INSERT INTO `providers_new` (`Provider_Tax_ID`, `Provider_Suffix`, `Provider_Network_ID`, `Provider_Region`, `Provider_Name`, `Provider_Doctor_First_Name`, `Provider_Doctor_Middle_Name`, `Provider_Doctor_Last_Name`, `Provider_Doctor_Degree`, `Provider_Specialty_1`, `Provider_Specialty_2`, `Provider_Specialty_3`, `Provider_Specialty_4`, `Provider_Address_Type`, `Provider_Address`, `Provider_City`, `Provider_County`, `Provider_State`, `Provider_Zip`, `Provider_Phone`, `Provider_Fax`, `Provider_Mailing_Address`, `Provider_Mailing_City`, `Provider_Mailing_County`, `Provider_Mailing_State`, `Provider_Mailing_Zip`, `Provider_Mailing_Phone`, `Provider_Mailing_Fax`, `Provider_Primary_Schedule`, `Provider_Secondary_Schedule`, `Provider_Rate_Sheet`, `Provider_Anes_Rate`, `Provider_Default_Rate`, `Provider_Max_DOS`, `Provider_Min_Match_Value`, `Provider_Effective_Date`, `Provider_Term_Date`, `Provider_Pend`, `Provider_Anes_Minutes`, `Provider_PPO`, `Provider_Hospital_1`, `Provider_Hospital_2`, `Provider_Hospital_3`, `Provider_Hospital_4`, `Provider_Type`, `Provider_NPI`, `Provider_Check_Override`, `Exclude_Dir`, `Audit_Status`, `Last_Change_Date`, `Medicare_ID`, `Provider_Lang`, `Provider_Latitude`, `Provider_Longitude`, `Provider_school`, `Provider_cert`) VALUES
('942854057', 'W12002323', 'W12002323', 'UTIHCPHY', 'Medical Center Radiation Oncology', 'Gordon', 'A', 'Watson', 'MD', 'Radiation Oncology', '', '', NULL, 'O', '5121 S Cottonwood St', 'Murray', 'Salt Lake', 'UT', '84107', '8015073888', NULL, '5121 S Cottonwood St', 'Murray', 'Salt Lake', 'UT', '84107', '8015073888', '          ', 'USTDMULT', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 8, '2008-07-01', '2008-07-01', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1588682629', 0, 'N', 0, '2012-06-01', NULL, NULL, 0, 0, NULL, NULL),
('870622942', 'W12002328', 'W12002328', 'UT01', 'Utah Imaging Associates', 'David', 'S', 'Francom', 'MD', 'Diagnostic Radiology', '', '', NULL, 'M', '380 N 200 W Ste 209', 'Bountiful', 'Davis', 'UT', '84010', '8017747006', '8012961715', '380 N 200 W Ste 209', 'Bountiful', 'Davis', 'UT', '84010', '8017747006', '8012961715', 'WUUTIMAGE5', '', '', '0.00', '35.00', '0.00', 3, '2010-08-02', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1497953384', 0, 'Y', 0, '2012-06-26', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W12002326', 'W12002326', 'WYBILLINGS', 'Billings Clinic - PMR', 'Terrence', 'J', 'Cahill', 'MD', 'Physical Medicine and Rehabilitation', '', '', NULL, 'O', '801 N 29th St', 'Billings', 'Yellowstone', 'Mt', '59101', '4062382501', '4062382723', '801 N 29th St', 'Billings', 'Yellowstone', 'Mt', '59101', '4062382501', '4062382723', '', '', '', '0.00', '17.00', '0.00', 3, '2010-06-11', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1528382603', 0, 'N', 0, '2014-05-22', NULL, NULL, 45.7875, -108.513, NULL, NULL),
('870622942', 'W12002327', 'W12002327', 'UT01', 'Utah Imaging Associates', 'David', 'S', 'Francom', 'MD', 'Diagnostic Radiology', '', '', NULL, 'B', 'PO Box 1369', 'Bountiful', 'Davis', 'UT', '84011', '8017747006', '8012961715', 'PO Box 1369', 'Bountiful', 'Davis', 'UT', '84011', '8017747006', '8012961715', 'WUUTIMAGE5', '', '', '0.00', '35.00', '0.00', 3, '2010-08-02', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1497953384', 0, 'N', 0, '2012-06-26', NULL, NULL, 0, 0, NULL, NULL),
('870575989', 'W12002329', 'W12002329', 'UT01', 'Country Hills Eye Center', 'Benjamin', 'T', 'Dastrup', 'MD', 'Ophthalmology', '', '', NULL, 'O', '875 Country Hills Dr', 'Ogden', 'Weber', 'UT', '84403', '8013991149', '8013944481', '875 Country Hills Dr', 'Ogden', 'Weber', 'UT', '84403', '8013991149', '8013944481', 'WISESTD', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 3, '2010-12-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1073797809', 0, 'N', 0, '2010-11-15', NULL, NULL, 41.1889, -111.958, NULL, NULL),
('870450251', 'W12001985', 'W12001985', 'UT01', 'The Eye Institute of Utah', '', '', 'The Eye Institute of Utah', '', 'Ophthalmology', '', '', NULL, 'O', '755 E 3900 S', 'Murray', 'Salt Lake', 'UT', '84107', '8012662283', '8012686151', '755 E 3900 S', 'Murray', 'Salt Lake', 'UT', '84107', '8012662283', '8012686151', 'WISESTD', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 6, '2010-06-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1366515041', 0, 'Y', 0, '2013-07-25', NULL, NULL, 40.6871, -111.87, NULL, NULL),
('460490860', 'W12002330', 'W12002330', 'UT01', 'Kane County Eye Care, Inc.', 'Stuart', 'K', 'Allan', 'OD', 'Optometry', '', '', NULL, 'O', '75 E 200 S Ste 1', 'Kanab', 'Kane', 'UT', '84741', '4356445717', '4356445790', '75 E 200 S Ste 1', 'Kanab', 'Kane', 'UT', '84741', '4356445717', '4356445790', 'WUTALBERT5', '', '', '0.00', '35.00', '0.00', 3, '2010-07-15', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1114986270', 0, 'N', 0, '2014-01-08', NULL, NULL, 37.0447, -112.527, NULL, NULL),
('810231784', 'W12001321', 'W12001321', 'WYBILLINGS', 'Billings Clinic - West End', 'Margaret', 'C', 'Kosnar', 'MD', 'Family Practice', '', '', NULL, 'O', '2675 Central Ave', 'Billings', 'Yellowstone', 'MT', '59102', '4062382501', '4062382978', '2675 Central Ave', 'Billings', 'Yellowstone', 'MT', '59102', '4062382501', '4062382978', '', '', '', '0.00', '17.00', '0.00', 3, '2010-04-30', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1669645669', 0, 'N', 0, '2010-07-01', NULL, NULL, 0, 0, NULL, NULL),
('860735726', 'W12002334', 'W12002334', 'Sinclair', 'Flagstaff Bone and Joint', 'Michael', 'D', 'Peterik', 'PA', 'Orthopedic Surgery', '', '', NULL, 'O', '77 W Forest Ave Ste 301', 'Flagstaff', 'Coconino', 'AZ', '86001', '9287732280', NULL, '77 W Forest Ave Ste 301', 'Flagstaff', 'Coconino', 'AZ', '86001', '9287732280', '          ', '', '', '', '0.00', '40.00', '0.00', 3, '2010-07-27', '2011-03-26', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1720004245', 0, 'N', 0, '2011-04-21', NULL, NULL, 0, 0, NULL, NULL),
('204985513', 'W12002331', 'W12002331', 'UT01', 'Heart of Utah', 'Ellen', 'M', 'Gallant', 'MD', 'Cardiovascular Disease', '', '', NULL, 'O', '4403 Harrison Blvd Ste 3400', 'Ogden', 'Weber', 'UT', '84403', '8013873400', '8013873420', '4403 Harrison Blvd Ste 3400', 'Ogden', 'Weber', 'UT', '84403', '8013873400', '8013873420', 'WUUTCARD5', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 3, '2010-07-01', NULL, 0, 0, 0, 'Saint Alphonsus Medical Center Nampa', NULL, '', '', 'HCFA|UB|', '1083648786', 0, 'N', 0, '2013-10-14', NULL, NULL, 41.1828, -111.949, NULL, NULL),
('204985513', 'W12002332', 'W12002332', 'UT01', 'Heart of Utah', 'Ellen', 'M', 'Gallant', 'MD', 'Cardiovascular Disease', '', '', NULL, 'B', 'PO Box 413041', 'Salt Lake City', 'Salt Lake City', 'UT', '84141', '8013873400', '8013873420', 'PO Box 413041', 'Salt Lake City', 'Salt Lake City', 'UT', '84141', '8013873400', '8013873420', 'WUUTCARD5', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 3, '2010-07-01', NULL, 0, 0, 0, 'Saint Alphonsus Medical Center Nampa', NULL, '', '', 'HCFA|UB|', '1083648786', 0, 'N', 0, '2013-10-14', NULL, NULL, 0, 0, NULL, NULL),
('752806777', 'W12002337', 'W12002337', 'TX01', 'Toyota Family Health Center', 'Julie', 'A', 'Bingham', 'MD', 'Family Practice', '', '', NULL, 'O', '1 Lone Star Pass Bldg 46', 'San Antonio', 'Bexar', 'TX', '78264', '2102635700', NULL, '1 Lone Star Pass Bldg 46', 'San Antonio', 'Bexar', 'TX', '78264', '2102635700', '          ', 'TXSTD', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2010-05-04', '2010-05-04', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1548375272', 0, 'N', 0, '2011-02-03', NULL, NULL, 0, 0, NULL, NULL),
('752806777', 'W12002339', 'W12002339', 'TX01', 'Toyota Family Health Center', 'James', 'E', 'Calhoun', 'PT', 'Physical Therapy', '', '', NULL, 'O', '1 Lone Star Pass Bldg 46', 'San Antonio', 'Bexar', 'TX', '78264', '2102635700', NULL, '1 Lone Star Pass Bldg 46', 'San Antonio', 'Bexar', 'TX', '78264', '2102635700', '          ', 'TXSTD', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2010-05-01', '2012-08-22', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1437292497', 0, 'N', 0, '2012-08-22', NULL, NULL, 0, 0, NULL, NULL),
('752806777', 'W12002340', 'W12002340', 'TX01', 'Toyota Family Health Center', 'Stephen', 'Anthony', 'Carter', 'MD', 'Family Practice', '', '', NULL, 'O', '1 Lone Star Pass Bldg 46', 'San Antonio', 'Bexar', 'TX', '78264', '2102635700', NULL, '1 Lone Star Pass Bldg 46', 'San Antonio', 'Bexar', 'TX', '78264', '2102635700', '          ', 'TXSTD', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2010-05-01', '2012-08-19', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1518083062', 0, 'N', 0, '2007-09-03', NULL, NULL, 0, 0, NULL, NULL),
('752806777', 'W12002341', 'W12002341', 'TX01', 'Toyota Family Health Center', 'Toni', 'L', 'Deer', 'PA-C', 'Family Practice', '', '', NULL, 'O', '1 Lone Star Pass Bldg 46', 'San Antonio', 'Bexar', 'TX', '78264', '2102635700', NULL, '1 Lone Star Pass Bldg 46', 'San Antonio', 'Bexar', 'TX', '78264', '2102635700', '          ', 'TXSTD', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2010-05-01', '2010-05-01', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '0000005933', 0, 'N', 0, '2010-06-29', NULL, NULL, 0, 0, NULL, NULL),
('752806777', 'W12002342', 'W12002342', 'TX01', 'Toyota Family Health Center', 'Steven', 'Thomas', 'Elliott', 'PTA', 'Physical Therapy', '', '', NULL, 'O', '1 Lone Star Pass Bldg 46', 'San Antonio', 'Bexar', 'TX', '78264', '2102635700', NULL, '1 Lone Star Pass Bldg 46', 'San Antonio', 'Bexar', 'TX', '78264', '2102635700', '          ', 'TXSTD', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2010-05-01', '2012-08-22', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1851421424', 0, 'N', 0, '2012-08-22', NULL, NULL, 0, 0, NULL, NULL),
('752806777', 'W12002343', 'W12002343', 'TX01', 'Toyota Family Health Center', 'Deborah', '', 'Gonzalez', 'FNP', 'Family Practice', '', '', NULL, 'O', '1 Lone Star Pass Bldg 46', 'San Antonio', 'Bexar', 'TX', '78264', '2102635700', NULL, '1 Lone Star Pass Bldg 46', 'San Antonio', 'Bexar', 'TX', '78264', '2102635700', '          ', 'TXSTD', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2010-05-01', '2010-05-01', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1669640884', 0, 'N', 0, '2010-06-29', NULL, NULL, 0, 0, NULL, NULL),
('752806777', 'W12002344', 'W12002344', 'TX01', 'Toyota Family Health Center', 'Shayesteh', 'M', 'Izaddoost', 'OD', 'Optometry', '', '', NULL, 'O', '1 Lone Star Pass Bldg 46', 'San Antonio', 'Bexar', 'TX', '78264', '2102635700', NULL, '1 Lone Star Pass Bldg 46', 'San Antonio', 'Bexar', 'TX', '78264', '2102635700', '', 'TXSTD', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2010-05-01', '2012-04-01', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1396875910', 0, 'N', 0, '2014-04-22', NULL, NULL, 0, 0, NULL, NULL),
('752806777', 'W12002345', 'W12002345', 'TX01', 'Toyota Family Health Center', 'Jeb', '', 'Johnson', 'MD', 'Family Practice', '', '', NULL, 'O', '1 Lone Star Pass Bldg 46', 'San Antonio', 'Bexar', 'TX', '78264', '2102635700', NULL, '1 Lone Star Pass Bldg 46', 'San Antonio', 'Bexar', 'TX', '78264', '2102635700', '          ', 'TXSTD', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2010-05-01', '2010-05-01', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '0000006970', 0, 'N', 0, '2010-06-29', NULL, NULL, 0, 0, NULL, NULL),
('752806777', 'W12002346', 'W12002346', 'TX01', 'Toyota Family Health Center', 'David', '', 'Muehe', 'PA', 'Family Practice', '', '', NULL, 'O', '1 Lone Star Pass Bldg 46', 'San Antonio', 'Bexar', 'TX', '78264', '2102635700', NULL, '1 Lone Star Pass Bldg 46', 'San Antonio', 'Bexar', 'TX', '78264', '2102635700', '          ', 'TXSTD', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2010-05-01', '2011-03-01', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1851421747', 0, 'Y', 0, '2011-02-14', NULL, NULL, 0, 0, NULL, NULL),
('752806777', 'W12002347', 'W12002347', 'TX01', 'Toyota Family Health Center', 'Diki', 'A', 'Reyes', 'FNP', 'Family Practice', '', '', NULL, 'O', '1 Lone Star Pass Bldg 46', 'San Antonio', 'Bexar', 'TX', '78264', '2102635700', NULL, '1 Lone Star Pass Bldg 46', 'San Antonio', 'Bexar', 'TX', '78264', '2102635700', '          ', 'TXSTD', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2010-05-01', '2010-10-17', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1528263621', 0, 'N', 0, '2009-11-04', NULL, NULL, 0, 0, NULL, NULL),
('752806777', 'W12002348', 'W12002348', 'TX01', 'Toyota Family Health Center', 'Stuart', 'Alfred', 'Saunders', 'PT', 'Physical Therapy', '', '', NULL, 'O', '1 Lone Star Pass Bldg 46', 'San Antonio', 'Bexar', 'TX', '78264', '2102635700', NULL, '1 Lone Star Pass Bldg 46', 'San Antonio', 'Bexar', 'TX', '78264', '2102635700', '          ', 'TXSTD', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2010-05-01', '2012-08-22', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1245359793', 0, 'N', 0, '2012-08-22', NULL, NULL, 0, 0, NULL, NULL),
('752806777', 'W12002349', 'W12002349', 'TX01', 'Toyota Family Health Center', 'Jeanne', 'D', 'Thacker', 'FNP', 'Family Practice', '', '', NULL, 'O', '1 Lone Star Pass Bldg 46', 'San Antonio', 'Bexar', 'TX', '78264', '2102635700', NULL, '1 Lone Star Pass Bldg 46', 'San Antonio', 'Bexar', 'TX', '78264', '2102635700', '          ', 'TXSTD', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2010-05-01', '2010-10-21', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1962479774', 0, 'Y', 0, '2010-10-26', NULL, NULL, 0, 0, NULL, NULL),
('870649259', 'W12002353', 'W12002353', 'UT01', 'Montpelier Clinic', 'Douglas', 'K', 'Casperson', 'PA-C', 'Orthopedic Surgery', '', '', NULL, 'O', '164 S 5th St', 'Montpelier', 'Bear Lake', 'ID', '83254', '2088474421', '2088474463', '164 S 5th St', 'Montpelier', 'Bear Lake', 'ID', '83254', '2088474421', '2088474463', 'WiseSTD', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 3, '2010-11-01', NULL, 0, 0, 0, 'Brigham City Community Hospital', 'Logan Regional Hospital', NULL, NULL, 'HCFA|UB|', '1336251610', 0, 'N', 0, '2012-11-02', NULL, NULL, 42.3165, -111.301, NULL, NULL),
('870649259', 'W12002351', 'W12002351', 'UT01', 'Alpine Orthopaedic Specialists', 'Douglas', 'K', 'Casperson', 'PA-C', 'Orthopedic Surgery', '', '', NULL, 'O', '2310 N 400 E Ste A', 'North Logan', 'Cache', 'UT', '84341', '4357872000', '4357871913', '2310 N 400 E Ste A', 'North Logan', 'Cache', 'UT', '84341', '4357872000', '4357871913', 'WiseSTD', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 3, '2010-11-01', NULL, 0, 0, 0, 'Brigham City Community Hospital', 'Logan Regional Hospital', NULL, NULL, 'HCFA|UB|', '1336251610', 0, 'N', 0, '2011-12-19', NULL, NULL, 41.7738, -111.823, NULL, NULL),
('870649259', 'W12002354', 'W12002354', 'UT01', 'Soda Springs Clinic', 'Douglas', 'K', 'Casperson', 'PA-C', 'Orthopedic Surgery', '', '', NULL, 'O', '296 S 3rd W Ste B', 'Soda Springs', 'Caribou', 'ID', '83276', '2085470438', '2085472798', '296 S 3rd W Ste B', 'Soda Springs', 'Caribou', 'ID', '83276', '2085470438', '2085472798', 'WiseSTD', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 3, '2010-11-01', NULL, 0, 0, 0, 'Brigham City Community Hospital', 'Logan Regional Hospital', NULL, NULL, 'HCFA|UB|', '1336251610', 0, 'N', 0, '2012-11-02', NULL, NULL, 42.6526, -111.613, NULL, NULL),
('870649259', 'W12002352', 'W12002352', 'UT01', 'Preston Clinic', 'Douglas', 'K', 'Casperson', 'PA-C', 'Orthopedic Surgery', '', '', NULL, 'O', '44 N 100 E', 'Preston', 'Franklin', 'ID', '83263', '2088523662', '2088521295', '44 N 100 E', 'Preston', 'Franklin', 'ID', '83263', '2088523662', '2088521295', 'WiseSTD', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 3, '2010-11-01', NULL, 0, 0, 0, 'Brigham City Community Hospital', 'Logan Regional Hospital', NULL, NULL, 'HCFA|UB|', '1336251610', 0, 'N', 0, '2012-11-02', NULL, NULL, 42.0971, -111.874, NULL, NULL),
('870649259', 'W12002350', 'W12002350', 'UT01', 'Alpine Orthopaedic Specialists', 'Douglas', 'K', 'Casperson', 'PA-C', 'Orthopedic Surgery', '', '', NULL, 'B', 'PO Box 6250', 'Logan', 'Cache', 'UT', '84341', '4357872000', '4357871913', 'PO Box 6250', 'Logan', 'Cache', 'UT', '84341', '4357872000', '4357871913', 'WiseSTD', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 3, '2010-11-01', NULL, 0, 0, 0, 'Brigham City Community Hospital', 'Logan Regional Hospital', NULL, NULL, 'HCFA|UB|', '1336251610', 0, 'Y', 0, '2011-12-19', NULL, NULL, 0, 0, NULL, NULL),
('562627040', 'W12002356', 'W12002356', 'UT01', 'University Health Care', 'Katherine', 'R', 'Dunn', 'PA', 'Mental Health', 'Genetic Counseling', '', NULL, 'O', '50 N Medical Dr', 'Salt Lake City', 'Salt Lake', 'UT', '84132', '8015812719', '8015852594', '50 N Medical Dr', 'Salt Lake City', 'Salt Lake', 'UT', '84132', '8015812719', '8015852594', 'WUUUMG5', 'WUSTDHCPC5', '', '0.00', '25.00', '0.00', 3, '2010-05-24', '2012-08-20', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1659534394', 0, 'N', 0, '2012-08-20', NULL, NULL, 0, 0, NULL, NULL),
('562627040', 'W12002355', 'W12002355', 'UT01', 'University of Utah Dept of Ob/Gyn', 'Katherine', 'R', 'Dunn', 'PA', 'Mental Health', 'Genetic Counseling', '', NULL, 'B', 'PO Box 413028', 'Salt Lake City', 'Salt Lake', 'UT', '84141', '8012133800', NULL, 'PO Box 413028', 'Salt Lake City', 'Salt Lake', 'UT', '84141', '8012133800', '          ', 'WUUUMG5', 'WUSTDHCPC5', '', '0.00', '25.00', '0.00', 3, '2010-05-24', '2012-08-20', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1659534394', 0, 'Y', 0, '2012-08-20', NULL, NULL, 0, 0, NULL, NULL),
('262388378', 'W12002357', 'W12002357', 'UT01', 'Utah Endocrinology Associates', 'James', 'R', 'Grua', 'MD', 'Endocrinology', '', '', NULL, 'O', '1380 E Medical Dr Ste 4500', 'St George', 'Washington', 'UT', '84790', '8017472800', '8017475222', '1380 E Medical Dr Ste 4500', 'St George', 'Washington', 'UT', '84790', '8017472800', '8017475222', 'WISESTD', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 3, '2010-07-15', '2012-10-01', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1134159288', 0, 'N', 0, '2014-06-04', NULL, NULL, 0, 0, NULL, NULL),
('061787631', 'W12002358', 'W12002358', 'UT01', 'Lone Peak General Surgery', 'Ian', 'R', 'Cavin', 'DO', 'General Surgery', '', '', NULL, 'O', '74 Kimballs Ln Ste 210', 'Salt Lake City', 'Salt Lake', 'UT', '84020', '8015663062', '8015018219', '74 Kimballs Ln Ste 210', 'Salt Lake City', 'Salt Lake', 'UT', '84020', '8015663062', '8015018219', 'WUUVPN10', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 3, '2010-06-01', '2010-08-31', 0, 0, 0, 'St Marks Hospital', '', '', '', 'HCFA|UB|', '1184647315', 0, 'N', 0, '2014-05-15', NULL, NULL, 0, 0, NULL, NULL),
