 0, '2013-10-24', NULL, NULL, 0, 0, NULL, NULL),
('562302331', 'W11000726', 'W11000726', 'UT01', 'Central Utah Anesthesia', 'William', 'E', 'Strong', 'MD', 'Anesthesiology', '', '', NULL, 'O', '1067 N 500 W', 'Provo', 'Utah', 'UT', '84604', '8013758049', NULL, '1067 N 500 W', 'Provo', 'Utah', 'UT', '84604', '8013758049', '          ', '', '', '1000', '48.00', '0.00', '0.00', 6, '2007-04-01', '2010-07-14', 1, 12, 0, 'Mountain View Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1750425302', 0, 'Y', 0, '2013-10-24', NULL, NULL, 0, 0, NULL, NULL),
('562302331', 'W11000727', 'W11000727', 'UT01', 'Central Utah Anesthesia', 'Dan', '', 'Thomas', 'MD', 'Anesthesiology', '', '', NULL, 'O', '1067 N 500 W', 'Provo', 'Utah', 'UT', '84604', '8013758049', NULL, '1067 N 500 W', 'Provo', 'Utah', 'UT', '84604', '8013758049', '          ', '', '', '1000', '48.00', '0.00', '0.00', 6, '2007-04-01', '2010-07-14', 1, 12, 0, '', '', '', '', 'HCFA|UB|', '1336362656', 0, 'Y', 0, '2013-10-24', NULL, NULL, 0, 0, NULL, NULL),
('562302331', 'W11000728', 'W11000728', 'UT01', 'Central Utah Anesthesia', 'Jeffrey', 'G', 'Priest', 'MD', 'Anesthesiology', '', '', NULL, 'B', '274 N Main St', 'Logan', 'Cache', 'UT', '84321', '4357531600', NULL, '274 N Main St', 'Logan', 'Cache', 'UT', '84321', '4357531600', '          ', '', '', '1000', '48.00', '0.00', '0.00', 6, '2007-04-01', '2010-07-14', 1, 12, 0, 'Mountain View Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1710100011', 0, 'Y', 0, '2013-10-24', NULL, NULL, 0, 0, NULL, NULL),
('562302331', 'W11000729', 'W11000729', 'UT01', 'Central Utah Anesthesia', 'William', 'E', 'Strong', 'MD', 'Anesthesiology', '', '', NULL, 'B', '274 N Main St', 'Logan', 'Cache', 'UT', '84321', '4357531600', NULL, '274 N Main St', 'Logan', 'Cache', 'UT', '84321', '4357531600', '          ', '', '', '1000', '48.00', '0.00', '0.00', 6, '2007-04-01', '2010-07-14', 1, 12, 0, 'Mountain View Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1750425302', 0, 'Y', 0, '2013-10-24', NULL, NULL, 0, 0, NULL, NULL),
('562302331', 'W11000730', 'W11000730', 'UT01', 'Central Utah Anesthesia', 'Dan', '', 'Thomas', 'MD', 'Anesthesiology', '', '', NULL, 'B', '274 N Main St', 'Logan', 'Cache', 'UT', '84321', '4357531600', NULL, '274 N Main St', 'Logan', 'Cache', 'UT', '84321', '4357531600', '          ', '', '', '1000', '48.00', '0.00', '0.00', 6, '2007-04-01', '2010-07-14', 1, 12, 0, '', '', '', '', 'HCFA|UB|', '1336362656', 0, 'Y', 0, '2013-10-24', NULL, NULL, 0, 0, NULL, NULL),
('870306646', 'W11000731', 'W11000731', 'UT01', 'Emergency Physicians Group', 'Adam', 'C', 'Stiles', 'MD', 'Emergency Medicine', '', '', NULL, 'O', '1200 E 3900 S', 'Salt Lake City', 'Salt Lake', 'UT', '84124', '8012687975', NULL, '1200 E 3900 S', 'Salt Lake City', 'Salt Lake', 'UT', '84124', '8012687975', '          ', 'WiseSTD', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 3, '2007-07-01', '2010-06-30', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1043304819', 0, 'Y', 0, '2011-07-19', NULL, NULL, 0, 0, NULL, NULL),
('870306646', 'W11000732', 'W11000732', 'UT01', 'Emergency Physicians Group', 'Adam', 'C', 'Stiles', 'MD', 'Emergency Medicine', '', '', NULL, 'B', 'PO Box 95970', 'South Jordan', 'Salt Lake', 'UT', '84095', '8012687975', NULL, 'PO Box 95970', 'South Jordan', 'Salt Lake', 'UT', '84095', '8012687975', '          ', 'WiseSTD', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 3, '2007-07-01', '2010-06-30', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1043304819', 0, 'Y', 0, '2011-07-19', NULL, NULL, 0, 0, NULL, NULL);