('261996389', 'W12002359', 'W12002359', 'UT01', 'Utah Podiatry Group PC', 'Scott', 'A', 'Clark', 'DPM', 'Podiatry', '', '', NULL, 'O', '4578 S Highland Dr Ste 380', 'Salt Lake City', 'Salt Lake', 'UT', '84117', '8015055277', NULL, '4578 S Highland Dr Ste 380', 'Salt Lake City', 'Salt Lake', 'UT', '84117', '8015055277', '          ', 'WISESTD', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 3, '2010-05-29', NULL, 0, 0, 0, 'St Marks Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1700865748', 0, 'N', 0, '2012-01-05', NULL, NULL, 40.6723, -111.841, NULL, NULL),
('261996389', 'W12002360', 'W12002360', 'UT01', 'Utah Podiatry Group PC', 'Scott', 'A', 'Clark', 'DPM', 'Podiatry', '', '', NULL, 'O', '620 E Medical Dr Ste 150', 'Bountiful', 'Davis', 'UT', '84010', '8015055277', NULL, '620 E Medical Dr Ste 150', 'Bountiful', 'Davis', 'UT', '84010', '8015055277', '          ', 'WISESTD', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 3, '2010-05-29', NULL, 0, 0, 0, 'St Marks Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1700865748', 0, 'N', 0, '2012-01-05', NULL, NULL, 40.8869, -111.869, NULL, NULL),
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('383813267', 'W12002412', 'W12002412', 'UT01', 'University Health Care', 'Matthew', 'K', 'Topham', 'MD', 'Pulmonary Disease', '', '', 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, '2008-06-01', '2012-08-23', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1275613721', 0, 'N', 0, '2012-08-24', NULL, NULL, 0, 0, NULL, NULL),
('272660267', 'W12002415', 'W12002415', 'ID01', 'Live Right Chiropractic', 'Yvonne', 'D', 'Honovich', 'DC', 'Chiropractic', '', '', NULL, 'O', '2300 S Orchard Ste A', 'Boise', 'Ada', 'ID', '83705', '2083833703', '2083833702', '2300 S Orchard Ste A', 'Boise', 'Ada', 'ID', '83705', '2083833703', '2083833702', 'IDCHIRO1', '', '', '0.00', '35.00', '0.00', 3, '2010-07-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1740309442', 0, 'N', 0, '2012-05-08', NULL, NULL, 43.5816, -116.244, NULL, NULL),
('870533854', 'W12002419', 'W12002419', 'UT01', 'West Jordan Medical Center', 'Joseph', 'F', 'Kasper', 'MD', 'Family Practice', '', '', NULL, 'O', '3570 W 9000 S Ste 200', 'West Jordan', 'Salt Lake', 'UT', '84088', '8015669211', '8012825952', '3570 W 9000 S Ste 200', 'West Jordan', 'Salt Lake', 'UT', '84088', '8015669211', '8012825952', 'WiseSTD', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 3, '2010-04-10', '2011-09-29', 0, 0, 0, 'St Marks Hospital', '', '', '', 'HCFA|UB|', '1972581528', 0, 'N', 0, '2013-03-27', NULL, NULL, 0, 0, NULL, NULL),
('621801973', 'W12002420', 'W12002420', 'UT01', 'Salt Lake Regional Hospitalists', 'Michael', 'D', 'Killpack', 'MD', 'Internal Medicine', '', '', NULL, 'O', '1050 E S Temple', 'Salt Lake City', 'Salt Lake', 'UT', '84102', '8013504111', '8013284361', '1050 E S Temple', 'Salt Lake City', 'Salt Lake', 'UT', '84102', '8013504111', '8013284361', 'WUSTDINT5', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 6, '2009-08-01', '2010-10-31', 0, 0, 0, 'Salt Lake Regional Medical Center', '', '', '', 'HCFA|UB|', '1588714091', 0, 'N', 0, '2012-06-28', NULL, NULL, 0, 0, NULL, NULL),
('621801973', 'W12002422', 'W12002422', 'UT01', 'Salt Lake Regional Hospitalists', 'Michael', 'D', 'Killpack', 'MD', 'Internal Medicine', '', '', NULL, 'M', '406 W S Jordan Pkwy Ste 450', 'South Jordan', 'Salt Lake', 'UT', '84095', '8013504111', '8013284361', '406 W S Jordan Pkwy Ste 450', 'South Jordan', 'Salt Lake', 'UT', '84095', '8013504111', '8013284361', 'WUSTDINT5', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 6, '2009-08-01', '2010-10-31', 0, 0, 0, 'Salt Lake Regional Medical Center', '', '', '', 'HCFA|UB|', '1588714091', 0, 'Y', 0, '2012-06-28', NULL, NULL, 0, 0, NULL, NULL),
('621801973', 'W12002421', 'W12002421', 'UT01', 'Salt Lake Regional Hospitalists', 'Michael', 'D', 'Killpack', 'MD', 'Internal Medicine', '', '', NULL, 'B', 'PO Box 281415', 'Atlanta', 'Fulton', 'GA', '30384', '8013504111', '8013284361', 'PO Box 281415', 'Atlanta', 'Fulton', 'GA', '30384', '8013504111', '8013284361', 'WUSTDINT5', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 6, '2009-08-01', '2010-10-31', 0, 0, 0, 'Salt Lake Regional Medical Center', '', '', '', 'HCFA|UB|', '1588714091', 0, 'Y', 0, '2012-06-28', NULL, NULL, 0, 0, NULL, NULL),
('272698171', 'W12002423', 'W12002423', 'UT01', 'The Avenues Womens Clinic', 'Hannele', '', 'Laine', 'MD', 'Obstetrics and Gynecology', '', '', NULL, 'O', '455 E S Temple Ste 202', 'Salt Lake City', 'Salt Lake', 'UT', '84111', '8013559951', NULL, '455 E S Temple Ste 202', 'Salt Lake City', 'Salt Lake', 'UT', '84111', '8013559951', '          ', 'WUSTDOBG5', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 3, '2010-09-01', NULL, 0, 0, 0, 'Salt Lake Regional Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1083817449', 0, 'N', 0, '2012-02-22', NULL, NULL, 40.7694, -111.878, NULL, NULL),
('261703236', 'W12002424', 'W12002424', 'UTMH1', 'Clinical Consultants LLC', 'Christopher', 'M', 'Lang', 'MD', 'Mental Health', 'Psychiatry', '', NULL, 'O', '7601 Redwood Rd Bldg E', 'West Jordan', 'Salt Lake', 'UT', '84084', '8012338670', '8012338682', '7601 Redwood Rd Bldg E', 'West Jordan', 'Salt Lake', 'UT', '84084', '8012338670', '8012338682', 'UTMD', '', '', '0.00', '35.00', '0.00', 6, '2010-06-22', '2011-08-20', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1174502546', 0, 'N', 0, '2013-02-27', NULL, NULL, 0, 0, NULL, NULL),
('261703236', 'W12002425', 'W12002425', 'UTMH1', 'Clinical Consultants ', 'Janette', 'M', 'Luna', 'LCSW', 'Mental Health', 'Social Worker', '', NULL, 'O', '7601 Redwood Rd Bldg E', 'West Jordan', 'Salt Lake', 'UT', '84084', '8012338670', '8012338682', '7601 Redwood Rd Bldg E', 'West Jordan', 'Salt Lake', 'UT', '84084', '8012338670', '8012338682', 'UTMD', '', '', '0.00', '35.00', '0.00', 6, '2010-06-22', '2013-02-14', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1427223601', 0, 'N', 0, '2013-02-27', 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
('261703236', 'W12002426', 'W12002426', 'UTMH1', 'Clinical Consultants ', 'James', 'B', 'Meservy', 'LCSW', 'Mental Health', 'Social Worker', '', NULL, 'O', '7601 Redwood Rd Bldg E', 'West Jordan', 'Salt Lake', 'UT', '84084', '8012338670', '8012338682', '7601 Redwood Rd Bldg E', 'West Jordan', 'Salt Lake', 'UT', '84084', '8012338670', '8012338682', 'UTMD', '', '', '0.00', '35.00', '0.00', 6, '2010-06-22', '2013-02-14', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1790959807', 0, 'N', 0, '2011-12-01', NULL, NULL, 0, 0, NULL, NULL),
('261703236', 'W12002427', 'W12002427', 'UTMH1', 'Clinical Consultants ', 'Wayne', 'R', 'Sears', 'LPC', 'Mental Health', 'Counseling', '', NULL, 'O', '7601 Redwood Rd Bldg E', 'West Jordan', 'Salt Lake', 'UT', '84084', '8012338670', '8012338682', '7601 Redwood Rd Bldg E', 'West Jordan', 'Salt Lake', 'UT', '84084', '8012338670', '8012338682', 'UTMD', '', '', '0.00', '35.00', '0.00', 6, '2010-06-22', '2013-02-14', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1063686160', 0, 'N', 0, '2014-06-02', NULL, NULL, 0, 0, NULL, NULL),
('261703236', 'W12002428', 'W12002428', 'UTMH1', 'Clinical Consultants LLC', 'Daniel', 'J', 'Thornhill', 'LCSW', 'Mental Health', 'Social Worker', '', NULL, 'O', '7601 Redwood Rd Bldg E', 'West Jordan', 'Salt Lake', 'UT', '84084', '8012338670', '8012338682', '7601 Redwood Rd Bldg E', 'West Jordan', 'Salt Lake', 'UT', '84084', '8012338670', '8012338682', 'UTMD', '', '', '0.00', '35.00', '0.00', 6, '2010-06-22', '2011-08-20', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1578737755', 0, 'N', 0, '2011-11-30', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W12002429', 'W12002429', 'WYBILLINGS', 'Billings Clinic - OB/GYN', 'Christopher', '', 'Montville', 'MD', 'Reproductive Endocrinology & Infertility', NULL, NULL, NULL, 'O', '801 N 29th St', 'Billings', 'Yellowstone', 'MT', '59102', '4062382501', '4062382978', '801 N 29th St', 'Billings', 'Yellowstone', 'MT', '59102', '4062382501', '4062382978', '', '', '', '0.00', '17.00', '0.00', 3, '2010-07-05', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1437195484', 0, 'N', 0, '2010-07-08', NULL, NULL, 0, 0, NULL, NULL),
('870218917', 'W12002430', 'W12002430', 'UT01', 'Tanner Memorial Clinic', 'Jared', 'A', 'Morris', 'DO', 'Family Practice', '', '', NULL, 'O', '2121 N 1700 W', 'Layton', 'Davis', 'UT', '84041', '8017734840', '8017749219', '2121 N 1700 W', 'Layton', 'Davis', 'UT', '84041', '8017734840', '8017749219', 'WUTANNER5', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 3, '2010-11-01', NULL, 0, 0, 0, 'Davis Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1992952287', 0, 'N', 0, '2013-07-29', NULL, NULL, 41.0893, -111.997, NULL, NULL),
('870218917', 'W12002433', 'W12002433', 'UT01', 'Tanner Memorial Clinic', 'Jon', 'C', 'Oberg', 'MD', 'General Surgery', 'Vascular Surgery', '', NULL, 'O', '2121 N 1700 W', 'Layton', 'Davis', 'UT', '84041', '8017734840', '8015258101', '2121 N 1700 W', 'Layton', 'Davis', 'UT', '84041', '8017734840', '8015258101', 'WUTANNER5', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 3, '2010-08-01', NULL, 0, 0, 0, 'Davis Hospital', 'Lakeview Hospital', '', '', 'HCFA|UB|', '1316035942', 0, 'N', 0, '2014-04-17', NULL, NULL, 41.0893, -111.997, NULL, NULL),
('870218917', 'W12002434', 'W12002434', 'UT01', 'Tanner Memorial Clinic', 'Jon', 'C', 'Oberg', 'MD', 'General Surgery', 'Vascular Surgery', '', NULL, 'B', 'PO Box 337', 'Layton', 'Davis', 'UT', '84041', '8017734840', '8017749219', 'PO Box 337', 'Layton', 'Davis', 'UT', '84041', '8017734840', '8017749219', 'WUTANNER5', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 3, '2010-08-01', NULL, 0, 0, 0, 'Davis Hospital', 'Lakeview Hospital', '', '', 'HCFA|UB|', '1316035942', 0, 'N', 0, '2014-04-17', NULL, NULL, 0, 0, NULL, NULL),
('272033824', 'W12002435', 'W12002435', 'WY01', 'Clear Creek Counseling', 'Dale', 'F', 'Oedekoven', 'LPC', 'Mental Health', 'Counseling', NULL, NULL, 'O', '801 E 4th St', 'Gillette', 'Campbell', 'WY', '82716', '3076869422', NULL, '801 E 4th St', 'Gillette', 'Campbell', 'WY', '82716', '3076869422', '          ', 'WYMA', '', '', '0.00', '35.00', '0.00', 3, '2010-06-01', '2011-07-05', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1083937486', 0, 'N', 0, '2011-05-18', NULL, NULL, 0, 0, NULL, NULL),
('331177233', 'W12002436', 'W12002436', 'UT01', 'Ogden Internal Medicine and Urology LLC', 'Samuel', 'J', 'Otto', 'MD', 'Urology', '', '', NULL, 'O', '620 E Medical Dr Ste 300', 'Bountiful', 'Davis', 'UT', '84010', '8012983247', '8012989675', '620 E Medical Dr Ste 300', 'Bountiful', 'Davis', 'UT', '84010', '8012983247', '8012989675', 'WISESTD', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 3, '2010-05-06', '2010-08-31', 0, 0, 0, 'Ogden Regional Medical Center', '', '', '', 'HCFA|UB|', '1154565273', 0, 'N', 0, '2014-04-09', NULL, NULL, 0, 0, NULL, NULL),
('621801973', 'W12002437', 'W12002437', 'UT01', 'Urology Specialists of Utah', 'Justin', 'P', 'Parkinson', 'MD', 'Urology', '', '', NULL, 'B', 'PO Box 281415', 'Atlanta', 'Fulton', 'GA', '30384', '8019843418', '8019843479', 'PO Box 281415', 'Atlanta', 'Fulton', 'GA', '30384', '8019843418', '8019843479', 'WUSTDSURG5', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 6, '2010-06-17', NULL, 0, 0, 0, 'Jordan Valley Medical Center', 'Salt Lake Regional Medical Center', 'Pioneer Valley Hospital', '', 'HCFA|UB|', '1851314066', 0, 'Y', 0, '2014-06-17', NULL, NULL, 0, 0, NULL, NULL),
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('870218917', 'W12002444', 'W12002444', 'UT01', 'Tanner Memorial Clinic', 'Robert', 'S', 'Rice', 'MD', 'Orthopedic Surgery', '', '', NULL, 'O', '380 N 400 W', 'Kaysville', 'Davis', 'UT', '84037', '8017734840', NULL, '380 N 400 W', 'Kaysville', 'Davis', 'UT', '84037', '8017734840', '', 'WUTANNER5', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 3, '2006-07-01', NULL, 0, 0, 0, 'Davis Hospital', '', '', '', 'HCFA|UB|', '1730166182', 0, 'N', 0, '2014-06-17', NULL, NULL, 41.0412, -111.946, NULL, NULL),
('870218917', 'W12002445', 'W12002445', 'UT01', 'Tanner Memorial Clinic', 'Robert', 'S', 'Rice', 'MD', 'Orthopedic Surgery', '', '', NULL, 'B', 'PO Box 337', 'Layton', 'Davis', 'UT', '84041', '8017734840', NULL, 'PO Box 337', 'Layton', 'Davis', 'UT', '84041', '8017734840', '', 'WUTANNER5', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 3, '2006-07-01', NULL, 0, 0, 0, 'Davis Hospital', '', '', '', 'HCFA|UB|', '1730166182', 0, 'Y', 0, '2014-06-17', NULL, NULL, 0, 0, NULL, NULL),
('870395551', 'W12002446', 'W12002446', 'UT01', '', 'Derrick', 'L', 'Stanbridge', 'DC', 'Chiropractic', '', '', NULL, 'O', '6033 S Fashion Point Dr', 'Ogden', 'Weber', 'UT', '84403', '8014756800', '8014756802', '6033 S Fashion Point Dr', 'Ogden', 'Weber', 'UT', '84403', '8014756800', '8014756802', 'WLABRAD', 'WUSTDHCPC5', '', '0.00', '0.00', '55.46', 3, '2010-06-07', '2010-10-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1326024977', 0, 'N', 0, '2006-08-31', NULL, NULL, 0, 0, NULL, NULL),
('870687383', 'W12002447', 'W12002447', 'UT01', 'Western Neurological Associates', 'Robert', 'A', 'Summerfield', 'MD', 'Neurology', '', '', NULL, 'O', '1151 E 3900 S Ste B150', 'Salt Lake City', 'Salt Lake', 'UT', '84124', '8012623441', '8012699005', '1151 E 3900 S Ste B150', 'Salt Lake City', 'Salt Lake', 'UT', '84124', '8012623441', '8012699005', 'WiseSTD', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 3, '2006-06-01', '2014-05-30', 0, 0, 0, 'St Marks Hospital', '', '', '', 'HCFA|UB|', '1215919659', 0, 'N', 0, '2014-07-11', NULL, NULL, 40.6871, -111.858, NULL, NULL),
('743003947', 'W12002448', 'W12002448', 'TX01', 'The San Antonio Orthopaedic Group', '', '', 'The San Antonio Orthopedic Group LLP', 'GROUP', 'Orthopedic Surgery', 'Physical Therapy', '', NULL, 'O', '12602 Toepperwein Rd Ste 210', 'San Antonio', 'Bexar', 'TX', '78233', '2108045400', NULL, '12602 Toepperwein Rd Ste 210', 'San Antonio', 'Bexar', 'TX', '78233', '2108045400', '', 'TXORTHO', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2010-07-01', '2012-08-19', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '0000009051', 0, 'N', 0, '2014-07-18', NULL, NULL, 0, 0, NULL, NULL),
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('261286085', 'W12002450', 'W12002450', 'WY01', 'Rehab Solutions', 'Heather', 'J', 'Martinson', 'DPT', 'Physical Therapy', '', '', NULL, 'B', '192 Holly St', 'Nampa', 'Canyon', 'ID', '83686', '2084679117', '2084614510', '192 Holly St', 'Nampa', 'Canyon', 'ID', '83686', '2084679117', '2084614510', 'WISEWYSTD', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 3, '2010-02-01', '2010-09-15', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1366630402', 0, 'Y', 0, '2013-03-12', NULL, NULL, 0, 0, NULL, NULL),
('870622942', 'W12002451', 'W12002451', 'UT01', 'Utah Imaging Associates ', '', '', 'Utah Imaging Associates LLC', 'GROUP', 'Imaging Center', 'Mammography', '', NULL, 'O', '3970 S 700 E Ste 14', 'Salt Lake City', 'Salt Lake', 'UT', '84107', '8012663820', '8012966199', '3970 S 700 E Ste 14', 'Salt Lake City', 'Salt Lake', 'UT', '84107', '8012663820', '8012966199', 'WUUTIMAGE5', '', '', '0.00', '35.00', '0.00', 3, '2010-05-24', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1629076229', 0, 'N', 0, '2013-04-15', NULL, NULL, 40.6861, -111.871, NULL, NULL),
('820425454', 'W11025303', 'W11025303', 'ID01', 'Boise Anesthesia, PA', 'MaryBeth', '', 'Puzio', 'CRNA', 'Nurse Anesthetist', '', '', NULL, 'o', '1055 N Curtis Rd', 'Boise', 'Ada', 'ID', '83706', '2083676416', '2083759530', '1055 N Curtis Rd', 'Boise', 'Ada', 'ID', '83706', '2083676416', '2083759530', 'IDSAMG3', '', '', '59.20', '10.00', '0.00', 3, '2010-07-01', '2011-06-30', 1, 15, 0, '', '', '', '', 'HCFA|UB|', '1912948464', 0, 'N', 0, '2012-11-01', NULL, NULL, 43.6127, -116.254, NULL, NULL),
('820425454', 'W11025304', 'W11025304', 'ID01', 'Boise Anesthesia, PA', 'MaryBeth', '', 'Puzio', 'CRNA', 'Nurse Anesthetist', '', '', NULL, 'o', '1717 Arlington Ave', 'Caldwell', 'Canyon', 'ID', '83605', '2084594641', NULL, '1717 Arlington Ave', 'Caldwell', 'Canyon', 'ID', '83605', '2084594641', '0         ', 'IDSAMG3', '', '', '59.20', '10.00', '0.00', 3, '2010-07-01', '2011-06-30', 1, 15, 0, '', '', '', '', 'HCFA|UB|', '1912948464', 0, 'N', 0, '2012-11-01', NULL, NULL, 0, 0, NULL, NULL),
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('820425454', 'W11025306', 'W11025306', 'ID01', 'Boise Anesthesia, PA', 'Jason', 'P', 'Jenkins', 'MD', 'Anesthesiology', '', '', NULL, 'o', '1717 Arlington Ave', 'Caldwell', 'Canyon', 'ID', '83605', '2084594641', NULL, '1717 Arlington Ave', 'Caldwell', 'Canyon', 'ID', '83605', '2084594641', '0         ', 'IDSAMG3', '', '', '59.20', '10.00', '0.00', 3, '2010-07-01', '2011-06-30', 1, 15, 0, 'Saint Alphonsus Regional Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1942252390', 0, 'N', 0, '2012-11-01', NULL, NULL, 0, 0, NULL, NULL),
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('820425454', 'W12024575', 'W12024575', 'ID01', 'Boise Anesthesia PA', 'Darron', 'D', 'Funk', 'CRNA', 'Nurse Anesthetist', '', '', NULL, 'B', 'PO Box 4268', 'Portland', 'Multnomah', 'OR', '97208', '8002758752', NULL, 'PO Box 4268   ', 'Portland', 'Multnomah', 'OR', '97208', '8002758752', '          ', 'IDSAMG3', '', '', '60.97', '10.00', '0.00', 3, '2011-07-01', '2012-06-30', 1, 15, 0, '', '', '', '', 'HCFA|UB|', '1174560759', 0, 'N', 0, '2012-10-30', NULL, NULL, 0, 0, NULL, NULL),
('820425454', 'W12024498', 'W12024498', 'ID01', 'Boise Anesthesia, PA', 'Marilyn', 'S', 'Armayor', 'CRNA', 'Nurse Anesthetist', '', '', NULL, 'B', 'PO Box 4268', 'Portland', 'Multnomah', 'OR', '97208', '8002758752', NULL, 'PO Box 4268      ', 'Portland', 'Multnomah', 'OR', '97208', '8002758752', '0         ', 'IDSAMG3', '', '', '59.20', '10.00', '0.00', 3, '2010-07-01', '2011-06-30', 1, 15, 0, '', '', '', '', 'HCFA|UB|', '1124079785', 0, 'N', 0, '2012-10-29', NULL, NULL, 0, 0, NULL, NULL),
('742592013', 'W12024563', 'W12024563', 'TX01', 'Dermatology Associates of San Antonio', '', '', 'Dermatology Associates of San Antonio', '', 'Dermatology', '', '', NULL, 'O', '18540 Sigma Rd', 'San Antonio', 'Bexar', 'TX', '78258', '2104904661', NULL, '18540 Sigma Rd  ', 'San Antonio', 'Bexar', 'TX', '78258', '2104904661', '          ', 'TXSTD', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2010-03-15', '2012-08-19', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '0000009777', 0, 'Y', 0, '2012-10-30', NULL, NULL, 29.6125, -98.4829, NULL, NULL),
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('820425454', 'W12024509', 'W12024509', 'ID01', 'Boise Anesthesia, PA', 'Terry', '', 'Black', 'CRNA', 'Nurse Anesthetist', '', '', NULL, 'B', 'PO Box 4268', 'Portland', 'Multnomah', 'OR', '97208', '8002758752', NULL, 'PO Box 4268     ', 'Portland', 'Multnomah', 'OR', '97208', '8002758752', '          ', 'IDSAMG3', '', '', '57.48', '10.00', '0.00', 3, '2010-02-01', '2010-06-30', 0, 15, 0, '', '', '', '', 'HCFA|UB|', '1902843584', 0, 'N', 0, '2012-10-29', NULL, NULL, 0, 0, NULL, NULL),
('820425454', 'W12024510', 'W12024510', 'ID01', 'Boise Anesthesia, PA', 'Terry', '', 'Black', 'CRNA', 'Nurse Anesthetist', '', '', NULL, 'B', 'PO Box 4268', 'Portland', 'Multnomah', 'OR', '97208', '8002758752', NULL, 'PO Box 4268      ', 'Portland', 'Multnomah', 'OR', '97208', '8002758752', '          ', 'IDSAMG3', '', '', '59.20', '10.00', '0.00', 3, '2010-07-01', '2011-06-30', 1, 15, 0, '', '', '', '', 'HCFA|UB|', '1902843584', 0, 'N', 0, '2012-10-29', NULL, NULL, 0, 0, NULL, NULL),
('820425454', 'W12024491', 'W12024491', 'ID01', 'Boise Anesthesia, PA', 'Brian', '', 'Allen', 'CRNA', 'Nurse Anesthetist', '', '', NULL, 'B', 'PO Box 4268', 'Portland', 'Multnomah', 'OR', '97208', '8002758752', NULL, 'PO Box 4268   ', 'Portland', 'Multnomah', 'OR', '97208', '8002758752', '0         ', 'IDSAMG3', '', '', '60.97', '10.00', '0.00', 3, '2011-07-01', '2012-06-30', 1, 15, 0, '', '', '', '', 'HCFA|UB|', '1982855482', 0, 'N', 0, '2012-10-29', NULL, NULL, 0, 0, NULL, NULL),
('621801973', 'W12024555', 'W12024555', 'UT01', 'Physician Group of Utah, Inc', 'Kimberly', 'Elyce', 'Simpson', 'NP', 'Family Practice', '', '', NULL, 'B', 'PO Box 281415', 'Atlanta', 'Fulton', 'GA', '30384', '8019843418', '8019843479', 'PO Box 281415   ', 'Atlanta', 'Fulton', 'GA', '30384', '8019843418', '8019843479', 'WUSTDINT5', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 6, '2012-09-04', '2014-04-30', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1235488917', 0, 'N', 0, '2013-07-25', NULL, NULL, 0, 0, NULL, NULL),
('820425454', 'W12024514', 'W12024514', 'ID01', 'Boise Anesthesia, PA', 'Jeffery', '', 'Borders', 'CRNA', 'Nurse Anesthetist', '', '', NULL, 'B', 'PO Box 4268', 'Portland', 'Multnomah', 'OR', '97208', '8002758752', NULL, 'PO Box 4268     ', 'Portland', 'Multnomah', 'OR', '97208', '8002758752', '0         ', 'IDSAMG3', '', '', '57.48', '10.00', '0.00', 3, '2010-02-01', '2010-06-30', 0, 15, 0, '', '', '', '', 'HCFA|UB|', '1942288964', 0, 'N', 0, '2012-10-29', NULL, NULL, 0, 0, NULL, NULL),
('820425454', 'W11025240', 'W11025240', 'ID01', 'Boise Anesthesia PA', 'Tyler', '', 'Coburn', 'CRNA', 'Nurse Anesthetist', '', '', NULL, 'O', '1055 N Curtis Rd', 'Boise', 'Ada', 'ID', '83706', '2083676416', '2083759530', '1055 N Curtis Rd', 'Boise', 'Ada', 'ID', '83706', '2083676416', '2083759530', 'IDSAMG3', '', '', '59.20', '10.00', '0.00', 3, '2010-07-01', '2011-07-01', 1, 15, 0, 'Saint Alphonsus Regional Medical Center', '', '', '', 'HCFA|UB|', '1588995435', 0, 'Y', 0, '2013-02-19', NULL, NULL, 43.6127, -116.254, NULL, NULL),
('820425454', 'W11025241', 'W11025241', 'ID01', 'Boise Anesthesia PA', 'Tyler', '', 'Coburn', 'CRNA', 'Nurse Anesthetist', '', '', NULL, 'O', '1717 Arlington Ave', 'Caldwell', 'Canyon', 'ID', '83605', '2084594641', NULL, '1717 Arlington Ave', 'Caldwell', 'Canyon', 'ID', '83605', '2084594641', '          ', 'IDSAMG3', '', '', '59.20', '10.00', '0.00', 3, '2010-07-01', '2011-07-01', 1, 15, 0, 'Saint Alphonsus Regional Medical Center', '', '', '', 'HCFA|UB|', '1588995435', 0, 'Y', 0, '2013-02-19', NULL, NULL, 0, 0, NULL, NULL),
('820425454', 'W11025242', 'W11025242', 'ID01', 'Boise Anesthesia PA', 'Tyler', '', 'Coburn', 'CRNA', 'Nurse Anesthetist', '', '', NULL, 'O', '900 N Liberty St Ste 450', 'Boise', 'Ada', 'ID', '83704', '2083677431', NULL, '900 N Liberty St Ste 450', 'Boise', 'Ada', 'ID', '83704', '2083677431', '          ', 'IDSAMG3', '', '', '59.20', '10.00', '0.00', 3, '2010-07-01', '2011-07-01', 1, 15, 0, 'Saint Alphonsus Regional Medical Center', '', '', '', 'HCFA|UB|', '1588995435', 0, 'Y', 0, '2013-02-19', NULL, NULL, 43.6133, -116.259, NULL, NULL),
('820425454', 'W12024520', 'W12024520', 'ID01', 'Boise Anesthesia, PA', 'Andrew', 'R', 'Cohen', 'MD', 'Anesthesiology', '', '', NULL, 'B', 'PO Box 4268', 'Portland', 'Multnomah', 'OR', '97208', '8002758752', NULL, 'PO Box 4268    ', 'Portland', 'Multnomah', 'OR', '97208', '8002758752', '0         ', 'IDSAMG3', '', '', '59.20', '10.00', '0.00', 3, '2010-07-01', '2011-06-30', 1, 15, 0, 'Saint Alphonsus Regional Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1518919943', 0, 'N', 0, '2012-10-29', NULL, NULL, 0, 0, NULL, NULL),
('870281028', 'W12024553', 'W12024553', 'UT01', 'Central Utah Clinic PC', 'Lawrence', 'J', 'Chase', 'MD', 'Plastic Surgery', 'Hand Surgery', '', NULL, 'O', '321 N Mall Dr Bldg N', 'St George', 'Washington', 'UT', '84790', '4356289393', '4356742520', '321 N Mall Dr Bldg N', 'St George', 'Washington', 'UT', '84790', '4356289393', '4356742520', 'WCUC', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 6, '2012-12-01', '2013-03-13', 0, 0, 0, 'Dixie Regional Medical Center', '', '', '', 'HCFA|UB|', '1538232863', 0, 'N', 0, '2014-04-16', NULL, NULL, 0, 0, NULL, NULL),
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('870519691', 'W12002467', 'W12002467', 'UT01', 'Utah Cancer Specialists', 'W', 'G', 'Harker', 'MD', 'Hematology and Oncology', 'Oncology', '', NULL, 'O', '900 Round Valley Dr Ste 200', 'Park City', 'Summit', 'UT', '84060', '4356587400', '4356587401', '900 Round Valley Dr Ste 200', 'Park City', 'Summit', 'UT', '84060', '4356587400', '4356587401', 'WUSTDONC5', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 3, '2006-11-01', NULL, 0, 0, 0, 'St Marks Hospital', 'Lakeview Hospital', '', '', 'HCFA|UB|', '1679522569', 0, 'N', 0, '2014-07-25', NULL, NULL, 40.6876, -111.468, NULL, NULL),
('870519691', 'W12002468', 'W12002468', 'UT01', 'Utah Cancer Specialists', 'Gregory', 'J', 'Litton', 'MD', 'Hematology and Oncology', 'Oncology', '', NULL, 'O', '5131 S Cottonwood St Ste L-2', 'Murray', 'Salt Lake', 'UT', '84107', '8012633416', '8012633428', '5131 S Cottonwood St Ste L-2', 'Murray', 'Salt Lake', 'UT', '84107', '8012633416', '8012633428', 'WUSTDONC5', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 3, '2006-11-01', NULL, 0, 0, 0, 'St Marks Hospital', '', '', '', 'HCFA|UB|', '1487603916', 0, 'N', 0, '2011-09-09', NULL, NULL, 40.6594, -111.894, NULL, NULL),
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('870519691', 'W12002470', 'W12002470', 'UT01', 'Utah Cancer Specialists', 'William', 'E', 'Nibley', 'MD', 'Hematology and Oncology', 'Pediatric Hematology and Oncolocy', 'Oncology', NULL, 'O', '5131 S Cottonwood St Ste L-2', 'Murray', 'Salt Lake', 'UT', '84107', '9012633416', '8012633248', '5131 S Cottonwood St Ste L-2', 'Murray', 'Salt Lake', 'UT', '84107', '9012633416', '8012633248', 'WUSTDONC5', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 3, '2006-11-01', NULL, 0, 0, 0, 'St Marks Hospital', '', '', '', 'HCFA|UB|', '1437108974', 0, 'N', 0, '2011-09-09', NULL, NULL, 40.6594, -111.894, NULL, NULL),
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('870519691', 'W12002473', 'W12002473', 'UT01', 'Utah Cancer Specialists', 'Johnathan', 'R', 'Whisenant', 'MD', 'Hematology and Oncology', 'Oncology', '', NULL, 'O', '5131 S Cottonwood St Ste L-2', 'Murray', 'Salt Lake', 'UT', '84107', '8012633416', '8012633428', '5131 S Cottonwood St Ste L-2', 'Murray', 'Salt Lake', 'UT', '84107', '8012633416', '8012633428', 'WUSTDONC5', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 3, '2006-11-01', NULL, 0, 0, 0, 'Lakeview Hospital', 'St Marks Hospital', '', '', 'HCFA|UB|', '1861441974', 0, 'N', 0, '2014-06-16', NULL, NULL, 40.6594, -111.894, NULL, NULL),
('870519691', 'W12002474', 'W12002474', 'UT01', 'Utah Cancer Specialists', 'Bruce', 'A', 'Bolonesi', 'PA', 'Hematology and Oncology', 'Oncology', '', NULL, 'O', '5131 S Cottonwood St Ste L-2', 'Murray', 'Salt Lake', 'UT', '84107', '8012633416', '8012633428', '5131 S Cottonwood St Ste L-2', 'Murray', 'Salt Lake', 'UT', '84107', '8012633416', '8012633428', 'WUSTDONC5', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 3, '2006-11-01', NULL, 0, 0, 0, 'Salt Lake Regional Medical Center', '', '', '', 'HCFA|UB|', '1619928199', 0, 'N', 0, '2014-06-04', NULL, NULL, 40.6594, -111.894, NULL, NULL),
('870519691', 'W12002475', 'W12002475', 'UT01', 'Utah Cancer Specialists', 'Michael', '', 'Gaffney', 'PA-C', 'Hematology and Oncology', 'Oncology', '', NULL, 'O', '5131 S Cottonwood St Ste L-2', 'Murray', 'Salt Lake', 'UT', '84107', '8012633416', '8012633428', '5131 S Cottonwood St Ste L-2', 'Murray', 'Salt Lake', 'UT', '84107', '8012633416', '8012633428', 'WUSTDONC5', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 3, '2006-11-01', NULL, 0, 0, 0, 'St Marks Hospital', '', '', '', 'HCFA|UB|', '1811947229', 0, 'N', 0, '2014-06-04', NULL, NULL, 40.6594, -111.894, NULL, NULL),
('870519691', 'W12002476', 'W12002476', 'UT01', 'Utah Cancer Specialists', 'Anne', 'W', 'Marceau', 'NP', 'Hematology and Oncology', 'Oncology', '', NULL, 'O', '5131 S Cottonwood St Ste L-2', 'Murray', 'Salt Lake', 'UT', '84107', '8012633416', '8012690304', '5131 S Cottonwood St Ste L-2', 'Murray', 'Salt Lake', 'UT', '84107', '8012633416', '8012690304', 'WUSTDONC5', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 3, '2006-11-01', NULL, 0, 0, 0, 'St Marks Hospital', '', '', '', 'HCFA|UB|', '1265482012', 0, 'N', 0, '2014-06-04', NULL, NULL, 40.6594, -111.894, NULL, NULL),
('870281028', 'W12002481', 'W12002481', 'UT01', 'Central Utah Clinic', 'Igor', 'Z', 'Abolnik', 'MD', 'Infectious Disease', '', '', NULL, 'O', '1055 N 500 W Ste 202', 'Provo', 'Utah', 'UT', '84604', '8013742362', NULL, '1055 N 500 W Ste 202', 'Provo', 'Utah', 'UT', '84604', '8013742362', '          ', 'WUUVPN11', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 6, '2010-07-15', '2011-02-28', 0, 0, 0, 'Timpanogos Regional Hospital', '', '', '', 'HCFA|UB|', '1194783829', 0, 'N', 0, '2013-06-05', NULL, NULL, 0, 0, NULL, NULL),
('870281028', 'W12002482', 'W12002482', 'UT01', 'Central Utah Clinic', 'Igor', 'Z', 'Abolnik', 'MD', 'Infectious Disease', '', '', NULL, 'B', 'PO Box 30079', 'Salt Lake City', 'Salt Lake', 'UT', '84130', '8013758858', NULL, 'PO Box 30079', 'Salt Lake City', 'Salt Lake', 'UT', '84130', '8013758858', '          ', 'WCUC', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 6, '2011-03-01', NULL, 0, 0, 0, 'Timpanogos Regional Hospital', '', '', '', 'HCFA|UB|', '1194783829', 0, 'Y', 0, '2013-06-05', NULL, NULL, 0, 0, NULL, NULL),
('870281028', 'W12002483', 'W12002483', 'UT01', 'Central Utah Clinic', 'Nancy', '', 'Ahlstrom', 'MD', 'Nephrology', '', '', NULL, 'O', '1055 N 500 W Ste 222', 'Provo', 'Utah', 'UT', '84604', '8013774623', NULL, '1055 N 500 W Ste 222', 'Provo', 'Utah', 'UT', '84604', '8013774623', '          ', 'WUUVPN11', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 6, '2010-07-15', '2011-02-28', 0, 0, 0, 'Timpanogos Regional Hospital', '', '', '', 'HCFA|UB|', '1962431122', 0, 'N', 0, '2013-11-11', NULL, NULL, 0, 0, NULL, NULL),
('870281028', 'W12002484', 'W12002484', 'UT01', 'Central Utah Clinic', 'Nancy', '', 'Ahlstrom', 'MD', 'Nephrology', '', '', NULL, 'o', '852 N 500 W', 'Provo', 'Utah', 'UT', '84604', '8018124624', '8013742615', '852 N 500 W', 'Provo', 'Utah', 'UT', '84604', '8018124624', '8013742615', 'WUUVPN11', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 6, '2010-07-15', '2011-02-28', 0, 0, 0, 'Timpanogos Regional Hospital', '', '', '', 'HCFA|UB|', '1962431122', 0, 'N', 0, '2013-11-11', 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
('870281028', 'W12002485', 'W12002485', 'UT01', 'Central Utah Clinic PC', 'Nancy', '', 'Ahlstrom', 'MD', 'Nephrology', '', '', NULL, 'B', 'PO Box 30079', 'Salt Lake City', 'Salt Lake', 'UT', '84130', '8013758858', '8013742615', 'PO Box 30079', 'Salt Lake City', 'Salt Lake', 'UT', '84130', '8013758858', '8013742615', 'WCUC', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 6, '2011-03-01', NULL, 0, 0, 0, 'Timpanogos Regional Hospital', '', '', '', 'HCFA|UB|', '1962431122', 0, 'Y', 0, '2013-11-11', NULL, NULL, 0, 0, NULL, NULL),
('870281028', 'W12002486', 'W12002486', 'UT01', 'Central Utah Clinic', 'Tala at', '', 'Al Shuquirat', 'MD', 'Pulmonary', 'Emergency Medicine', '', NULL, 'O', '1055 N 500 W', 'Provo', 'Utah', 'UT', '84604', '8013742362', '8013742615', '1055 N 500 W', 'Provo', 'Utah', 'UT', '84604', '8013742362', '8013742615', 'WUUVPN11', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 6, '2010-07-15', '2011-02-28', 0, 0, 0, 'Mountain View Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1104875574', 0, 'N', 0, '2013-08-19', NULL, NULL, 0, 0, NULL, NULL),
('870281028', 'W12002487', 'W12002487', 'UT01', 'Central Utah Clinic', 'Tala at', '', 'Al Shuquirat', 'MD', 'Pulmonary', 'Emergency Medicine', '', NULL, 'O', '1120 E 100 N Ste 1', 'Payson', 'Utah', 'UT', '84651', '8014654813', NULL, '1120 E 100 N Ste 1', 'Payson', 'Utah', 'UT', '84651', '8014654813', '          ', 'WUUVPN11', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 6, '2010-07-15', '2011-02-28', 0, 0, 0, 'Mountain View Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1104875574', 0, 'N', 0, '2013-08-19', NULL, NULL, 0, 0, NULL, NULL),
('870281028', 'W12002488', 'W12002488', 'UT01', 'Central Utah Clinic PC', 'Tala at', '', 'Al Shuquirat', 'MD', 'Pulmonary', 'Emergency Medicine', '', NULL, 'B', 'PO Box 30079', 'Salt Lake City', 'Salt Lake', 'UT', '84130', '8013758858', '8013742615', 'PO Box 30079', 'Salt Lake City', 'Salt Lake', 'UT', '84130', '8013758858', '8013742615', 'WCUC', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 6, '2011-03-01', NULL, 0, 0, 0, 'Mountain View Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1104875574', 0, 'Y', 0, '2013-08-19', NULL, NULL, 0, 0, NULL, NULL),
('870281028', 'W12002489', 'W12002489', 'UT01', 'Central Utah Clinic', 'Dennis', 'R', 'Allen', 'PT', 'Physical Therapy', '', '', NULL, 'O', '1055 N 500 W Ste 122', 'Provo', 'Utah', 'UT', '84604', '8014290610', NULL, '1055 N 500 W Ste 122', 'Provo', 'Utah', 'UT', '84604', '8014290610', '          ', 'WUUVPN11', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 6, '2010-07-15', '2011-02-28', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1407893043', 0, 'N', 0, '2011-04-12', NULL, NULL, 0, 0, NULL, NULL),
('870281028', 'W12002490', 'W12002490', 'UT01', 'Central Utah Clinic', 'Dennis', 'R', 'Allen', 'PT', 'Physical Therapy', '', '', NULL, 'B', 'PO Box 30079', 'Salt Lake City', 'Salt Lake', 'UT', '84130', '8014290610', NULL, 'PO Box 30079', 'Salt Lake City', 'Salt Lake', 'UT', '84130', '8014290610', '          ', 'WUUVPN11', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 6, '2010-07-15', '2011-02-28', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1407893043', 0, 'Y', 0, '2011-04-12', NULL, NULL, 0, 0, NULL, NULL),
('870281028', 'W12002491', 'W12002491', 'UT01', 'Central Utah Clinic', 'Douglas', '', 'Allen', 'DO', 'Obstetrics and Gynecology', '', '', NULL, 'O', '1886 W 800 N', 'Pleasant Grove', 'Utah', 'UT', '84062', '8017565288', '8017567589', '1886 W 800 N', 'Pleasant Grove', 'Utah', 'UT', '84062', '8017565288', '8017567589', 'WUUVPN11', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 6, '2010-07-15', '2011-02-28', 0, 0, 0, 'Timpanogos Regional Hospital', '', '', '', 'HCFA|UB|', '1659575686', 0, 'N', 0, '2012-04-25', NULL, NULL, 0, 0, NULL, NULL),
('870281028', 'W12002492', 'W12002492', 'UT01', 'Central Utah Clinic', 'Douglas', '', 'Allen', 'DO', 'Obstetrics and Gynecology', '', '', NULL, 'B', 'Po Box 30079', 'Salt Lake City', 'Salt Lake', 'UT', '84130', '8017565288', '8017567589', 'Po Box 30079', 'Salt Lake City', 'Salt Lake', 'UT', '84130', '8017565288', '8017567589', 'WCUC', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 6, '2011-03-01', NULL, 0, 0, 0, 'Timpanogos Regional Hospital', '', '', '', 'HCFA|UB|', '1659575686', 0, 'Y', 0, '2012-04-25', NULL, NULL, 0, 0, NULL, NULL),
('870281028', 'W12002493', 'W12002493', 'UT01', 'Central Utah Clinic', 'Marvin', 'R', 'Allen', 'MD', 'Cardiovascular Disease', '', '', NULL, 'O', '1055 N 500 W Ste 101', 'Provo', 'Utah', 'UT', '84604', '8013734366', NULL, '1055 N 500 W Ste 101', 'Provo', 'Utah', 'UT', '84604', '8013734366', '          ', 'WUUVPN11', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 6, '2010-07-15', '2011-02-28', 0, 0, 0, 'Timpanogos Regional Hospital', 'Mountain View Regional Hospital', '', '', 'HCFA|UB|', '1831154566', 0, 'N', 0, '2013-09-09', NULL, NULL, 0, 0, NULL, NULL),
('870281028', 'W12002494', 'W12002494', 'UT01', 'Central Utah Clinic', 'Marvin', 'R', 'Allen', 'MD', 'Cardiovascular Disease', '', '', NULL, 'O', '700 W 800 N Ste 230', 'Orem', 'Utah', 'UT', '84057', '8013734366', NULL, '700 W 800 N Ste 230', 'Orem', 'Utah', 'UT', '84057', '8013734366', '          ', 'WUUVPN11', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 6, '2010-07-15', '2011-02-28', 0, 0, 0, 'Timpanogos Regional Hospital', 'Mountain View Regional Hospital', '', '', 'HCFA|UB|', '1831154566', 0, 'N', 0, '2013-09-09', NULL, NULL, 0, 0, NULL, NULL),
('870281028', 'W12002495', 'W12002495', 'UT01', 'Central Utah Clinic PC', 'Marvin', 'R', 'Allen', 'MD', 'Cardiovascular Disease', '', '', NULL, 'B', 'PO Box 30079', 'Salt Lake City', 'Salt Lake', 'UT', '84130', '8013758858', NULL, 'PO Box 30079', 'Salt Lake City', 'Salt Lake', 'UT', '84130', '8013758858', '          ', 'WCUC', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 6, '2011-03-01', NULL, 0, 0, 0, 'Timpanogos Regional Hospital', 'Mountain View Regional Hospital', '', '', 'HCFA|UB|', '1831154566', 0, 'Y', 0, '2013-09-09', NULL, NULL, 0, 0, NULL, NULL),
('870281028', 'W12002496', 'W12002496', 'UT01', 'Central Utah Clinic', 'Mohammad', 'M', 'Alsolaiman', 'MD', 'Gastroenterology', '', '', NULL, 'O', '1055 N 500 W Bldg B Ste 100', 'Provo', 'Utah', 'UT', '84604', '8013742362', '8014290629', '1055 N 500 W Bldg B Ste 100', 'Provo', 'Utah', 'UT', '84604', '8013742362', '8014290629', 'WUUVPN11', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 6, '2010-07-15', '2011-02-28', 0, 0, 0, 'Timpanogos Regional Hospital', '', '', '', 'HCFA|UB|', '1215986484', 0, 'N', 0, '2013-08-27', NULL, NULL, 0, 0, NULL, NULL),
('870281028', 'W12002497', 'W12002497', 'UT01', 'Central Utah Clinic PC', 'Mohammad', 'M', 'Alsolaiman', 'MD', 'Gastroenterology', '', '', NULL, 'B', 'PO Box 30079', 'Salt Lake City', 'Salt Lake', 'UT', '84130', '8013758858', '8014290629', 'PO Box 30079', 'Salt Lake City', 'Salt Lake', 'UT', '84130', '8013758858', '8014290629', 'WCUC', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 6, '2011-03-01', NULL, 0, 0, 0, 'Timpanogos Regional Hospital', '', '', '', 'HCFA|UB|', '1215986484', 0, 'Y', 0, '2013-08-27', NULL, NULL, 0, 0, NULL, NULL),
('870281028', 'W12002498', 'W12002498', 'UT01', 'Central Utah Clinic', 'James', 'N', 'Anderson', 'PT', 'Physical Therapy', '', '', NULL, 'O', '1055 N 500 W Ste 122', 'Provo', 'Utah', 'UT', '84604', '8014290610', '8014290629', '1055 N 500 W Ste 122', 'Provo', 'Utah', 'UT', '84604', '8014290610', '8014290629', 'WUUVPN11', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 6, '2010-07-15', '2011-02-28', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1932201647', 0, 'N', 0, '2013-10-15', NULL, NULL, 0, 0, NULL, NULL),
('870281028', 'W12002499', 'W12002499', 'UT01', 'Central Utah Clinic PC', 'James', 'N', 'Anderson', 'PT', 'Physical Therapy', '', '', NULL, 'B', 'PO Box 30079', 'Salt Lake City', 'Salt Lake', 'UT', '84130', '8013758858', '8014290629', 'PO Box 30079', 'Salt Lake City', 'Salt Lake', 'UT', '84130', '8013758858', '8014290629', 'WCUC', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 6, '2011-03-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1932201647', 0, 'Y', 0, '2013-10-15', NULL, NULL, 0, 0, NULL, NULL),
('870281028', 'W12002500', 'W12002500', 'UT01', 'Central Utah Clinic', 'Kirk', 'R', 'Anderson', 'MD', 'Internal Medicine', '', '', NULL, 'O', '1055 N 500 W Ste 212  Bld C', 'Provo', 'Utah', 'UT', '84604', '8013742362', NULL, '1055 N 500 W Ste 212  Bld C', 'Provo', 'Utah', 'UT', '84604', '8013742362', '', 'WUUVPN11', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 6, '2010-07-15', '2011-02-28', 0, 0, 0, 'Timpanogos Regional Hospital', '', '', '', 'HCFA|UB|', '1801854021', 0, 'N', 0, '2014-06-16', NULL, NULL, 0, 0, NULL, NULL),
('870281028', 'W12002501', 'W12002501', 'UT01', 'Central Utah Clinic PC', 'Kirk', 'R', 'Anderson', 'MD', 'Internal Medicine', '', '', NULL, 'B', 'PO Box 30079', 'Salt Lake City', 'Salt Lake', 'UT', '84130', '8013758858', NULL, 'PO Box 30079', 'Salt Lake City', 'Salt Lake', 'UT', '84130', '8013758858', '', 'WCUC', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 6, '2011-03-01', NULL, 0, 0, 0, 'Timpanogos Regional Hospital', '', '', '', 'HCFA|UB|', '1801854021', 0, 'Y', 0, '2014-06-16', NULL, NULL, 0, 0, NULL, NULL),
('870281028', 'W12002502', 'W12002502', 'UT01', 'Central Utah Clinic', 'Ronald', 'W', 'Asay', 'MD', 'Cardiovascular Disease', '', '', NULL, 'O', '1055 N 500 W Ste 101  Bld C', 'Provo', 'Utah', 'UT', '84604', '8013734366', NULL, '1055 N 500 W Ste 101  Bld C', 'Provo', 'Utah', 'UT', '84604', '8013734366', '', 'WUUVPN11', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 6, '2010-07-15', '2011-02-28', 0, 0, 0, 'Timpanogos Regional Hospital', '', '', '', 'HCFA|UB|', '1578521308', 0, 'N', 0, '2014-06-04', NULL, NULL, 0, 0, NULL, NULL),
('870281028', 'W12002503', 'W12002503', 'UT01', 'Central Utah Clinic PC', 'Ronald', 'W', 'Asay', 'MD', 'Cardiovascular Disease', '', '', NULL, 'B', 'PO Box 30079', 'Salt Lake City', 'Salt Lake', 'UT', '84130', '8013758858', NULL, 'PO Box 30079', 'Salt Lake City', 'Salt Lake', 'UT', '84130', '8013758858', '', 'WCUC', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 6, '2011-03-01', NULL, 0, 0, 0, 'Timpanogos Regional Hospital', '', '', '', 'HCFA|UB|', '1578521308', 0, 'Y', 0, '2014-06-04', NULL, NULL, 0, 0, NULL, NULL),
('870281028', 'W12002504', 'W12002504', 'UT01', 'Central Utah Clinic', 'C', 'W', 'Bacon', 'MD', 'Orthopedic Surgery', '', '', NULL, 'O', '1055 N 500 W Ste 121 Bld C', 'Provo', 'Utah', 'UT', '84604', '8013737350', NULL, '1055 N 500 W Ste 121 Bld C', 'Provo', 'Utah', 'UT', '84604', '8013737350', '          ', 'WUUVPN11', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 6, '2010-07-15', '2011-02-28', 0, 0, 0, 'Timpanogos Regional Hospital', 'Mountain View Hospital', '', '', 'HCFA|UB|', '1962505750', 0, 'N', 0, '2013-12-09', NULL, NULL, 0, 0, NULL, NULL),
('870281028', 'W12002505', 'W12002505', 'UT01', 'Central Utah Clinic', 'C', 'W', 'Bacon', 'MD', 'Orthopedic Surgery', '', '', NULL, 'O', '50 S Medical Dr', 'Payson', 'Utah', 'UT', '84651', '8014652527', NULL, '50 S Medical Dr', 'Payson', 'Utah', 'UT', '84651', '8014652527', '          ', 'WUUVPN11', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 6, '2010-07-15', '2011-02-28', 0, 0, 0, 'Timpanogos Regional Hospital', 'Mountain View Hospital', '', '', 'HCFA|UB|', '1962505750', 0, 'N', 0, '2013-12-09', NULL, NULL, 0, 0, NULL, NULL),
('870281028', 'W12002506', 'W12002506', 'UT01', 'Central Utah Clinic', 'C', 'W', 'Bacon', 'MD', 'Orthopedic Surgery', '', '', NULL, 'O', '680 W 800 N', 'Orem', 'Utah', 'UT', '84057', '8012245373', NULL, '680 W 800 N', 'Orem', 'Utah', 'UT', '84057', '8012245373', '          ', 'WUUVPN11', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 6, '2010-07-15', '2011-02-28', 0, 0, 0, 'Timpanogos Regional Hospital', 'Mountain View Hospital', '', '', 'HCFA|UB|', '1962505750', 0, 'N', 0, '2013-12-09', NULL, NULL, 0, 0, NULL, NULL),
('870281028', 'W12002507', 'W12002507', 'UT01', 'Central Utah Clinic PC', 'C', 'W', 'Bacon', 'MD', 'Orthopedic Surgery', '', '', NULL, 'B', 'PO Box 30079', 'Salt Lake City', 'Salt Lake', 'UT', '84130', '8013758858', NULL, 'PO Box 30079', 'Salt Lake City', 'Salt Lake', 'UT', '84130', '8013758858', '          ', 'WCUC', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 6, '2011-03-01', NULL, 0, 0, 0, 'Timpanogos Regional Hospital', 'Mountain View Hospital', '', '', 'HCFA|UB|', '1962505750', 0, 'Y', 0, '2013-12-09', NULL, NULL, 0, 0, NULL, NULL),
('870281028', 'W12002508', 'W12002508', 'UT01', 'Central Utah Clinic', 'Douglas', 'K', 'Bagley', 'PT', 'Physical Therapy', '', '', NULL, 'O', '1055 N 500 W Ste 207', 'Provo', 'Utah', 'UT', '84604', '8013737350', NULL, '1055 N 500 W Ste 207', 'Provo', 'Utah', 'UT', '84604', '8013737350', '          ', 'WUUVPN11', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 6, '2010-07-15', '2011-02-28', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1538155411', 0, 'N', 0, '2013-08-20', NULL, NULL, 0, 0, NULL, NULL),
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('870281028', 'W12002576', 'W12002576', 'UT01', 'Central Utah Clinic PC', 'David', 'T', 'Cragun', 'MD', 'Cardiovascular Disease', '', '', NULL, 'B', 'PO Box 30079', 'Salt Lake City', 'Salt Lake', 'UT', '84130', '8013758858', NULL, 'PO Box 30079', 'Salt Lake City', 'Salt Lake', 'UT', '84130', '8013758858', '          ', 'WCUC', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 6, '2011-03-01', NULL, 0, 0, 0, 'Mountain View Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1821005349', 0, 'Y', 0, '2013-03-30', NULL, NULL, 0, 0, NULL, NULL),
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('870281028', 'W12002580', 'W12002580', 'UT01', 'Central Utah Clinic', 'Sean', 'R', 'Curzon', 'DO', 'Internal Medicine', '', '', NULL, 'O', '700 W 800 N 400', 'Orem', 'Utah', 'UT', '84057', '8012218811', NULL, '700 W 800 N 400', 'Orem', 'Utah', 'UT', '84057', '8012218811', '          ', 'WUUVPN11', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 6, '2010-07-15', '2011-02-28', 0, 0, 0, 'Timpanogos Regional Hospital', '', '', '', 'HCFA|UB|', '1780600247', 0, 'N', 0, '2014-02-07', NULL, NULL, 0, 0, NULL, NULL),
('870281028', 'W12002581', 'W12002581', 'UT01', 'Central Utah Clinic PC', 'Sean', 'R', 'Curzon', 'DO', 'Internal Medicine', '', '', NULL, 'B', 'PO Box 30079', 'Salt Lake City', 'Salt Lake', 'UT', '84130', '8013758858', NULL, 'PO Box 30079', 'Salt Lake City', 'Salt Lake', 'UT', '84130', '8013758858', '          ', 'WCUC', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 6, '2011-03-01', NULL, 0, 0, 0, 'Timpanogos Regional Hospital', '', '', '', 'HCFA|UB|', '1780600247', 0, 'Y', 0, '2014-02-07', 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
('870281028', 'W12002582', 'W12002582', 'UT01', 'Central Utah Clinic', 'Charles', 'F', 'Dahl', 'MD', 'Cardiovascular Disease', '', '', NULL, 'O', '1055 N 500 W Ste 101 Bld C', 'Provo', 'Utah', 'UT', '84604', '8013734366', NULL, '1055 N 500 W Ste 101 Bld C', 'Provo', 'Utah', 'UT', '84604', '8013734366', '          ', 'WUUVPN11', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 6, '2010-07-15', '2011-02-28', 0, 0, 0, 'Timpanogos Regional Hospital', '', '', '', 'HCFA|UB|', '1912965344', 0, 'N', 0, '2013-07-19', NULL, NULL, 0, 0, NULL, NULL),
('870281028', 'W12002583', 'W12002583', 'UT01', 'Central Utah Clinic', 'Charles', 'F', 'Dahl', 'MD', 'Cardiovascular Disease', '', '', NULL, 'O', '700 W 800 N Ste 230', 'Orem', 'Utah', 'UT', '84057', '8013734366', NULL, '700 W 800 N Ste 230', 'Orem', 'Utah', 'UT', '84057', '8013734366', '          ', 'WUUVPN11', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 6, '2010-07-15', '2011-02-28', 0, 0, 0, 'Timpanogos Regional Hospital', '', '', '', 'HCFA|UB|', '1912965344', 0, 'N', 0, '2013-07-19', NULL, NULL, 0, 0, NULL, NULL),
('870281028', 'W12002584', 'W12002584', 'UT01', 'Central Utah Clinic PC', 'Charles', 'F', 'Dahl', 'MD', 'Cardiovascular Disease', '', '', NULL, 'B', 'PO Box 30079', 'Salt Lake City', 'Salt Lake', 'UT', '84130', '8013758858', NULL, 'PO Box 30079', 'Salt Lake City', 'Salt Lake', 'UT', '84130', '8013758858', '          ', 'WCUC', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 6, '2011-03-01', NULL, 0, 0, 0, 'Timpanogos Regional Hospital', '', '', '', 'HCFA|UB|', '1912965344', 0, 'Y', 0, '2013-07-19', NULL, NULL, 0, 0, NULL, NULL),
('743003947', 'W12003118', 'W12003118', 'TX01', 'The San Antonio Orthopaedic Group', 'Patrick', 'J', 'Denard', 'MD', 'Orthopedic Surgery', '', '', NULL, 'O', '150 E Sonterra Blvd Ste 300', 'San Antonio', 'Bexar', 'TX', '78258', '2104897220', '2104026257', '150 E Sonterra Blvd Ste 300', 'San Antonio', 'Bexar', 'TX', '78258', '2104897220', '2104026257', 'TXORTHO', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2010-10-01', '2012-08-19', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1578684627', 0, 'N', 0, '2013-03-28', NULL, NULL, 29.6152, -98.4924, NULL, NULL),
('870281028', 'W12002585', 'W12002585', 'UT01', 'St George Clinic', 'Nancy', 'R', 'Davis', 'NP', 'Family Practice', '', '', NULL, 'B', 'PO Box 30079', 'Salt Lake City', 'Salt Lake', 'UT', '84130', '4356736131', '4356738557', 'PO Box 30079', 'Salt Lake City', 'Salt Lake', 'UT', '84130', '4356736131', '4356738557', 'WUUVPN11', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 6, '2010-07-15', '2011-02-28', 0, 0, 0, 'Dixie Regional Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1821101288', 0, 'Y', 0, '2011-12-20', NULL, NULL, 0, 0, NULL, NULL),
('870281028', 'W12002586', 'W12002586', 'UT01', 'St George Clinic', 'Nancy', 'R', 'Davis', 'NP', 'Family Practice', '', '', NULL, 'O', '736 S 900 E Ste 203', 'St George', 'Washington', 'UT', '84790', '4356736131', '4356738557', '736 S 900 E Ste 203', 'St George', 'Washington', 'UT', '84790', '4356736131', '4356738557', 'WUUVPN11', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 6, '2010-07-15', '2011-02-28', 0, 0, 0, 'Dixie Regional Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1821101288', 0, 'N', 0, '2011-12-20', NULL, NULL, 0, 0, NULL, NULL),
('870281028', 'W12002587', 'W12002587', 'UT01', 'Central Utah Clinic', 'Thomas', 'A', 'Dickinson', 'MD', 'Gastroenterology', '', '', NULL, 'O', '1055 N 500 W Ste 100 Bld B', 'Provo', 'Utah', 'UT', '84604', '8013741268', NULL, '1055 N 500 W Ste 100 Bld B', 'Provo', 'Utah', 'UT', '84604', '8013741268', '          ', 'WUUVPN11', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 6, '2010-07-15', '2011-02-28', 0, 0, 0, 'Timpanogos Regional Hospital', 'Mountain View Hospital', '', '', 'HCFA|UB|', '1376591354', 0, 'N', 0, '2013-11-14', NULL, NULL, 0, 0, NULL, NULL),
('870281028', 'W12002588', 'W12002588', 'UT01', 'Central Utah Clinic PC', 'Thomas', 'A', 'Dickinson', 'MD', 'Gastroenterology', '', '', NULL, 'B', 'PO Box 30079', 'Salt Lake City', 'Salt Lake', 'UT', '84130', '8013758858', NULL, 'PO Box 30079', 'Salt Lake City', 'Salt Lake', 'UT', '84130', '8013758858', '          ', 'WCUC', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 6, '2011-03-01', NULL, 0, 0, 0, 'Timpanogos Regional Hospital', 'Mountain View Hospital', '', '', 'HCFA|UB|', '1376591354', 0, 'Y', 0, '2013-11-14', NULL, NULL, 0, 0, NULL, NULL),
('870281028', 'W12002589', 'W12002589', 'UT01', 'Central Utah Clinic', 'Mark', 'L', 'Donaldson', 'MD', 'Dermatology', '', '', NULL, 'O', '1055 N 500 W Ste 111 Bld C', 'Provo', 'Utah', 'UT', '84604', '8013748999', NULL, '1055 N 500 W Ste 111 Bld C', 'Provo', 'Utah', 'UT', '84604', '8013748999', '          ', 'WUUVPN11', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 6, '2010-07-15', '2011-02-28', 0, 0, 0, 'Timpanogos Regional Hospital', '', '', '', 'HCFA|UB|', '1982662102', 0, 'N', 0, '2014-02-10', NULL, NULL, 0, 0, NULL, NULL),
('870281028', 'W12002590', 'W12002590', 'UT01', 'Central Utah Clinic PC', 'Mark', 'L', 'Donaldson', 'MD', 'Dermatology', '', '', NULL, 'B', 'PO Box 30079', 'Salt Lake City', 'Salt Lake', 'UT', '84130', '8013758858', NULL, 'PO Box 30079', 'Salt Lake City', 'Salt Lake', 'UT', '84130', '8013758858', '          ', 'WCUC', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 6, '2011-03-01', NULL, 0, 0, 0, 'Timpanogos Regional Hospital', '', '', '', 'HCFA|UB|', '1982662102', 0, 'Y', 0, '2014-02-10', NULL, NULL, 0, 0, NULL, NULL),
('870281028', 'W12002594', 'W12002594', 'UT01', 'Central Utah Clinic', 'Peter', '', 'Duros', 'MD', 'Internal Medicine', '', '', NULL, 'B', '1055 N 500 W', 'Provo', 'Utah', 'UT', '84604', '8013758858', NULL, '1055 N 500 W', 'Provo', 'Utah', 'UT', '84604', '8013758858', '          ', 'WUUVPN11', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 6, '2010-07-15', '2011-02-28', 0, 0, 0, 'Timpanogos Regional Hospital', '', '', '', 'HCFA|UB|', '1669498119', 0, 'Y', 0, '2013-07-10', NULL, NULL, 0, 0, NULL, NULL),
('870281028', 'W12002595', 'W12002595', 'UT01', 'Central Utah Clinic', 'Peter', '', 'Duros', 'MD', 'Internal Medicine', '', '', NULL, 'O', '700 W 800 N 400', 'Orem', 'Utah', 'UT', '84057', '8012218811', NULL, '700 W 800 N 400', 'Orem', 'Utah', 'UT', '84057', '8012218811', '          ', 'WUUVPN11', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 6, '2010-07-15', '2011-02-28', 0, 0, 0, 'Timpanogos Regional Hospital', '', '', '', 'HCFA|UB|', '1669498119', 0, 'N', 0, '2013-07-10', NULL, NULL, 0, 0, NULL, NULL),
('870281028', 'W12002596', 'W12002596', 'UT01', 'Central Utah Clinic PC', 'Peter', '', 'Duros', 'MD', 'Internal Medicine', '', '', NULL, 'B', 'PO Box 30079', 'Salt Lake City', 'Salt Lake', 'UT', '84130', '8013758858', NULL, 'PO Box 30079', 'Salt Lake City', 'Salt Lake', 'UT', '84130', '8013758858', '          ', 'WCUC', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 6, '2011-03-01', NULL, 0, 0, 0, 'Timpanogos Regional Hospital', '', '', '', 'HCFA|UB|', '1669498119', 0, 'Y', 0, '2013-07-10', NULL, NULL, 0, 0, NULL, NULL),
('870281028', 'W12002597', 'W12002597', 'UT01', 'Central Utah Clinic Wasatch Otolaryngology Group', 'Bradford', 'K', 'Ence', 'MD', 'Ear, Nose and Throat', '', '', NULL, 'B', '1055 N 500 W', 'Provo', 'Utah', 'UT', '84604', '8013758858', NULL, '1055 N 500 W', 'Provo', 'Utah', 'UT', '84604', '8013758858', '          ', 'WUUVPN11', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 6, '2010-07-15', '2011-02-28', 0, 0, 0, 'Mountain View Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1588766299', 0, 'Y', 0, '2013-09-23', NULL, NULL, 0, 0, NULL, NULL),
('870281028', 'W12002598', 'W12002598', 'UT01', 'Wasatch Otolaryngology Group', 'Bradford', 'K', 'Ence', 'MD', 'Ear, Nose and Throat', '', '', NULL, 'O', '39 Professional Way Ste 1', 'Payson', 'Utah', 'UT', '84651', '8014654805', NULL, '39 Professional Way Ste 1', 'Payson', 'Utah', 'UT', '84651', '8014654805', '          ', 'WUUVPN11', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 6, '2010-07-15', '2011-02-28', 0, 0, 0, 'Mountain View Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1588766299', 0, 'N', 0, '2013-09-23', NULL, NULL, 0, 0, NULL, NULL),
('870281028', 'W12002599', 'W12002599', 'UT01', 'Central Utah Clinic PC', 'Bradford', 'K', 'Ence', 'MD', 'Ear, Nose and Throat', '', '', NULL, 'B', 'Po Box 30079', 'Salt Lake City', 'Salt Lake', 'UT', '84130', '8013758858', NULL, 'Po Box 30079', 'Salt Lake City', 'Salt Lake', 'UT', '84130', '8013758858', '          ', 'WCUC', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 6, '2011-03-01', NULL, 0, 0, 0, 'Mountain View Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1588766299', 0, 'Y', 0, '2013-09-23', NULL, NULL, 0, 0, NULL, NULL),
('870281028', 'W12002600', 'W12002600', 'UT01', 'Central Utah Clinic', 'Jonathan', 'R', 'Faux', 'MD', 'Orthopedic Surgery', 'Foot and Ankle', '', NULL, 'O', '1055 N 500 W Ste 121', 'Provo', 'Utah', 'UT', '84604', '8013577350', NULL, '1055 N 500 W Ste 121', 'Provo', 'Utah', 'UT', '84604', '8013577350', '          ', 'WUUVPN11', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 6, '2010-07-15', '2011-02-28', 0, 0, 0, 'Mountain View Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1538250287', 0, 'N', 0, '2013-10-30', NULL, NULL, 0, 0, NULL, NULL),
('870281028', 'W12002601', 'W12002601', 'UT01', 'Central Utah Clinic', 'Jonathan', 'R', 'Faux', 'MD', 'Orthopedic Surgery', 'Foot and Ankle', '', NULL, 'O', '50 S Medical Dr', 'Payson', 'Utah', 'UT', '84651', '8014652527', NULL, '50 S Medical Dr', 'Payson', 'Utah', 'UT', '84651', '8014652527', '          ', 'WUUVPN11', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 6, '2010-07-15', '2011-02-28', 0, 0, 0, 'Mountain View Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1538250287', 0, 'N', 0, '2013-10-30', NULL, NULL, 0, 0, NULL, NULL),
('870281028', 'W12002602', 'W12002602', 'UT01', 'Central Utah Clinic', 'Jonathan', 'R', 'Faux', 'MD', 'Orthopedic Surgery', 'Foot and Ankle', '', NULL, 'O', '700 W 800 N Ste 100', 'Orem', 'Utah', 'UT', '84057', '8012245373', NULL, '700 W 800 N Ste 100', 'Orem', 'Utah', 'UT', '84057', '8012245373', '          ', 'WUUVPN11', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 6, '2010-07-15', '2011-02-28', 0, 0, 0, 'Mountain View Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1538250287', 0, 'N', 0, '2013-10-30', NULL, NULL, 0, 0, NULL, NULL),
('870281028', 'W12002603', 'W12002603', 'UT01', 'Central Utah Clinic PC', 'Jonathan', 'R', 'Faux', 'MD', 'Orthopedic Surgery', 'Foot and Ankle', '', NULL, 'B', 'PO Box 30079', 'Salt Lake City', 'Salt Lake', 'UT', '84130', '8013758858', '8013742615', 'PO Box 30079', 'Salt Lake City', 'Salt Lake', 'UT', '84130', '8013758858', '8013742615', 'WCUC', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 6, '2011-03-01', NULL, 0, 0, 0, 'Mountain View Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1538250287', 0, 'Y', 0, '2013-10-30', NULL, NULL, 0, 0, NULL, NULL),
('870281028', 'W12002604', 'W12002604', 'UT01', 'Central Utah Clinic', 'Walstir', 'H', 'Fonseca', 'MD', 'Internal Medicine', '', '', NULL, 'B', '1055 N 500 W', 'Provo', 'Utah', 'UT', '84604', '8013758858', NULL, '1055 N 500 W', 'Provo', 'Utah', 'UT', '84604', '8013758858', '          ', 'WUUVPN11', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 6, '2010-07-15', '2011-02-28', 0, 0, 0, 'Timpanogos Regional Hospital', '', '', '', 'HCFA|UB|', '1013933506', 0, 'Y', 0, '2013-09-23', NULL, NULL, 0, 0, NULL, NULL),
('870281028', 'W12002605', 'W12002605', 'UT01', 'Central Utah Clinic', 'Walstir', 'H', 'Fonseca', 'MD', 'Internal Medicine', '', '', NULL, 'O', '700 W 800 N Ste 400', 'Orem', 'Utah', 'UT', '84057', '8012218811', NULL, '700 W 800 N Ste 400', 'Orem', 'Utah', 'UT', '84057', '8012218811', '          ', 'WUUVPN11', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 6, '2010-07-15', '2011-02-28', 0, 0, 0, 'Timpanogos Regional Hospital', '', '', '', 'HCFA|UB|', '1013933506', 0, 'N', 0, '2013-09-23', NULL, NULL, 0, 0, NULL, NULL),
('870281028', 'W12002606', 'W12002606', 'UT01', 'Central Utah Clinic PC', 'Walstir', 'H', 'Fonseca', 'MD', 'Internal Medicine', '', '', NULL, 'B', 'PO Box 30079', 'Salt Lake City', 'Salt Lake', 'UT', '84130', '8013758858', NULL, 'PO Box 30079', 'Salt Lake City', 'Salt Lake', 'UT', '84130', '8013758858', '          ', 'WCUC', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 6, '2011-03-01', NULL, 0, 0, 0, 'Timpanogos Regional Hospital', '', '', '', 'HCFA|UB|', '1013933506', 0, 'Y', 0, '2013-09-23', NULL, NULL, 0, 0, NULL, NULL),
('870281028', 'W12002607', 'W12002607', 'UT01', 'Central Utah Clinic', 'Matthew', 'S', 'Frazier', 'DO', 'Orthopedic Surgery', '', '', NULL, 'O', '1055 N 500 W Ste 207', 'Provo', 'Utah', 'UT', '84604', '8013737350', NULL, '1055 N 500 W Ste 207', 'Provo', 'Utah', 'UT', '84604', '8013737350', '          ', 'WUUVPN11', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 6, '2010-07-15', '2011-02-28', 0, 0, 0, 'Timpanogos Regional Hospital', '', '', '', 'HCFA|UB|', '1598977944', 0, 'N', 0, '2013-04-30', NULL, NULL, 0, 0, NULL, NULL),
('870281028', 'W12002608', 'W12002608', 'UT01', 'Central Utah Clinic', 'Matthew', 'S', 'Frazier', 'DO', 'Orthopedic Surgery', '', '', NULL, 'O', '700 W 800 N Ste 100', 'Orem', 'Utah', 'UT', '84057', '8012245373', NULL, '700 W 800 N Ste 100', 'Orem', 'Utah', 'UT', '84057', '8012245373', '          ', 'WUUVPN11', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 6, '2010-07-15', '2011-02-28', 0, 0, 0, 'Timpanogos Regional Hospital', '', '', '', 'HCFA|UB|', '1598977944', 0, 'N', 0, '2013-04-30', NULL, NULL, 0, 0, NULL, NULL),
('870281028', 'W12002609', 'W12002609', 'UT01', 'Central Utah Clinic PC', 'Matthew', 'S', 'Frazier', 'DO', 'Orthopedic Surgery', '', '', NULL, 'B', 'PO Box 30079', 'Salt Lake City', 'Salt Lake', 'UT', '84130', '8013758858', NULL, 'PO Box 30079', 'Salt Lake City', 'Salt Lake', 'UT', '84130', '8013758858', '          ', 'WCUC', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 6, '2011-03-01', NULL, 0, 0, 0, 'Timpanogos Regional Hospital', '', '', '', 'HCFA|UB|', '1598977944', 0, 'Y', 0, '2013-04-30', NULL, NULL, 0, 0, NULL, NULL),
('870281028', 'W12002610', 'W12002610', 'UT01', 'Central Utah Clinic', 'John', 'Kay', 'Frischknecht', 'MD', 'Cardiovascular Disease', '', '', NULL, 'O', '1055 N 500 W Ste 101 Bld C', 'Provo', 'Utah', 'UT', '84604', '8013734366', NULL, '1055 N 500 W Ste 101 Bld C', 'Provo', 'Utah', 'UT', '84604', '8013734366', '          ', 'WUUVPN11', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 6, '2010-07-15', '2011-02-28', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1235197674', 0, 'N', 0, '2013-08-29', NULL, NULL, 0, 0, NULL, NULL),
('870281028', 'W12002611', 'W12002611', 'UT01', 'Central Utah Clinic', 'John', 'Kay', 'Frischknecht', 'MD', 'Cardiovascular Disease', '', '', NULL, 'O', '700 W 800 N Ste 230', 'Orem', 'Utah', 'UT', '84057', '8013734366', NULL, '700 W 800 N Ste 230', 'Orem', 'Utah', 'UT', '84057', '8013734366', '          ', 'WUUVPN11', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 6, '2010-07-15', '2011-02-28', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1235197674', 0, 'N', 0, '2013-08-29', NULL, NULL, 0, 0, NULL, NULL),
('870281028', 'W12002612', 'W12002612', 'UT01', 'Central Utah Clinic PC', 'John', 'Kay', 'Frischknecht', 'MD', 'Cardiovascular Disease', '', '', NULL, 'B', 'PO Box 30079', 'Salt Lake City', 'Salt Lake', 'UT', '84130', '8013758858', '          ', 'PO Box 30079', 'Salt Lake City', 'Salt Lake', 'UT', '84130', '8013758858', '          ', 'WCUC', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 6, '2011-03-01', '2013-06-28', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1235197674', 0, 'Y', 0, '2014-04-21', NULL, NULL, 0, 0, NULL, NULL),
('870281028', 'W12002613', 'W12002613', 'UT01', 'Central Utah Clinic Wasatch Otolaryngology Group', 'Randal', 'B', 'Gibb', 'MD', 'Ear, Nose and Throat', '', '', NULL, 'B', '1055 N 500 W', 'Provo', 'Utah', 'UT', '84604', '8013758858', NULL, '1055 N 500 W', 'Provo', 'Utah', 'UT', '84604', '8013758858', '          ', 'WUUVPN11', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 6, '2010-07-15', '2011-02-28', 0, 0, 0, 'Mountain View Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1679675383', 0, 'Y', 0, '2013-08-19', NULL, NULL, 0, 0, NULL, NULL),
('870281028', 'W12002614', 'W12002614', 'UT01', 'Wasatch Otolaryngology Group', 'Randal', 'B', 'Gibb', 'MD', 'Ear, Nose and Throat', '', '', NULL, 'O', '39 Professional Way Ste 1', 'Payson', 'Utah', 'UT', '84651', '8014654805', NULL, '39 Professional Way Ste 1', 'Payson', 'Utah', 'UT', '84651', '8014654805', '          ', 'WUUVPN11', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 6, '2010-07-15', '2011-02-28', 0, 0, 0, 'Mountain View Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1679675383', 0, 'N', 0, '2013-08-19', NULL, NULL, 0, 0, NULL, NULL),
('870281028', 'W12002615', 'W12002615', 'UT01', 'Central Utah Clinic PC', 'Randal', 'B', 'Gibb', 'MD', 'Ear, Nose and Throat', '', '', NULL, 'B', 'PO Box 30079', 'Salt Lake City', 'Salt Lake', 'UT', '84130', '8013758858', NULL, 'PO Box 30079', 'Salt Lake City', 'Salt Lake', 'UT', '84130', '8013758858', '          ', 'WCUC', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 6, '2011-03-01', NULL, 0, 0, 0, 'Mountain View Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1679675383', 0, 'Y', 0, '2013-08-19', NULL, NULL, 0, 0, NULL, NULL),
('870281028', 'W12002618', 'W12002618', 'UT01', 'Central Utah Clinic PC', 'Kent', 'M', 'Gledhill', 'MD', 'Radiologist', '', '', NULL, 'B', 'PO Box 30079', 'Salt Lake City', 'Salt Lake', 'UT', '84130', '8013758858', '8018124699', 'PO Box 30079', 'Salt Lake City', 'Salt Lake', 'UT', '84130', '8013758858', '8018124699', 'WCUC', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 6, '2011-03-01', NULL, 0, 0, 0, 'Timpanogos Regional Hospital', '', '', '', 'HCFA|UB|', '1871539833', 0, 'Y', 0, '2014-07-16', NULL, NULL, 0, 0, NULL, NULL),
('870281028', 'W12002619', 'W12002619', 'UT01', 'Central Utah Clinic', 'Stanley', 'W', 'Green', 'MD', 'Radiologist', '', '', NULL, 'B', '1055 N 500 W Ste 112 Bld C', 'Provo', 'Utah', 'UT', '84604', '8018124624', NULL, '1055 N 500 W Ste 112 Bld C', 'Provo', 'Utah', 'UT', '84604', '8018124624', '          ', 'WUUVPN11', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 6, '2010-07-15', '2011-02-28', 0, 0, 0, 'Timpanogos Regional Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1184610065', 0, 'N', 0, '2011-04-08', NULL, NULL, 0, 0, NULL, NULL),
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('870281028', 'W12002628', 'W12002628', 'UT01', 'Central Utah Clinic', 'Sanford', 'T', 'Hamilton', 'MD', 'Ear, Nose and Throat', '', '', NULL, 'O', '1175 E 50 S Ste 211', 'American Fork', 'Utah', 'UT', '84003', '8014654805', NULL, '1175 E 50 S Ste 211', 'American Fork', 'Utah', 'UT', '84003', '8014654805', '          ', 'WUUVPN11', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 6, '2010-07-15', '2011-02-28', 0, 0, 0, 'Timpanogos Regional Hospital', '', '', '', 'HCFA|UB|', '1356488126', 0, 'N', 0, '2013-04-17', NULL, NULL, 0, 0, NULL, NULL),
('870281028', 'W12002629', 'W12002629', 'UT01', 'Central Utah Clinic PC', 'Sanford', 'T', 'Hamilton', 'MD', 'Ear, Nose and Throat', '', '', NULL, 'B', 'PO Box 30079', 'Salt Lake City', 'Salt Lake', 'UT', '84130', '8013758858', NULL, 'PO Box 30079', 'Salt Lake City', 'Salt Lake', 'UT', '84130', '8013758858', '          ', 'WCUC', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 6, '2011-03-01', NULL, 0, 0, 0, 'Timpanogos Regional Hospital', '', '', '', 'HCFA|UB|', '1356488126', 0, 'Y', 0, '2013-04-17', NULL, NULL, 0, 0, NULL, NULL),
('870281028', 'W12002631', 'W12002631', 'UT01', 'Central Utah Clinic', 'Terry', 'C', 'Hammond', 'MD', 'Nephrology', '', '', NULL, 'O', '852 N 500 W Ste B', 'Provo', 'Utah', 'UT', '84604', '8013774623', '8018155500', '852 N 500 W Ste B', 'Provo', 'Utah', 'UT', '84604', '8013774623', '8018155500', 'WUUVPN11', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 6, '2010-07-15', '2011-02-28', 0, 0, 0, 'Timpanogos Regional Hospital', '', '', '', 'HCFA|UB|', '1124064845', 0, 'N', 0, '2013-12-02', NULL, NULL, 0, 0, NULL, NULL),
('870281028', 'W12002632', 'W12002632', 'UT01', 'Central Utah Clinic PC', 'Terry', 'C', 'Hammond', 'MD', 'Nephrology', '', '', NULL, 'B', 'PO Box 30079', 'Salt Lake City', 'Salt Lake', 'UT', '84130', '8013758858', '8018155500', 'PO Box 30079', 'Salt Lake City', 'Salt Lake', 'UT', '84130', '8013758858', '8018155500', 'WCUC', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 6, '2011-03-01', NULL, 0, 0, 0, 'Timpanogos Regional Hospital', '', '', '', 'HCFA|UB|', '1124064845', 0, 'Y', 0, '2013-12-02', NULL, NULL, 0, 0, NULL, NULL),
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('870281028', 'W12002640', 'W12002640', 'UT01', 'Central Utah Clinic PC', 'Jonathan', 'P', 'Hubbard', 'DO', 'Family Practice', '', '', NULL, 'B', 'PO Box 30079', 'Salt Lake City', 'Salt Lake', 'UT', '84130', '4356736131', '4356738557', 'PO Box 30079', 'Salt Lake City', 'Salt Lake', 'UT', '84130', '4356736131', '4356738557', 'WCUC', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 6, '2011-03-01', NULL, 0, 0, 0, 'Dixie Regional Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1609894922', 0, 'Y', 0, '2013-09-13', NULL, NULL, 0, 0, NULL, NULL),
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('870281028', 'W12002644', 'W12002644', 'UT01', 'Central Utah Clinic', 'Chun', '', 'Hwang', 'MD', 'Cardiovascular Disease', '', '', NULL, 'O', '1055 N 500 W Ste 101 Bld C', 'Provo', 'Utah', 'UT', '84604', '8013734366', NULL, '1055 N 500 W Ste 101 Bld C', 'Provo', 'Utah', 'UT', '84604', '8013734366', '          ', 'WUUVPN11', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 6, '2010-07-15', '2011-02-28', 0, 0, 0, 'Timpanogos Regional Hospital', '', '', '', 'HCFA|UB|', '1649238080', 0, 'N', 0, '2014-02-10', NULL, NULL, 0, 0, NULL, NULL),
('870281028', 'W12002645', 'W12002645', 'UT01', 'Central Utah Clinic PC', 'Chun', '', 'Hwang', 'MD', 'Cardiovascular Disease', '', '', NULL, 'B', 'PO Box 30079', 'Salt Lake City', 'Salt Lake', 'UT', '84130', '8013758858', NULL, 'PO Box 30079', 'Salt Lake City', 'Salt Lake', 'UT', '84130', '8013758858', '          ', 'WCUC', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 6, '2011-03-01', NULL, 0, 0, 0, 'Timpanogos Regional Hospital', '', '', '', 'HCFA|UB|', '1649238080', 0, 'Y', 0, '2014-02-10', NULL, NULL, 0, 0, NULL, NULL),
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('870281028', 'W12002647', 'W12002647', 'UT01', 'Central Utah Clinic', 'Richard', 'T', 'Jackson', 'MD', 'Orthopedic Surgery', '', '', NULL, 'O', '130 S White Sage Ave', 'Delta', 'Millard', 'UT', '84624', '4358645113', NULL, '130 S White Sage Ave', 'Delta', 'Millard', 'UT', '84624', '4358645113', '          ', 'WUUVPN11', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 6, '2010-07-15', '2011-02-28', 0, 0, 0, 'Mountain View Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1144323163', 0, 'N', 0, '2013-11-07', NULL, NULL, 0, 0, NULL, NULL),
('870281028', 'W12002648', 'W12002648', 'UT01', 'Central Utah Clinic', 'Richard', 'T', 'Jackson', 'MD', 'Orthopedic Surgery', '', '', NULL, 'O', '700 S Hwy 99', 'Fillmore', 'Millard', 'UT', '84631', '4357435555', NULL, '700 S Hwy 99', 'Fillmore', 'Millard', 'UT', '84631', '4357435555', '          ', 'WUUVPN11', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 6, '2010-07-15', '2011-02-28', 0, 0, 0, 'Mountain View Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1144323163', 0, 'N', 0, '2013-11-07', NULL, NULL, 0, 0, NULL, NULL),
('870281028', 'W12002649', 'W12002649', 'UT01', 'Central Utah Clinic', 'Richard', 'T', 'Jackson', 'MD', 'Orthopedic Surgery', '', '', NULL, 'O', '700 W 800 N Ste 100', 'Orem', 'Utah', 'UT', '84057', '8012245373', NULL, '700 W 800 N Ste 100', 'Orem', 'Utah', 'UT', '84057', '8012245373', '          ', 'WUUVPN11', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 6, '2010-07-15', '2011-02-28', 0, 0, 0, 'Mountain View Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1144323163', 0, 'N', 0, '2013-11-07', NULL, NULL, 0, 0, NULL, NULL),
('870281028', 'W12002650', 'W12002650', 'UT01', 'Central Utah Clinic', 'Robert', 'T', 'Jackson', 'MD', 'Orthopedic Surgery', '', '', NULL, 'O', '1055 N 500 W Ste 121 Bldg C', 'Provo', 'Utah', 'UT', '84604', '8013737350', NULL, '1055 N 500 W Ste 121 Bldg C', 'Provo', 'Utah', 'UT', '84604', '8013737350', '', 'WUUVPN11', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 6, '2010-07-15', '2011-02-28', 0, 0, 0, 'Mountain View Hospital', 'Timpanogos Regional Hospital', '', '', 'HCFA|UB|', '1407959695', 0, 'N', 0, '2014-03-27', NULL, NULL, 0, 0, NULL, NULL),
('870281028', 'W12002651', 'W12002651', 'UT01', 'Central Utah Clinic', 'Robert', 'T', 'Jackson', 'MD', 'Orthopedic Surgery', '', '', NULL, 'O', '700 W 800 N Ste 100', 'Orem', 'Utah', 'UT', '84057', '8012245373', NULL, '700 W 800 N Ste 100', 'Orem', 'Utah', 'UT', '84057', '8012245373', '', 'WUUVPN11', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 6, '2010-07-15', '2011-02-28', 0, 0, 0, 'Mountain View Hospital', 'Timpanogos Regional Hospital', '', '', 'HCFA|UB|', '1407959695', 0, 'N', 0, '2014-03-27', NULL, NULL, 0, 0, NULL, NULL),
('870281028', 'W12002652', 'W12002652', 'UT01', 'Central Utah Clinic', 'Scott', 'T', 'Jackson', 'MD', 'Orthopedic Surgery', '', '', NULL, 'O', '50 S Medical Dr', 'Payson', 'Utah', 'UT', '84651', '8014652527', NULL, '50 S Medical Dr', 'Payson', 'Utah', 'UT', '84651', '8014652527', '          ', 'WUUVPN11', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 6, '2010-07-15', '2011-02-28', 0, 0, 0, 'Mountain View Hospital', 'Timpanogos Regional Hospital', '', '', 'HCFA|UB|', '1578666533', 0, 'N', 0, '2013-11-21', NULL, NULL, 0, 0, NULL, NULL),
('870281028', 'W12002653', 'W12002653', 'UT01', 'Central Utah Clinic', 'Scott', 'T', 'Jackson', 'MD', 'Orthopedic Surgery', '', '', NULL, 'O', '700 W 800 N Ste 100', 'Orem', 'Utah', 'UT', '84057', '8012245373', NULL, '700 W 800 N Ste 100', 'Orem', 'Utah', 'UT', '84057', '8012245373', '          ', 'WUUVPN11', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 6, '2010-07-15', '2011-02-28', 0, 0, 0, 'Mountain View Hospital', 'Timpanogos Regional Hospital', '', '', 'HCFA|UB|', '1578666533', 0, 'N', 0, '2013-11-21', NULL, NULL, 0, 0, NULL, NULL),
('870281028', 'W12002654', 'W12002654', 'UT01', 'Central Utah Clinic', 'Curtis', 'C', 'Johnson', 'MD', 'Hand Surgery', 'Orthopedic Surgery', '', NULL, 'O', '1055 N 500 W Ste 121 Bldg C', 'Provo', 'Utah', 'UT', '84604', '8013737350', NULL, '1055 N 500 W Ste 121 Bldg C', 'Provo', 'Utah', 'UT', '84604', '8013737350', '          ', 'WUUVPN11', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 6, '2010-07-15', '2011-02-28', 0, 0, 0, 'Timpanogos Regional Hospital', 'Mountain View Hospital', '', '', 'HCFA|UB|', '1205939089', 0, 'N', 0, '2013-12-10', NULL, NULL, 0, 0, NULL, NULL),
('870281028', 'W12002655', 'W12002655', 'UT01', 'Central Utah Clinic', 'Curtis', 'C', 'Johnson', 'MD', 'Hand Surgery', 'Orthopedic Surgery', '', NULL, 'O', '50 S Medical Dr', 'Payson', 'Utah', 'UT', '84651', '8014652527', NULL, '50 S Medical Dr', 'Payson', 'Utah', 'UT', '84651', '8014652527', '          ', 'WUUVPN11', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 6, '2010-07-15', '2011-02-28', 0, 0, 0, 'Timpanogos Regional Hospital', 'Mountain View Hospital', '', '', 'HCFA|UB|', '1205939089', 0, 'N', 0, '2013-12-10', NULL, NULL, 0, 0, NULL, NULL),
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('870281028', 'W12002658', 'W12002658', 'UT01', 'Central Utah Clinic PC', 'Jeffrey', 'W', 'Johnson', 'MD', 'Internal Medicine', '', '', NULL, 'B', 'PO Box 30079', 'Salt Lake City', 'Salt Lake', 'UT', '84130', '8013758858', NULL, 'PO Box 30079', 'Salt Lake City', 'Salt Lake', 'UT', '84130', '8013758858', '          ', 'WCUC', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 6, '2011-03-01', NULL, 0, 0, 0, 'Timpanogos Regional Hospital', '', '', '', 'HCFA|UB|', '1285692400', 0, 'Y', 0, '2013-10-24', NULL, NULL, 0, 0, NULL, NULL),
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('870281028', 'W12002660', 'W12002660', 'UT01', 'Central Utah Clinic PC', 'Justin', 'E', 'Jones', 'MD', 'Family Practice', '', '', NULL, 'B', 'PO Box 30079', 'Salt Lake City', 'Salt Lake', 'UT', '84130', '8018125033', NULL, 'PO Box 30079', 'Salt Lake City', 'Salt Lake', 'UT', '84130', '8018125033', '', 'WCUC', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 6, '2011-03-01', NULL, 0, 0, 0, 'Timpanogos Regional Hospital', '', '', '', 'HCFA|UB|', '1760547699', 0, 'Y', 0, '2014-06-16', NULL, NULL, 0, 0, NULL, NULL),
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('870281028', 'W12002664', 'W12002664', 'UT01', 'Central Utah Clinic', 'Kirt', 'M', 'Kimball', 'MD', 'Orthopedic Surgery', '', '', NULL, 'o', '50 S Medical Dr', 'Payson', 'Utah', 'UT', '84651', '8014652527', '8013742615', '50 S Medical Dr', 'Payson', 'Utah', 'UT', '84651', '8014652527', '8013742615', 'WUUVPN11', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 6, '2010-07-15', '2011-02-28', 0, 0, 0, 'Mountain View Hospital', 'Timpanogos Regional Hospital', '', '', 'HCFA|UB|', '1548363419', 0, 'N', 0, '2014-01-24', NULL, NULL, 0, 0, NULL, NULL),
('870281028', 'W12002665', 'W12002665', 'UT01', 'Central Utah Clinic', 'Kirt', 'M', 'Kimball', 'MD', 'Orthopedic Surgery', '', '', NULL, 'O', '700 W 800 N Ste 100', 'Orem', 'Utah', 'UT', '84057', '8012245373', NULL, '700 W 800 N Ste 100', 'Orem', 'Utah', 'UT', '84057', '8012245373', '          ', 'WUUVPN11', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 6, '2010-07-15', '2011-02-28', 0, 0, 0, 'Mountain View Hospital', 'Timpanogos Regional Hospital', '', '', 'HCFA|UB|', '1548363419', 0, 'N', 0, '2014-01-24', NULL, NULL, 0, 0, NULL, NULL),
('870281028', 'W12002666', 'W12002666', 'UT01', 'Central Utah Clinic', 'Patrick', 'W', 'Kronmiller', 'MD', 'Urology', '', '', NULL, 'O', '15 S 1000 E Ste 225', 'Payson', 'Utah', 'UT', '84651', '8013788858', '', '15 S 1000 E Ste 225', 'Payson', 'Utah', 'UT', '84651', '8013788858', '', 'WUUVPN11', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 6, '2010-07-15', '2011-02-28', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1801907514', 0, 'N', 0, '2014-07-22', NULL, NULL, 0, 0, NULL, NULL),
('870281028', 'W12002667', 'W12002667', 'UT01', 'Central Utah Clinic', 'Patrick', 'W', 'Kronmiller', 'MD', 'Urology', '', '', NULL, 'O', '1055 N 500 W', 'Provo', 'Utah', 'UT', '84604', '8013788858', '', '1055 N 500 W', 'Provo', 'Utah', 'UT', '84604', '8013788858', '', 'WUUVPN11', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 6, '2010-07-15', '2011-02-28', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1801907514', 0, 'N', 0, '2014-07-22', NULL, NULL, 0, 0, NULL, NULL),
('870281028', 'W12002668', 'W12002668', 'UT01', 'Central Utah Clinic PC', 'Patrick', 'W', 'Kronmiller', 'MD', 'Urology', '', '', NULL, 'B', 'PO Box 30079', 'Salt Lake City', 'Salt Lake', 'UT', '84130', '8013758858', '', 'PO Box 30079', 'Salt Lake City', 'Salt Lake', 'UT', '84130', '8013758858', '', 'WCUC', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 6, '2011-03-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1801907514', 0, 'Y', 0, '2014-07-22', NULL, NULL, 0, 0, NULL, NULL),
('870281028', 'W12002669', 'W12002669', 'UT01', 'Central Utah Clinic', 'Mitchell', 'W', 'Larsen', 'MD', 'Orthopedic Surgery', '', '', NULL, 'O', '1055 N 500 W Ste 121', 'Provo', 'Utah', 'UT', '84604', '8013577350', NULL, '1055 N 500 W Ste 121', 'Provo', 'Utah', 'UT', '84604', '8013577350', '          ', 'WUUVPN11', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 6, '2010-07-15', '2011-02-28', 0, 0, 0, 'Mountain View Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1205928546', 0, 'N', 0, '2014-01-28', NULL, NULL, 0, 0, NULL, NULL),
('870281028', 'W12002670', 'W12002670', 'UT01', 'Central Utah Clinic', 'Mitchell', 'W', 'Larsen', 'MD', 'Orthopedic Surgery', '', '', NULL, 'O', '50 S Medical Dr Ste 6', 'Payson', 'Utah', 'UT', '84651', '8014652527', NULL, '50 S Medical Dr Ste 6', 'Payson', 'Utah', 'UT', '84651', '8014652527', '          ', 'WUUVPN11', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 6, '2010-07-15', '2011-02-28', 0, 0, 0, 'Mountain View Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1205928546', 0, 'N', 0, '2014-01-28', NULL, NULL, 0, 0, NULL, NULL),
('870281028', 'W12002671', 'W12002671', 'UT01', 'Central Utah Clinic', 'Mitchell', 'W', 'Larsen', 'MD', 'Orthopedic Surgery', '', '', NULL, 'o', '700 W 800 N Ste 100', 'Orem', 'Utah', 'UT', '84057', '8012245373', '8013742615', '700 W 800 N Ste 100', 'Orem', 'Utah', 'UT', '84057', '8012245373', '8013742615', 'WUUVPN11', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 6, '2010-07-15', '2011-02-28', 0, 0, 0, 'Mountain View Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1205928546', 0, 'N', 0, '2014-01-28', NULL, NULL, 0, 0, NULL, NULL),
('870281028', 'W12002672', 'W12002672', 'UT01', 'Central Utah Clinic PC', 'Mitchell', 'W', 'Larsen', 'MD', 'Orthopedic Surgery', '', '', NULL, 'B', 'PO Box 30079', 'Salt Lake City', 'Salt Lake', 'UT', '84130', '8013758858', '8013742615', 'PO Box 30079', 'Salt Lake City', 'Salt Lake', 'UT', '84130', '8013758858', '8013742615', 'WCUC', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 6, '2011-03-01', NULL, 0, 0, 0, 'Mountain View Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1205928546', 0, 'Y', 0, '2014-01-28', NULL, NULL, 0, 0, NULL, NULL),
('870281028', 'W12002673', 'W12002673', 'UT01', 'Central Utah Clinic', 'Brent', 'T', 'Layton', 'MD', 'Radiologist', '', '', NULL, 'O', '1055 N 500 W Ste 112 Bld C', 'Provo', 'Utah', 'UT', '84604', '8018124624', NULL, '1055 N 500 W Ste 112 Bld C', 'Provo', 'Utah', 'UT', '84604', '8018124624', '          ', 'WUUVPN11', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 6, '2010-07-15', '2011-02-28', 0, 0, 0, 'Mountain View Hospital', 'Timpanogos Regional Hospital', NULL, NULL, 'HCFA|UB|', '1346286317', 0, 'Y', 0, '2014-01-17', NULL, NULL, 0, 0, NULL, NULL),
('870281028', 'W12002674', 'W12002674', 'UT01', 'Central Utah Clinic PC', 'Brent', 'T', 'Layton', 'MD', 'Radiologist', '', '', NULL, 'B', 'PO Box 30079', 'Salt Lake City', 'Salt Lake', 'UT', '84130', '8013758858', NULL, 'PO Box 30079', 'Salt Lake City', 'Salt Lake', 'UT', '84130', '8013758858', '          ', 'WCUC', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 6, '2011-03-01', NULL, 0, 0, 0, 'Mountain View Hospital', 'Timpanogos Regional Hospital', NULL, NULL, 'HCFA|UB|', '1346286317', 0, 'Y', 0, '2014-01-17', NULL, NULL, 0, 0, NULL, NULL),
('870281028', 'W12002675', 'W12002675', 'UT01', 'Central Utah Clinic', 'Martin', 'M', 'Lee', 'MD', 'Internal Medicine', '', '', NULL, 'O', '1055 N 500 W', 'Provo', 'Utah', 'UT', '84604', '8013742362', '8014290629', '1055 N 500 W', 'Provo', 'Utah', 'UT', '84604', '8013742362', '8014290629', 'WUUVPN11', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 6, '2010-07-14', '2011-02-28', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1013937663', 0, 'N', 0, '2011-04-13', NULL, NULL, 0, 0, NULL, NULL),
('870281028', 'W12002676', 'W12002676', 'UT01', 'Central Utah Clinic', 'Martin', 'M', 'Lee', 'MD', 'Internal Medicine', '', '', NULL, 'B', 'PO Box 30079', 'Salt Lake City', 'Salt Lake', 'UT', '84130', '8013758858', '8014290629', 'PO Box 30079', 'Salt Lake City', 'Salt Lake', 'UT', '84130', '8013758858', '8014290629', 'WUUVPN11', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 6, '2010-07-14', '2011-02-28', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1013937663', 0, 'Y', 0, '2011-04-13', NULL, NULL, 0, 0, NULL, NULL),
('870281028', 'W12002677', 'W12002677', 'UT01', 'Central Utah Clinic', 'E', 'William', 'Leroy', 'MD', 'Internal Medicine', '', '', NULL, 'B', '1055 N 500 W', 'Provo', 'Utah', 'UT', '84604', '8013758858', NULL, '1055 N 500 W', 'Provo', 'Utah', 'UT', '84604', '8013758858', '          ', 'WUUVPN11', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 6, '2010-07-15', '2011-02-28', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1356432009', 0, 'Y', 0, '2011-04-13', NULL, NULL, 0, 0, NULL, NULL),
('870281028', 'W12002678', 'W12002678', 'UT01', 'Central Utah Clinic', 'E', 'William', 'Leroy', 'MD', 'Internal Medicine', '', '', NULL, 'O', '1120 E 100 N', 'Payson', 'Utah', 'UT', '84651', '8014654813', NULL, '1120 E 100 N', 'Payson', 'Utah', 'UT', '84651', '8014654813', '          ', 'WUUVPN11', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 6, '2010-07-15', '2011-02-28', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1356432009', 0, 'N', 0, '2011-04-13', NULL, NULL, 0, 0, NULL, NULL),
('870281028', 'W12002679', 'W12002679', 'UT01', 'Central Utah Clinic PC', 'E', 'William', 'Leroy', 'MD', 'Internal Medicine', '', '', NULL, 'B', 'PO Box 30079', 'Salt Lake City', 'Salt Lake', 'UT', '84130', '8013758858', NULL, 'PO Box 30079', 'Salt Lake City', 'Salt Lake', 'UT', '84130', '8013758858', '          ', 'WCUC', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 6, '2011-03-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1356432009', 0, 'Y', 0, '2013-04-09', 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
('870281028', 'W12002680', 'W12002680', 'UT01', 'Central Utah Clinic', 'Yun', '', 'Ling', 'MD', 'Internal Medicine', '', '', NULL, 'B', '1055 N 500 W', 'Provo', 'Utah', 'UT', '84604', '8014654813', '8013742615', '1055 N 500 W', 'Provo', 'Utah', 'UT', '84604', '8014654813', '8013742615', 'WUUVPN11', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 6, '2010-07-15', '2011-02-28', 0, 0, 0, 'Timpanogos Regional Hospital', '', '', '', 'HCFA|UB|', '1063475341', 0, 'Y', 0, '2013-09-23', NULL, NULL, 0, 0, NULL, NULL),
('870281028', 'W12002681', 'W12002681', 'UT01', 'Central Utah Clinic', 'Yun', '', 'Ling', 'MD', 'Internal Medicine', '', '', NULL, 'O', '1175 E 50 S Ste 241', 'Payson', 'Utah', 'UT', '84004', '8014925999', '8013742615', '1175 E 50 S Ste 241', 'Payson', 'Utah', 'UT', '84004', '8014925999', '8013742615', 'WUUVPN11', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 6, '2010-07-15', '2011-02-28', 0, 0, 0, 'Timpanogos Regional Hospital', '', '', '', 'HCFA|UB|', '1063475341', 0, 'N', 0, '2013-09-23', NULL, NULL, 0, 0, NULL, NULL),
('870281028', 'W12002682', 'W12002682', 'UT01', 'Central Utah Clinic PC', 'Yun', '', 'Ling', 'MD', 'Internal Medicine', '', '', NULL, 'B', 'PO Box 30079', 'Salt Lake City', 'Salt Lake', 'UT', '84130', '8013758858', '8013742615', 'PO Box 30079', 'Salt Lake City', 'Salt Lake', 'UT', '84130', '8013758858', '8013742615', 'WCUC', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 6, '2011-03-01', NULL, 0, 0, 0, 'Timpanogos Regional Hospital', '', '', '', 'HCFA|UB|', '1063475341', 0, 'Y', 0, '2013-09-23', NULL, NULL, 0, 0, NULL, NULL),
('870281028', 'W12002683', 'W12002683', 'UT01', 'Central Utah Clinic', 'Troy', '', 'Lunceford', 'MD', 'Internal Medicine', '', '', NULL, 'B', '1055 N 500 W', 'Provo', 'Utah', 'UT', '84604', '8014654813', '8013742615', '1055 N 500 W', 'Provo', 'Utah', 'UT', '84604', '8014654813', '8013742615', 'WUUVPN11', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 6, '2010-07-15', '2011-02-28', 0, 0, 0, 'Mountain View Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1194842286', 0, 'Y', 0, '2012-08-21', NULL, NULL, 0, 0, NULL, NULL),
('870281028', 'W12002684', 'W12002684', 'UT01', 'Central Utah Clinic', 'Troy', '', 'Lunceford', 'MD', 'Internal Medicine', '', '', NULL, 'O', '1120 E 100 N Ste 1', 'Payson', 'Utah', 'UT', '84651', '8014654813', '8013742615', '1120 E 100 N Ste 1', 'Payson', 'Utah', 'UT', '84651', '8014654813', '8013742615', 'WUUVPN11', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 6, '2010-07-15', '2011-02-28', 0, 0, 0, 'Mountain View Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1194842286', 0, 'N', 0, '2012-08-21', NULL, NULL, 0, 0, NULL, NULL),
('870281028', 'W12002685', 'W12002685', 'UT01', 'Central Utah Clinic PC', 'Troy', '', 'Lunceford', 'MD', 'Internal Medicine', '', '', NULL, 'B', 'PO Box 30079', 'Salt Lake City', 'Utah', 'UT', '84130', '8013758858', '8013742615', 'PO Box 30079', 'Salt Lake City', 'Utah', 'UT', '84130', '8013758858', '8013742615', 'WCUC', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 6, '2011-03-01', NULL, 0, 0, 0, 'Mountain View Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1194842286', 0, 'Y', 0, '2013-04-09', NULL, NULL, 0, 0, NULL, NULL),
('870281028', 'W12002686', 'W12002686', 'UT01', 'Central Utah Clinic', 'Kent', 'G', 'Marshall', 'MD', 'Internal Medicine', '', '', NULL, 'B', '1055 N 500 W', 'Provo', 'Utah', 'UT', '84604', '8013758858', NULL, '1055 N 500 W', 'Provo', 'Utah', 'UT', '84604', '8013758858', '          ', 'WUUVPN11', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 6, '2010-07-15', '2011-02-28', 0, 0, 0, 'Timpanogos Regional Hospital', '', '', '', 'HCFA|UB|', '1962422543', 0, 'Y', 0, '2014-01-17', NULL, NULL, 0, 0, NULL, NULL),
('870281028', 'W12002687', 'W12002687', 'UT01', 'Central Utah Clinic', 'Kent', 'G', 'Marshall', 'MD', 'Internal Medicine', '', '', NULL, 'O', '700 W 800 N Ste 400', 'Orem', 'Utah', 'UT', '84057', '8012218811', NULL, '700 W 800 N Ste 400', 'Orem', 'Utah', 'UT', '84057', '8012218811', '          ', 'WUUVPN11', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 6, '2010-07-15', '2011-02-28', 0, 0, 0, 'Timpanogos Regional Hospital', '', '', '', 'HCFA|UB|', '1962422543', 0, 'N', 0, '2014-01-17', NULL, NULL, 0, 0, NULL, NULL),
('870281028', 'W12002688', 'W12002688', 'UT01', 'Central Utah Clinic PC', 'Kent', 'G', 'Marshall', 'MD', 'Internal Medicine', '', '', NULL, 'B', 'PO Box 30079', 'Salt Lake City', 'Salt Lake', 'UT', '84130', '8013758858', NULL, 'PO Box 30079', 'Salt Lake City', 'Salt Lake', 'UT', '84130', '8013758858', '          ', 'WCUC', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 6, '2011-03-01', NULL, 0, 0, 0, 'Timpanogos Regional Hospital', '', '', '', 'HCFA|UB|', '1962422543', 0, 'Y', 0, '2014-01-17', NULL, NULL, 0, 0, NULL, NULL),
('870281028', 'W12002689', 'W12002689', 'UT01', 'Central Utah Clinic', 'Susan', 'J', 'Maturlo', 'MD', 'Endocrinology', '', '', NULL, 'O', '1055 N 500 W Ste 212 Bld C', 'Provo', 'Utah', 'UT', '84604', '8014298095', NULL, '1055 N 500 W Ste 212 Bld C', 'Provo', 'Utah', 'UT', '84604', '8014298095', '', 'WUUVPN11', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 6, '2010-07-15', '2011-02-28', 0, 0, 0, 'Timpanogos Regional Hospital', '', '', '', 'HCFA|UB|', '1023076460', 0, 'N', 0, '2014-06-24', NULL, NULL, 0, 0, NULL, NULL),
('870281028', 'W12002690', 'W12002690', 'UT01', 'Central Utah Clinic PC', 'Susan', 'J', 'Maturlo', 'MD', 'Endocrinology', '', '', NULL, 'B', 'PO Box 30079', 'Salt Lake City', 'Salt Lake', 'UT', '84130', '8013758858', NULL, 'PO Box 30079', 'Salt Lake City', 'Salt Lake', 'UT', '84130', '8013758858', '', 'WCUC', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 6, '2011-03-01', NULL, 0, 0, 0, 'Timpanogos Regional Hospital', '', '', '', 'HCFA|UB|', '1023076460', 0, 'Y', 0, '2014-06-24', NULL, NULL, 0, 0, NULL, NULL),
('870281028', 'W12002691', 'W12002691', 'UT01', 'Central Utah Clinic', 'Bruce', 'C', 'McAllister', 'MD', 'Radiation Oncology', '', '', NULL, 'O', '1055 N 500 W Bldg C Ste 102', 'Provo', 'Utah', 'UT', '84604', '8013742367', '8014290600', '1055 N 500 W Bldg C Ste 102', 'Provo', 'Utah', 'UT', '84604', '8013742367', '8014290600', 'WUUVPN11', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 6, '2010-07-15', '2011-02-28', 0, 0, 0, 'Timpanogos Regional Hospital', 'Mountain View Hospital', '', '', 'HCFA|UB|', '1144223835', 0, 'N', 0, '2014-05-16', NULL, NULL, 0, 0, NULL, NULL),
('870281028', 'W12002692', 'W12002692', 'UT01', 'Central Utah Clinic PC', 'Bruce', 'C', 'McAllister', 'MD', 'Radiation Oncology', '', '', NULL, 'B', 'PO Box 30079', 'Salt Lake City', 'Utah', 'UT', '84130', '8013758858', '8014290600', 'PO Box 30079', 'Salt Lake City', 'Utah', 'UT', '84130', '8013758858', '8014290600', 'WCUC', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 6, '2011-03-01', NULL, 0, 0, 0, 'Timpanogos Regional Hospital', 'Mountain View Hospital', '', '', 'HCFA|UB|', '1144223835', 0, 'Y', 0, '2014-05-16', NULL, NULL, 0, 0, NULL, NULL),
('870281028', 'W12002693', 'W12002693', 'UT01', 'Central Utah Clinic', 'Bartley', 'B', 'Mortensen', 'PT', 'Physical Therapy', '', '', NULL, 'O', '1055 N 500 W Ste 102', 'Provo', 'Utah', 'UT', '84604', '8014290610', '8014290629', '1055 N 500 W Ste 102', 'Provo', 'Utah', 'UT', '84604', '8014290610', '8014290629', 'WUUVPN11', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 6, '2010-07-15', '2011-02-28', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1659473361', 0, 'N', 0, '2011-04-08', NULL, NULL, 0, 0, NULL, NULL),
('870281028', 'W12002694', 'W12002694', 'UT01', 'Central Utah Clinic', 'Bartley', 'B', 'Mortensen', 'PT', 'Physical Therapy', '', '', NULL, 'B', 'PO Box 30079', 'Salt Lake City', 'Salt Lake', 'UT', '84130', '8013758858', '8014290629', 'PO Box 30079', 'Salt Lake City', 'Salt Lake', 'UT', '84130', '8013758858', '8014290629', 'WUUVPN11', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 6, '2010-07-15', '2011-02-28', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1659473361', 0, 'Y', 0, '2011-04-08', NULL, NULL, 0, 0, NULL, NULL),
('870281028', 'W12002695', 'W12002695', 'UT01', 'Central Utah Clinic', 'Devon', 'A', 'Nelson', 'MD', 'Orthopedic Surgery', '', '', NULL, 'O', '1055 N 500 W Ste 121 Bldg C', 'Provo', 'Utah', 'UT', '84604', '8013737350', NULL, '1055 N 500 W Ste 121 Bldg C', 'Provo', 'Utah', 'UT', '84604', '8013737350', '          ', 'WUUVPN11', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 6, '2010-07-15', '2011-02-28', 0, 0, 0, 'Mountain View Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1235232307', 0, 'N', 0, '2013-11-04', NULL, NULL, 0, 0, NULL, NULL),
('870281028', 'W12002696', 'W12002696', 'UT01', 'Central Utah Clinic', 'Devon', 'A', 'Nelson', 'MD', 'Orthopedic Surgery', '', '', NULL, 'O', '50 S Medical Dr', 'Payson', 'Utah', 'UT', '84651', '8014652527', NULL, '50 S Medical Dr', 'Payson', 'Utah', 'UT', '84651', '8014652527', '          ', 'WUUVPN11', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 6, '2010-07-15', '2011-02-28', 0, 0, 0, 'Mountain View Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1235232307', 0, 'N', 0, '2013-11-04', NULL, NULL, 0, 0, NULL, NULL),
('870281028', 'W12002697', 'W12002697', 'UT01', 'Central Utah Clinic', 'Devon', 'A', 'Nelson', 'MD', 'Orthopedic Surgery', '', '', NULL, 'O', '700 W 800 N Ste 100', 'Orem', 'Utah', 'UT', '84057', '8012245373', NULL, '700 W 800 N Ste 100', 'Orem', 'Utah', 'UT', '84057', '8012245373', '          ', 'WUUVPN11', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 6, '2010-07-15', '2011-02-28', 0, 0, 0, 'Mountain View Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1235232307', 0, 'N', 0, '2013-11-04', NULL, NULL, 0, 0, NULL, NULL),
('870281028', 'W12002698', 'W12002698', 'UT01', 'Central Utah Clinic', 'Erica', 'C', 'Nelson', 'CNM', 'Obstetrics and Gynecology', '', '', NULL, 'O', '1886 W 800 N', 'Pleasant Grove', 'Utah', 'UT', '84062', '8017565288', NULL, '1886 W 800 N', 'Pleasant Grove', 'Utah', 'UT', '84062', '8017565288', '', 'WUUVPN11', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 6, '2010-07-15', '2011-02-28', 0, 0, 0, 'Timpanogos Regional Hospital', '', '', '', 'HCFA|UB|', '1386974525', 0, 'N', 0, '2014-05-28', NULL, NULL, 0, 0, NULL, NULL),
('870281028', 'W12002699', 'W12002699', 'UT01', 'Central Utah Clinic', 'Erica', 'C', 'Nelson', 'CNM', 'Obstetrics and Gynecology', '', '', NULL, 'B', 'PO Box 30079', 'Salt Lake City', 'Salt Lake', 'UT', '84130', '8017565288', NULL, 'PO Box 30079', 'Salt Lake City', 'Salt Lake', 'UT', '84130', '8017565288', '', 'WUUVPN11', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 6, '2010-07-15', '2011-02-28', 0, 0, 0, 'Timpanogos Regional Hospital', '', '', '', 'HCFA|UB|', '1386974525', 0, 'Y', 0, '2014-05-28', NULL, NULL, 0, 0, NULL, NULL),
('870281028', 'W12002700', 'W12002700', 'UT01', 'Central Utah Clinic', 'Thu', 'A', 'Nguyen', 'MD', 'Neurology', '', '', NULL, 'O', '1175 E 50 S Ste 161', 'American Fork', 'Utah', 'UT', '84003', '8014925992', NULL, '1175 E 50 S Ste 161', 'American Fork', 'Utah', 'UT', '84003', '8014925992', '          ', 'WUUVPN11', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 6, '2010-07-15', '2011-02-28', 0, 0, 0, 'Timpanogos Regional Hospital', '', '', '', 'HCFA|UB|', '1649204389', 0, 'N', 0, '2013-11-25', NULL, NULL, 0, 0, NULL, NULL),
('870281028', 'W12002701', 'W12002701', 'UT01', 'Central Utah Clinic', 'Thu', 'A', 'Nguyen', 'MD', 'Neurology', '', '', NULL, 'B', 'PO Box 30079', 'Salt Lake City', 'Salt Lake', 'UT', '84130', '8013758858', NULL, 'PO Box 30079', 'Salt Lake City', 'Salt Lake', 'UT', '84130', '8013758858', '          ', 'WUUVPN11', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 6, '2010-07-15', '2011-02-28', 0, 0, 0, 'Timpanogos Regional Hospital', '', '', '', 'HCFA|UB|', '1649204389', 0, 'N', 0, '2013-11-25', NULL, NULL, 0, 0, NULL, NULL),
('870281028', 'W12002702', 'W12002702', 'UT01', 'Central Utah Clinic', 'Larry', 'K', 'Nobuhara', 'MD', 'Internal Medicine', '', '', NULL, 'O', '1055 N 500 W Ste 212 Bldg C', 'Provo', 'Utah', 'UT', '84604', '8013742362', NULL, '1055 N 500 W Ste 212 Bldg C', 'Provo', 'Utah', 'UT', '84604', '8013742362', '          ', 'WUUVPN11', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 6, '2010-07-15', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '0000007887', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870281028', 'W12002703', 'W12002703', 'UT01', 'Central Utah Clinic', 'Larry', 'K', 'Nobuhara', 'MD', 'Internal Medicine', '', '', NULL, 'B', 'PO Box 30079', 'Salt Lake City', 'Utah', 'UT', '84130', '8013758858', NULL, 'PO Box 30079', 'Salt Lake City', 'Utah', 'UT', '84130', '8013758858', '          ', 'WUUVPN11', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 6, '2010-07-15', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '0000007887', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870281028', 'W12002704', 'W12002704', 'UT01', 'Central Utah Clinic', 'Lawrence', 'K', 'Nobuhara', 'MD', 'Internal Medicine', '', '', NULL, 'O', '1055 N 500 W', 'Provo', 'Utah', 'UT', '84604', '8013742362', '8014290629', '1055 N 500 W', 'Provo', 'Utah', 'UT', '84604', '8013742362', '8014290629', 'WUUVPN11', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 6, '2010-07-15', '2011-02-28', 0, 0, 0, 'Timpanogos Regional Hospital', '', '', '', 'HCFA|UB|', '1740399385', 0, 'N', 0, '2014-04-07', NULL, NULL, 0, 0, NULL, NULL),
('870281028', 'W12002705', 'W12002705', 'UT01', 'Central Utah Clinic', 'Lawrence', 'K', 'Nobuhara', 'MD', 'Internal Medicine', '', '', NULL, 'B', 'PO Box 30079', 'Salt Lake City', 'Salt Lake', 'UT', '84130', '8013758858', '8014290629', 'PO Box 30079', 'Salt Lake City', 'Salt Lake', 'UT', '84130', '8013758858', '8014290629', 'WUUVPN11', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 6, '2010-07-15', '2011-02-28', 0, 0, 0, 'Timpanogos Regional Hospital', '', '', '', 'HCFA|UB|', '1740399385', 0, 'Y', 0, '2014-04-07', NULL, NULL, 0, 0, NULL, NULL),
('870281028', 'W12002706', 'W12002706', 'UT01', 'Central Utah Clinic', 'Richard', 'K', 'Olsen', 'MD', 'Internal Medicine', '', '', NULL, 'O', '1055 N 500 W Ste 212 Bld C', 'Provo', 'Utah', 'UT', '84604', '8013742362', NULL, '1055 N 500 W Ste 212 Bld C', 'Provo', 'Utah', 'UT', '84604', '8013742362', '          ', 'WUUVPN11', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 6, '2010-07-15', '2011-02-28', 0, 0, 0, 'Timpanogos Regional Hospital', '', '', '', 'HCFA|UB|', '1932157138', 0, 'N', 0, '2014-01-28', NULL, NULL, 0, 0, NULL, NULL),
('870281028', 'W12002707', 'W12002707', 'UT01', 'Central Utah Clinic', 'Richard', 'K', 'Olsen', 'MD', 'Internal Medicine', '', '', NULL, 'B', 'PO Box 30079', 'Salt Lake City', 'Salt Lake', 'UT', '84130', '8013758858', NULL, 'PO Box 30079', 'Salt Lake City', 'Salt Lake', 'UT', '84130', '8013758858', '          ', 'WUUVPN11', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 6, '2010-07-15', '2011-02-28', 0, 0, 0, 'Timpanogos Regional Hospital', '', '', '', 'HCFA|UB|', '1932157138', 0, 'Y', 0, '2014-01-28', NULL, NULL, 0, 0, NULL, NULL),
('870281028', 'W12002708', 'W12002708', 'UT01', 'St George Clinic', 'Gus', 'C', 'Pendleton', 'MD', 'Family Practice', '', '', NULL, 'O', '736 S 900 E Ste 203', 'St George', 'Washington', 'UT', '84790', '4356736131', '4356738557', '736 S 900 E Ste 203', 'St George', 'Washington', 'UT', '84790', '4356736131', '4356738557', 'WUUVPN11', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 6, '2010-07-15', '2011-02-28', 0, 0, 0, 'Dixie Regional Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1649361874', 0, 'N', 0, '2013-10-16', NULL, NULL, 0, 0, NULL, NULL),
('870281028', 'W12002709', 'W12002709', 'UT01', 'St George Clinic', 'Gus', 'C', 'Pendleton', 'MD', 'Family Practice', '', '', NULL, 'B', 'PO Box 30079', 'Salt Lake City', 'Salt Lake', 'UT', '84130', '4356736131', '4356738557', 'PO Box 30079', 'Salt Lake City', 'Salt Lake', 'UT', '84130', '4356736131', '4356738557', 'WUUVPN11', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 6, '2010-07-15', '2011-02-28', 0, 0, 0, 'Dixie Regional Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1649361874', 0, 'Y', 0, '2013-10-16', NULL, NULL, 0, 0, NULL, NULL),
('870281028', 'W12002710', 'W12002710', 'UT01', 'Central Utah Clinic', 'Samuel', 'R', 'Peterson', 'MD', 'Dermatology', '', '', NULL, 'O', '1055 N 500 W Ste 111 Bld C', 'Provo', 'Utah', 'UT', '84604', '8013748999', NULL, '1055 N 500 W Ste 111 Bld C', 'Provo', 'Utah', 'UT', '84604', '8013748999', '', 'WUUVPN11', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 6, '2010-07-15', '2011-02-28', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1073571295', 0, 'N', 0, '2014-06-25', NULL, NULL, 0, 0, NULL, NULL),
('870281028', 'W12002711', 'W12002711', 'UT01', 'Central Utah Clinic', 'Samuel', 'R', 'Peterson', 'MD', 'Dermatology', '', '', NULL, 'B', 'PO Box 30079', 'Salt Lake City', 'Salt Lake', 'UT', '84130', '8013758858', NULL, 'PO Box 30079', 'Salt Lake City', 'Salt Lake', 'UT', '84130', '8013758858', '', 'WUUVPN11', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 6, '2010-07-15', '2011-02-28', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1073571295', 0, 'Y', 0, '2014-06-25', NULL, NULL, 0, 0, NULL, NULL),
('870281028', 'W12002712', 'W12002712', 'UT01', '', 'McKay', 'L', 'Platt', 'MD', 'Urology', '', '', NULL, 'O', '1055 N 500 W Ste 211', 'Provo', 'Utah', 'UT', '84604', '8013577327', NULL, '1055 N 500 W Ste 211', 'Provo', 'Utah', 'UT', '84604', '8013577327', '          ', 'WUUVPN11', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 6, '2010-07-15', '2011-02-28', 0, 0, 0, 'Timpanogos Regional Hospital', 'Mountain View Hospital', '', '', 'HCFA|UB|', '1336230085', 0, 'N', 0, '2013-09-09', NULL, NULL, 0, 0, NULL, NULL),
('870281028', 'W12002713', 'W12002713', 'UT01', '', 'McKay', 'L', 'Platt', 'MD', 'Urology', '', '', NULL, 'B', 'PO Box 30079', 'Salt Lake City', 'Salt Lake', 'UT', '84130', '8013758858', NULL, 'PO Box 30079', 'Salt Lake City', 'Salt Lake', 'UT', '84130', '8013758858', '          ', 'WUUVPN11', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 6, '2010-07-15', '2011-02-28', 0, 0, 0, 'Timpanogos Regional Hospital', 'Mountain View Hospital', '', '', 'HCFA|UB|', '1336230085', 0, 'Y', 0, '2013-09-09', NULL, NULL, 0, 0, NULL, NULL),
('870281028', 'W12002714', 'W12002714', 'UT01', 'Central Utah Clinic', 'Ryan', 'A', 'Richards', 'MD', 'Orthopedic Surgery', '', '', NULL, 'O', '1055 N 500 W Ste 121', 'Provo', 'Utah', 'UT', '84604', '8013577350', NULL, '1055 N 500 W Ste 121', 'Provo', 'Utah', 'UT', '84604', '8013577350', '          ', 'WUUVPN11', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 6, '2010-07-15', '2011-02-28', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1427149178', 0, 'N', 0, '2011-04-08', NULL, NULL, 0, 0, NULL, NULL),
('870281028', 'W12002715', 'W12002715', 'UT01', 'Central Utah Clinic', 'Ryan', 'A', 'Richards', 'MD', 'Orthopedic Surgery', '', '', NULL, 'O', '50 S Medical Dr Ste 6', 'Payson', 'Utah', 'UT', '84651', '8014652527', NULL, '50 S Medical Dr Ste 6', 'Payson', 'Utah', 'UT', '84651', '8014652527', '          ', 'WUUVPN11', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 6, '2010-07-15', '2011-02-28', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1427149178', 0, 'N', 0, '2011-04-08', NULL, NULL, 0, 0, NULL, NULL),
('870281028', 'W12002716', 'W12002716', 'UT01', 'Central Utah Clinic', 'Ryan', 'A', 'Richards', 'MD', 'Orthopedic Surgery', '', '', NULL, 'O', '700 W 800 N Ste 100', 'Orem', 'Utah', 'UT', '84057', '8012245373', NULL, '700 W 800 N Ste 100', 'Orem', 'Utah', 'UT', '84057', '8012245373', '          ', 'WUUVPN11', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 6, '2010-07-15', '2011-02-28', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1427149178', 0, 'N', 0, '2011-04-08', NULL, NULL, 0, 0, NULL, NULL),
('870281028', 'W12002717', 'W12002717', 'UT01', 'Central Utah Clinic', 'Ryan', 'A', 'Richards', 'MD', 'Orthopedic Surgery', '', '', NULL, 'B', 'PO Box 30079', 'Salt Lake City', 'Salt Lake', 'UT', '84130', '8013758858', NULL, 'PO Box 30079', 'Salt Lake City', 'Salt Lake', 'UT', '84130', '8013758858', '          ', 'WUUVPN11', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 6, '2010-07-15', '2011-02-28', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1427149178', 0, 'Y', 0, '2011-04-08', NULL, NULL, 0, 0, NULL, NULL),
('870281028', 'W12002718', 'W12002718', 'UT01', 'Central Utah Clinic', 'Joseph', 'L', 'Richey', 'MD', 'Orthopedic Surgery', '', '', NULL, 'o', '1055 N 500 W Ste 121', 'Provo', 'Utah', 'UT', '84604', '8013737350', '8013742615', '1055 N 500 W Ste 121', 'Provo', 'Utah', 'UT', '84604', '8013737350', '8013742615', 'WUUVPN11', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 6, '2010-07-15', '2011-02-28', 0, 0, 0, 'Mountain View Hospital', '', '', '', 'HCFA|UB|', '1982708913', 0, 'N', 0, '2014-04-14', NULL, NULL, 0, 0, NULL, NULL),
('870281028', 'W12002719', 'W12002719', 'UT01', 'Central Utah Clinic', 'Joseph', 'L', 'Richey', 'MD', 'Orthopedic Surgery', '', '', NULL, 'B', 'PO Box 30079', 'Salt Lake City', 'Utah', 'UT', '84130', '8013758858', '8013742615', 'PO Box 30079', 'Salt Lake City', 'Utah', 'UT', '84130', '8013758858', '8013742615', 'WUUVPN11', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 6, '2010-07-15', '2011-02-28', 0, 0, 0, 'Mountain View Hospital', '', '', '', 'HCFA|UB|', '1982708913', 0, 'Y', 0, '2014-04-14', NULL, NULL, 0, 0, NULL, NULL),
('870281028', 'W12002720', 'W12002720', 'UT01', 'Central Utah Clinic', 'Rex', 'Fowler', 'Ripplinger', 'MD', 'Internal Medicine', 'Emergency Medicine', '', NULL, 'O', '1055 N 500 W', 'Provo', 'Utah', 'UT', '84604', '8013742362', '8013742615', '1055 N 500 W', 'Provo', 'Utah', 'UT', '84604', '8013742362', '8013742615', 'WUUVPN11', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 6, '2010-07-15', '2011-02-28', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1083674972', 0, 'N', 0, '2011-04-08', NULL, NULL, 0, 0, NULL, NULL),
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('870281028', 'W12002753', 'W12002753', 'UT01', 'Central Utah Clinic', 'Brett', 'L', 'Thorpe', 'MD', 'Gastroenterology', '', '', NULL, 'B', 'PO Box 30079', 'Salt Lake City', 'Utah', 'UT', '84130', '8013758858', '8014298041', 'PO Box 30079', 'Salt Lake City', 'Utah', 'UT', '84130', '8013758858', '8014298041', 'WUUVPN11', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 6, '2010-07-15', '2011-02-28', 0, 0, 0, 'Timpanogos Regional Hospital', 'Mountain View Hospital', '', '', 'HCFA|UB|', '1962432583', 0, 'Y', 0, '2013-09-20', NULL, NULL, 0, 0, NULL, NULL),
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('870281028', 'W12002771', 'W12002771', 'UT01', 'Central Utah Clinic', 'David', 'C', 'Wang', 'MD', 'Cardiovascular Disease', '', '', NULL, 'O', '1055 N 500 W Ste 101', 'Provo', 'Utah', 'UT', '84604', '8013734366', NULL, '1055 N 500 W Ste 101', 'Provo', 'Utah', 'UT', '84604', '8013734366', '          ', 'WUUVPN11', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 6, '2010-07-15', '2011-02-28', 0, 0, 0, 'Timpanogos Regional Hospital', '', '', '', 'HCFA|UB|', '1649491440', 0, 'Y', 0, '2011-10-04', NULL, NULL, 0, 0, NULL, NULL),
('870281028', 'W12002772', 'W12002772', 'UT01', 'Central Utah Clinic', 'David', 'C', 'Wang', 'MD', 'Cardiovascular Disease', '', '', NULL, 'B', 'PO Box 30079', 'Salt Lake City', 'Salt Lake', 'UT', '84130', '8013758858', NULL, 'PO Box 30079', 'Salt Lake City', 'Salt Lake', 'UT', '84130', '8013758858', '          ', 'WUUVPN11', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 6, '2010-07-15', '2011-02-28', 0, 0, 0, 'Timpanogos Regional Hospital', '', '', '', 'HCFA|UB|', '1649491440', 0, 'Y', 0, '2011-10-04', NULL, NULL, 0, 0, NULL, NULL);
INSERT INTO `providers_new` (`Provider_Tax_ID`, `Provider_Suffix`, `Provider_Network_ID`, `Provider_Region`, `Provider_Name`, `Provider_Doctor_First_Name`, `Provider_Doctor_Middle_Name`, `Provider_Doctor_Last_Name`, `Provider_Doctor_Degree`, `Provider_Specialty_1`, `Provider_Specialty_2`, `Provider_Specialty_3`, `Provider_Specialty_4`, `Provider_Address_Type`, `Provider_Address`, `Provider_City`, `Provider_County`, `Provider_State`, `Provider_Zip`, `Provider_Phone`, `Provider_Fax`, `Provider_Mailing_Address`, `Provider_Mailing_City`, `Provider_Mailing_County`, `Provider_Mailing_State`, `Provider_Mailing_Zip`, `Provider_Mailing_Phone`, `Provider_Mailing_Fax`, `Provider_Primary_Schedule`, `Provider_Secondary_Schedule`, `Provider_Rate_Sheet`, `Provider_Anes_Rate`, `Provider_Default_Rate`, `Provider_Max_DOS`, `Provider_Min_Match_Value`, `Provider_Effective_Date`, `Provider_Term_Date`, `Provider_Pend`, `Provider_Anes_Minutes`, `Provider_PPO`, `Provider_Hospital_1`, `Provider_Hospital_2`, `Provider_Hospital_3`, `Provider_Hospital_4`, `Provider_Type`, `Provider_NPI`, `Provider_Check_Override`, `Exclude_Dir`, `Audit_Status`, `Last_Change_Date`, `Medicare_ID`, `Provider_Lang`, `Provider_Latitude`, `Provider_Longitude`, `Provider_school`, `Provider_cert`) VALUES
('870281028', 'W12002773', 'W12002773', 'UT01', 'Central Utah Clinic', 'Roberta', 'L', 'Ward', 'CNM', 'Obstetrics and Gynecology', '', '', NULL, 'O', '1886 W 800 N', 'Pleasant Grove', 'Utah', 'UT', '84062', '8017565288', '8017567589', '1886 W 800 N', 'Pleasant Grove', 'Utah', 'UT', '84062', '8017565288', '8017567589', 'WUUVPN11', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 6, '2010-07-15', '2011-02-28', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1679686034', 0, 'N', 0, '2012-04-04', NULL, NULL, 0, 0, NULL, NULL),
('870281028', 'W12002774', 'W12002774', 'UT01', 'Central Utah Clinic', 'Roberta', 'L', 'Ward', 'CNM', 'Obstetrics and Gynecology', '', '', NULL, 'B', 'PO Box 30079', 'Salt Lake City', 'Salt Lake', 'UT', '84130', '8017565288', '8017567589', 'PO Box 30079', 'Salt Lake City', 'Salt Lake', 'UT', '84130', '8017565288', '8017567589', 'WUUVPN11', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 6, '2010-07-15', '2011-02-28', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1679686034', 0, 'Y', 0, '2012-04-04', NULL, NULL, 0, 0, NULL, NULL),
('870281028', 'W12002775', 'W12002775', 'UT01', 'Wasatch Otolaryngology Group', '', '', 'Wasatch Otolaryngology Group', 'GROUP', '', '', '', NULL, 'O', '39 Professional Way', 'Payson', 'Utah', 'UT', '84651', '8014654805', NULL, '39 Professional Way', 'Payson', 'Utah', 'UT', '84651', '8014654805', '          ', 'WUUVPN11', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 6, '2010-07-15', '2011-02-28', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '0000009522', 0, 'Y', 0, '2011-04-13', NULL, NULL, 0, 0, NULL, NULL),
('870281028', 'W12002776', 'W12002776', 'UT01', 'Wasatch Otolaryngology Group', '', '', 'Wasatch Otolaryngology Group', 'GROUP', '', '', '', NULL, 'O', '700 W 800 N', 'Orem', 'Utah', 'UT', '84057', '8014290620', NULL, '700 W 800 N', 'Orem', 'Utah', 'UT', '84057', '8014290620', '          ', 'WUUVPN11', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 6, '2010-07-15', '2011-02-28', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '0000009522', 0, 'Y', 0, '2011-04-13', NULL, NULL, 0, 0, NULL, NULL),
('870281028', 'W12002777', 'W12002777', 'UT01', 'Wasatch Otolaryngology Group', '', '', 'Wasatch Otolaryngology Group', 'GROUP', '', '', '', NULL, 'B', 'PO Box 30079', 'Salt Lake City', 'Salt Lake', 'UT', '84130', '8013758858', NULL, 'PO Box 30079', 'Salt Lake City', 'Salt Lake', 'UT', '84130', '8013758858', '          ', 'WUUVPN11', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 6, '2010-07-15', '2011-02-28', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '0000009522', 0, 'Y', 0, '2013-10-24', NULL, NULL, 0, 0, NULL, NULL),
('870281028', 'W12002778', 'W12002778', 'UT01', 'Central Utah Clinic', 'David', 'H', 'Watters', 'MD', 'Radiologist', '', '', NULL, 'B', '1055 N 500 W Ste 112 Bld C', 'Provo', 'Utah', 'UT', '84604', '8018124624', NULL, '1055 N 500 W Ste 112 Bld C', 'Provo', 'Utah', 'UT', '84604', '8018124624', '          ', 'WUUVPN11', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 6, '2010-07-15', '2011-02-28', 0, 0, 0, 'Mountain View Hospital', 'Timpanogos Regional Hospital', NULL, NULL, 'HCFA|UB|', '1558397570', 0, 'N', 0, '2014-01-17', NULL, NULL, 0, 0, NULL, NULL),
('870281028', 'W12002779', 'W12002779', 'UT01', 'Central Utah Clinic PC-Radiology', 'David', 'H', 'Watters', 'MD', 'Radiologist', '', '', NULL, 'O', '852 N 500 W', 'Provo', 'Utah', 'UT', '84604', '8018124624', '8018124699', '852 N 500 W', 'Provo', 'Utah', 'UT', '84604', '8018124624', '8018124699', 'WUUVPN11', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 6, '2010-07-15', '2011-02-28', 0, 0, 0, 'Mountain View Hospital', 'Timpanogos Regional Hospital', NULL, NULL, 'HCFA|UB|', '1558397570', 0, 'Y', 0, '2014-01-17', NULL, NULL, 0, 0, NULL, NULL),
('870281028', 'W12002780', 'W12002780', 'UT01', 'Central Utah Clinic', 'Karl', 'N', 'Weenig', 'MD', 'Family Practice', 'Sports Medicine', '', NULL, 'O', '1055 N 500 W Ste 121', 'Provo', 'Utah', 'UT', '84604', '8013577350', NULL, '1055 N 500 W Ste 121', 'Provo', 'Utah', 'UT', '84604', '8013577350', '          ', 'WUUVPN11', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 6, '2010-07-15', '2011-02-28', 0, 0, 0, 'Mountain View Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1740242973', 0, 'N', 0, '2013-08-28', NULL, NULL, 0, 0, NULL, NULL),
('870281028', 'W12002781', 'W12002781', 'UT01', 'Central Utah Clinic', 'Karl', 'N', 'Weenig', 'MD', 'Family Practice', 'Sports Medicine', '', NULL, 'o', '50 S Medical Dr Ste 6', 'Payson', 'Utah', 'UT', '84651', '8014652527', '8013742615', '50 S Medical Dr Ste 6', 'Payson', 'Utah', 'UT', '84651', '8014652527', '8013742615', 'WUUVPN11', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 6, '2010-07-15', '2011-02-28', 0, 0, 0, 'Mountain View Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1740242973', 0, 'N', 0, '2013-08-28', NULL, NULL, 0, 0, NULL, NULL),
('870281028', 'W12002782', 'W12002782', 'UT01', 'Central Utah Clinic', 'Karl', 'N', 'Weenig', 'MD', 'Family Practice', 'Sports Medicine', '', NULL, 'O', '700 W 800 N Ste 100', 'Orem', 'Utah', 'UT', '84057', '8012245373', '8018124699', '700 W 800 N Ste 100', 'Orem', 'Utah', 'UT', '84057', '8012245373', '8018124699', 'WUUVPN11', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 6, '2010-07-15', '2011-02-28', 0, 0, 0, 'Mountain View Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1740242973', 0, 'N', 0, '2013-08-28', NULL, NULL, 0, 0, NULL, NULL),
('870281028', 'W12002783', 'W12002783', 'UT01', 'Central Utah Clinic', 'Karl', 'N', 'Weenig', 'MD', 'Family Practice', 'Sports Medicine', '', NULL, 'B', 'PO Box 30079', 'Salt Lake City', 'Salt Lake', 'UT', '84130', '8013758858', '8018124699', 'PO Box 30079', 'Salt Lake City', 'Salt Lake', 'UT', '84130', '8013758858', '8018124699', 'WUUVPN11', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 6, '2010-07-15', '2011-02-28', 0, 0, 0, 'Mountain View Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1740242973', 0, 'Y', 0, '2013-08-28', NULL, NULL, 0, 0, NULL, NULL),
('870281028', 'W12002784', 'W12002784', 'UT01', 'Central Utah Clinic', 'John', 'T', 'Wells', 'MD', 'Orthopedic Surgery', '', '', NULL, 'O', '1184 E 80 N', 'American Fork', 'Utah', 'UT', '84003', '8017633885', NULL, '1184 E 80 N', 'American Fork', 'Utah', 'UT', '84003', '8017633885', '          ', 'WUUVPN11', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 6, '2010-07-15', '2011-02-28', 0, 0, 0, 'Timpanogos Regional Hospital', '', '', '', 'HCFA|UB|', '1740371376', 0, 'N', 0, '2013-09-13', NULL, NULL, 0, 0, NULL, NULL),
('870281028', 'W12002785', 'W12002785', 'UT01', 'Central Utah Clinic', 'John', 'T', 'Wells', 'MD', 'Orthopedic Surgery', '', '', NULL, 'B', '1055 N 500 W', 'Provo', 'Utah', 'UT', '84604', '8013758858', NULL, '1055 N 500 W', 'Provo', 'Utah', 'UT', '84604', '8013758858', '          ', 'WUUVPN11', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 6, '2010-07-15', '2011-02-28', 0, 0, 0, 'Timpanogos Regional Hospital', '', '', '', 'HCFA|UB|', '1740371376', 0, 'Y', 0, '2013-09-13', NULL, NULL, 0, 0, NULL, NULL),
('870281028', 'W12002786', 'W12002786', 'UT01', 'Central Utah Clinic', 'John', 'T', 'Wells', 'MD', 'Orthopedic Surgery', '', '', NULL, 'B', 'PO Box 30079', 'Salt Lake City', 'Salt Lake', 'UT', '84130', '8013758858', NULL, 'PO Box 30079', 'Salt Lake City', 'Salt Lake', 'UT', '84130', '8013758858', '          ', 'WUUVPN11', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 6, '2010-07-15', '2011-02-28', 0, 0, 0, 'Timpanogos Regional Hospital', '', '', '', 'HCFA|UB|', '1740371376', 0, 'Y', 0, '2013-09-13', NULL, NULL, 0, 0, NULL, NULL),
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('820161600', 'W12002859', 'W12002859', 'ID01', 'St Lukes Clinic Cardiothoracic & Vascular Assoc', 'Matthew', 'W', 'Schoolfield', 'MD This Provider will terminate on July 1st', 'Cardiovascular Disease', '', '', NULL, 'O', '333 N 1st St Ste 280', 'Boise', 'Ada', 'ID', '83702', '2083456545', '2083451213', '333 N 1st St Ste 280', 'Boise', 'Ada', 'ID', '83702', '2083456545', '2083451213', '', '', '', '0.00', '15.00', '0.00', 8, '2010-07-01', '2012-07-01', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1275758377', 0, 'N', 0, '2012-05-31', NULL, NULL, 43.6135, -116.194, NULL, NULL),
('820161600', 'W12002860', 'W12002860', 'ID01', 'St Lukes Clinic Cardiothoracic & Vascular Assoc', 'David', 'C', 'Stuesse', 'MD This Provider will terminate on July 1st', 'Cardiovascular Disease', '', '', NULL, 'O', '333 N 1st St Ste 280', 'Boise', 'Ada', 'ID', '83702', '2083456545', '2083451213', '333 N 1st St Ste 280', 'Boise', 'Ada', 'ID', '83702', '2083456545', '2083451213', '', '', '', '0.00', '15.00', '0.00', 8, '2010-07-01', '2012-07-01', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1427155290', 0, 'N', 0, '2012-05-31', NULL, NULL, 43.6135, -116.194, NULL, NULL),
('820161600', 'W12002861', 'W12002861', 'ID01', 'St Lukes Clinic Cardiothoracic & Vascular Assoc', 'Michael', 'J', 'Tullis', 'MD This Provider will terminate on July 1st', 'Cardiovascular Disease', '', '', NULL, 'O', '333 N 1st St Ste 280', 'Boise', 'Ada', 'ID', '83702', '2083456545', '2083451213', '333 N 1st St Ste 280', 'Boise', 'Ada', 'ID', '83702', '2083456545', '2083451213', '', '', '', '0.00', '15.00', '0.00', 8, '2010-07-01', '2012-07-01', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1598717985', 0, 'Y', 0, '2012-10-09', NULL, NULL, 43.6135, -116.194, NULL, NULL),
('820161600', 'W12002862', 'W12002862', 'ID01', 'CVA Vascular Lab', 'Michael', 'J', 'Tullis', 'MD This Provider will terminate on July 1st', 'Cardiovascular Disease', '', '', NULL, 'O', '977 S Progress Way', 'Meridian', 'Ada', 'ID', '83642', '2088989381', NULL, '977 S Progress Way', 'Meridian', 'Ada', 'ID', '83642', '2088989381', '          ', '', '', '', '0.00', '15.00', '0.00', 8, '2010-07-01', '2012-07-01', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1598717985', 0, 'N', 0, '2012-10-09', NULL, NULL, 0, 0, NULL, NULL),
('870549057', 'W12003063', 'W12003063', 'UT01', 'Utah Valley Pediatrics', 'Jeffrey', 'L', 'Jensen', 'MD', 'Pediatrics', '', '', NULL, 'O', '1355 N University Ave Ste 210', 'Provo', 'Utah', 'UT', '84604', '8013738930', NULL, '1355 N University Ave Ste 210', 'Provo', 'Utah', 'UT', '84604', '8013738930', '          ', 'WUUVPN11', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 3, '2010-07-15', '2011-03-31', 0, 0, 0, 'Timpanogos Regional Hospital', '', '', '', 'HCFA|UB|', '1275591471', 0, 'N', 0, '2014-01-06', NULL, NULL, 0, 0, NULL, NULL),
('262653132', 'W12002871', 'W12002871', 'UT01', 'Alpine Family Medicine', 'Daniel', 'W', 'Egan', 'MD', 'Family Practice', '', '', NULL, 'O', '155 W Canyon Crest Rd Ste 200', 'Alpine', 'Utah', 'UT', '84004', '8017639851', '8017639852', '155 W Canyon Crest Rd Ste 200', 'Alpine', 'Utah', 'UT', '84004', '8017639851', '8017639852', 'WUUVPN11', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 3, '2010-07-15', '2011-01-30', 0, 0, 0, 'Timpanogos Regional Hospital', '', '', '', 'HCFA|UB|', '1417066564', 0, 'N', 0, '2013-08-13', NULL, NULL, 0, 0, NULL, NULL),
('262653132', 'W12002872', 'W12002872', 'UT01', 'Alpine Family Medicine', 'Peter', 'V', 'Sundwall', 'MD', 'Family Practice', '', '', NULL, 'O', '155 W Canyon Crest Rd Ste 200', 'Alpine', 'Utah', 'UT', '84004', '8017639851', '8017639852', '155 W Canyon Crest Rd Ste 200', 'Alpine', 'Utah', 'UT', '84004', '8017639851', '8017639852', 'WUUVPN11', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 3, '2010-07-15', '2011-01-31', 0, 0, 0, 'Timpanogos Regional Hospital', '', '', '', 'HCFA|UB|', '1558470641', 0, 'N', 0, '2013-09-23', NULL, NULL, 0, 0, NULL, NULL),
('270354831', 'W12002873', 'W12002873', 'UT01', 'Integrative Medical Associates', 'Stuart', 'B', 'Porter', 'DO', 'Family Practice', '', '', NULL, 'O', '3650 N University Ave Ste 200', 'Provo', 'Utah', 'UT', '84604', '8013739920', NULL, '3650 N University Ave Ste 200', 'Provo', 'Utah', 'UT', '84604', '8013739920', '          ', 'WUUVPN11', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 3, '2010-07-15', '2010-12-31', 0, 0, 0, 'Timpanogos Regional Hospital', 'Mountain View Hospital', '', '', 'HCFA|UB|', '1689612996', 0, 'N', 0, '2013-04-11', NULL, NULL, 0, 0, NULL, NULL),
('270627913', 'W12002874', 'W12002874', 'UT01', 'Hobble Creek Med Center', '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', '          ', 'WUUVPN11', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 3, '2010-07-15', '2011-01-31', 0, 0, 0, 'Mountain View Hospital', '', '', '', 'HCFA|UB|', '1245258425', 0, 'N', 0, '2013-06-19', 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
('270627913', 'W12002875', 'W12002875', 'UT01', 'Hobble Creek Med Center', 'Deborah', 'A', 'Hill', 'NP', 'Pediatrics', '', '', NULL, 'O', '269 E 400 S', 'Springville', 'Utah', 'UT', '84663', '8014919883', NULL, '269 E 400 S', 'Springville', 'Utah', 'UT', '84663', '8014919883', '          ', 'WUUVPN11', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 3, '2010-07-15', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1821016015', 0, 'N', 0, '2009-09-25', NULL, NULL, 40.1611, -111.606, NULL, NULL),
('270627913', 'W12002876', 'W12002876', 'UT01', 'Hobble Creek Med Center', NULL, NULL, 'Hobble Creek Med Center', 'GROUP', 'Clinic', '', '', NULL, 'B', 'PO Box 9117', 'Belfast', 'Waldo', 'ME', '04915', '8014919883', NULL, 'PO Box 9117', 'Belfast', 'Waldo', 'ME', '04915', '8014919883', '          ', 'WUUVPN11', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 3, '2010-07-15', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '0000006737', 0, 'N', 0, '2009-10-05', NULL, NULL, 0, 0, NULL, NULL),
('270627913', 'W12002877', 'W12002877', 'UT01', 'Hobble Creek Med Center', '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', '          ', 'WUUVPN11', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 3, '2010-07-15', '2011-12-31', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1598799462', 0, 'N', 0, '2011-02-03', NULL, NULL, 0, 0, NULL, NULL),
('270627913', 'W12002878', 'W12002878', 'UT01', 'Hobble Creek Med Center', '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', '          ', 'WUUVPN11', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 3, '2010-07-15', '2011-12-31', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1225062904', 0, 'N', 0, '2011-02-03', NULL, NULL, 0, 0, NULL, NULL),
('528723936', 'W12002879', 'W12002879', 'UT01', '', 'Steven', 'G', 'Nance', 'MD', 'Obstetrics and Gynecology', '', '', NULL, 'O', '285 E 400 S', 'Springville', 'Utah', 'UT', '84663', '8014890111', NULL, '285 E 400 S', 'Springville', 'Utah', 'UT', '84663', '8014890111', '', 'WUUVPN11', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 3, '2010-07-15', '2011-02-28', 0, 0, 0, 'Mountain View Regional Hospital', '', '', '', 'HCFA|UB|', '1376645887', 0, 'N', 0, '2014-04-04', NULL, NULL, 0, 0, NULL, NULL),
('547769846', 'W12002880', 'W12002880', 'UT01', 'Foot & Ankle Institute', 'Val', 'G', 'Mullinax', 'DPM', 'Podiatry', '', '', NULL, 'O', '1928 N State St Ste 6', 'Provo', 'Utah', 'UT', '84604', '8013743010', NULL, '1928 N State St Ste 6', 'Provo', 'Utah', 'UT', '84604', '8013743010', '', 'WUUVPN11', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 3, '2013-02-15', '2013-02-15', 0, 0, 0, 'Timpanogos Regional Hospital', '', '', '', 'HCFA|UB|', '1528179256', 0, 'N', 0, '2014-06-04', NULL, NULL, 0, 0, NULL, NULL),
('547769846', 'W12002881', 'W12002881', 'UT01', 'Foot & Ankle Institute', 'Val', 'G', 'Mullinax', 'DPM', 'Podiatry', '', '', NULL, 'O', '78 E 900 N', 'Spanish Fork', 'Utah', 'UT', '84660', '8013743010', NULL, '78 E 900 N', 'Spanish Fork', 'Utah', 'UT', '84660', '8013743010', '', 'WUUVPN11', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 3, '2010-07-15', '2011-10-26', 0, 0, 0, 'Timpanogos Regional Hospital', '', '', '', 'HCFA|UB|', '1528179256', 0, 'N', 0, '2014-06-04', NULL, NULL, 0, 0, NULL, NULL),
('651189885', 'W12002882', 'W12002882', 'UT01', '', 'Jon', 'B', 'Bishop', 'MD', 'Plastic Surgery', '', '', NULL, 'O', '700 W 800 N Ste 442', 'Orem', 'Utah', 'UT', '84057', '8018020120', NULL, '700 W 800 N Ste 442', 'Orem', 'Utah', 'UT', '84057', '8018020120', '          ', 'WUUVPN11', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 3, '2010-07-15', '2011-01-20', 0, 0, 0, 'Timpanogos Regional Hospital', '', '', '', 'HCFA|UB|', '1609818616', 0, 'N', 0, '2014-01-29', NULL, NULL, 0, 0, NULL, NULL),
('841380939', 'W12002883', 'W12002883', 'UT01', '', 'Kipp', '', 'Robins', 'MD', 'Ear, Nose and Throat', '', '', NULL, 'O', '2230 N University Pkwy Ste 9B', 'Provo', 'Utah', 'UT', '84604', '8013753175', NULL, '2230 N University Pkwy Ste 9B', 'Provo', 'Utah', 'UT', '84604', '8013753175', '          ', 'WUUVPN11', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 3, '2010-07-15', NULL, 0, 0, 0, 'Timpanogos Regional Hospital', '', '', '', 'HCFA|UB|', '1396741476', 0, 'N', 0, '2013-04-16', NULL, NULL, 40.2621, -111.666, NULL, NULL),
('841429983', 'W12002884', 'W12002884', 'UT01', 'Cotton Tree Medical', 'Richard', 'J', 'Holmes', 'MD', 'Family Practice', 'Obstetrics and Gynecology', '', NULL, 'O', '2230 N University Pkwy Ste 1A', 'Provo', 'Utah', 'UT', '84604', '8013773413', NULL, '2230 N University Pkwy Ste 1A', 'Provo', 'Utah', 'UT', '84604', '8013773413', '          ', 'WUUVPN11', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 3, '2010-07-15', '2011-01-31', 0, 0, 0, 'Timpanogos Regional Hospital', '', '', '', 'HCFA|UB|', '1083601942', 0, 'N', 0, '2011-01-28', NULL, NULL, 0, 0, NULL, NULL),
('841429983', 'W12002885', 'W12002885', 'UT01', 'Cotton Tree Medical', 'James', '', 'Woodmansee', 'MD', 'Family Practice', 'Obstetrics and Gynecology', '', NULL, 'O', '2230 N University Pkwy Ste 1A', 'Provo', 'Utah', 'UT', '84604', '8013773413', NULL, '2230 N University Pkwy Ste 1A', 'Provo', 'Utah', 'UT', '84604', '8013773413', '', 'WUUVPN11', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 3, '2010-07-15', '2011-01-31', 0, 0, 0, 'Timpanogos Regional Hospital', '', '', '', 'HCFA|UB|', '1093703530', 0, 'N', 0, '2014-04-10', NULL, NULL, 0, 0, NULL, NULL),
('870235759', 'W12002886', 'W12002886', 'UT01', 'Central Utah Foot & Ankle Clinic', NULL, NULL, 'Central Utah Foot & Ankle Clinic', 'GROUP', NULL, '', '', NULL, 'O', '120 N 1220 E', 'American Fork', 'Utah', 'UT', '84003', '8017564200', NULL, '120 N 1220 E', 'American Fork', 'Utah', 'UT', '84003', '8017564200', '          ', 'WUUVPN11', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 3, '2010-07-15', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '0000005621', 0, 'Y', 0, '2006-10-19', NULL, NULL, 40.379, -111.765, NULL, NULL),
('870235759', 'W12002887', 'W12002887', 'UT01', 'Central Utah Foot & Ankle Clinic', NULL, NULL, 'Central Utah Foot & Ankle Clinic', 'GROUP', NULL, '', '', NULL, 'O', '150 W 800 N', 'Provo', 'Utah', 'UT', '84601', '8013755353', NULL, '150 W 800 N', 'Provo', 'Utah', 'UT', '84601', '8013755353', '          ', 'WUUVPN11', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 3, '2010-07-15', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '0000005621', 0, 'Y', 0, '2006-10-19', NULL, NULL, 40.2443, -111.661, NULL, NULL),
('870235759', 'W12002888', 'W12002888', 'UT01', 'Central Utah Foot & Ankle Clinic', 'Mark', 'F', 'Rogers', 'DPM', 'Podiatry', '', '', NULL, 'O', '120 N 1220 E Ste 12', 'American Fork', 'Utah', 'UT', '84003', '8017564200', '8017568252', '120 N 1220 E Ste 12', 'American Fork', 'Utah', 'UT', '84003', '8017564200', '8017568252', 'WUUVPN11', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 3, '2010-07-15', '2013-07-01', 0, 0, 0, 'Timpanogos Regional Hospital', 'Mountain View Hospital', '', '', 'HCFA|UB|', '1619958345', 0, 'N', 0, '2013-08-20', NULL, NULL, 0, 0, NULL, NULL),
('870235759', 'W12002889', 'W12002889', 'UT01', 'Central Utah Foot & Ankle Clinic', 'Mark', 'F', 'Rogers', 'DPM', 'Podiatry', '', '', NULL, 'O', '150 W 800 N', 'Provo', 'Utah', 'UT', '84601', '8013755353', NULL, '150 W 800 N', 'Provo', 'Utah', 'UT', '84601', '8013755353', '          ', 'WUUVPN11', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 3, '2010-07-15', '2013-07-01', 0, 0, 0, 'Timpanogos Regional Hospital', 'Mountain View Hospital', '', '', 'HCFA|UB|', '1619958345', 0, 'N', 0, '2013-08-20', NULL, NULL, 0, 0, NULL, NULL),
('870235759', 'W12002890', 'W12002890', 'UT01', 'Central Utah Foot & Ankle Clinic', 'Scott', '', 'Rogers', 'DPM', 'Podiatry', '', '', NULL, 'O', '120 N 1220 E Ste 12', 'American Fork', 'Utah', 'UT', '84003', '8017564200', NULL, '120 N 1220 E Ste 12', 'American Fork', 'Utah', 'UT', '84003', '8017564200', '          ', 'WUUVPN11', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 3, '2010-07-15', '2011-01-31', 0, 0, 0, 'Mountain West Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1821046418', 0, 'N', 0, '2011-10-24', NULL, NULL, 0, 0, NULL, NULL),
('870235759', 'W12002891', 'W12002891', 'UT01', 'Central Utah Foot & Ankle Clinic', 'Scott', '', 'Rogers', 'DPM', 'Podiatry', '', '', NULL, 'O', '150 W 800 N', 'Provo', 'Utah', 'UT', '84601', '8013755353', NULL, '150 W 800 N', 'Provo', 'Utah', 'UT', '84601', '8013755353', '          ', 'WUUVPN11', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 3, '2010-07-15', '2011-01-31', 0, 0, 0, 'Mountain West Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1821046418', 0, 'N', 0, '2011-10-24', NULL, NULL, 0, 0, NULL, NULL),
('870235759', 'W12002892', 'W12002892', 'UT01', 'Central Utah Foot & Ankle Clinic', 'Thomas', 'G', 'Rogers', 'DPM', 'Podiatry', '', '', NULL, 'O', '120 N 1220 E Ste 12', 'American Fork', 'Utah', 'UT', '84003', '8017564200', '8017568252', '120 N 1220 E Ste 12', 'American Fork', 'Utah', 'UT', '84003', '8017564200', '8017568252', 'WUUVPN11', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 3, '2010-07-15', '2011-01-31', 0, 0, 0, 'Timpanogos Regional Hospital', '', '', '', 'HCFA|UB|', '1720069446', 0, 'N', 0, '2014-04-07', NULL, NULL, 0, 0, NULL, NULL),
('870235759', 'W12002893', 'W12002893', 'UT01', 'Central Utah Foot & Ankle Clinic', 'Thomas', 'G', 'Rogers', 'DPM', 'Podiatry', '', '', NULL, 'O', '150 W 800 N', 'Provo', 'Utah', 'UT', '84601', '8013755353', NULL, '150 W 800 N', 'Provo', 'Utah', 'UT', '84601', '8013755353', '', 'WUUVPN11', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 3, '2010-07-15', NULL, 0, 0, 0, 'Timpanogos Regional Hospital', '', '', '', 'HCFA|UB|', '1720069446', 0, 'N', 0, '2014-04-07', NULL, NULL, 40.2443, -111.661, NULL, NULL),
('870281299', 'W12002894', 'W12002894', 'UT01', 'American Fork Clinic', '', '', 'American Fork Clinic', 'GROUP', 'Primary Care with Extended Hours', '', '', NULL, 'O', '226 N 1100 E Ste A', 'American Fork', 'Utah', 'UT', '84003', '8018553843', NULL, '226 N 1100 E Ste A', 'American Fork', 'Utah', 'UT', '84003', '8018553843', '          ', 'WUUVPN11', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 3, '2010-07-15', '2011-02-01', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1942311006', 0, 'N', 0, '2013-10-25', NULL, NULL, 0, 0, NULL, NULL),
('870281299', 'W12002895', 'W12002895', 'UT01', 'American Fork Clinic', 'Michael', 'L', 'Cosgrave', 'MD', 'Family Practice', '', '', NULL, 'O', '226 N 1100 E Ste A', 'American Fork', 'Utah', 'UT', '84003', '8018553843', NULL, '226 N 1100 E Ste A', 'American Fork', 'Utah', 'UT', '84003', '8018553843', '          ', 'WUUVPN11', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 3, '2010-07-15', '2011-02-02', 0, 0, 0, 'Salt Lake Regional Medical Center', 'St Marks Hospital', NULL, NULL, 'HCFA|UB|', '1023127214', 0, 'N', 0, '2013-10-25', NULL, NULL, 0, 0, NULL, NULL),
('870281299', 'W12002896', 'W12002896', 'UT01', 'American Fork Clinic', 'David', 'K', 'Hafen', 'MD', 'Family Practice', '', '', NULL, 'O', '226 N 1100 E Ste A', 'American Fork', 'Utah', 'UT', '84003', '8018553843', NULL, '226 N 1100 E Ste A', 'American Fork', 'Utah', 'UT', '84003', '8018553843', '          ', 'WUUVPN11', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 3, '2010-07-15', '2011-02-07', 0, 0, 0, 'Timpanogos Regional Hospital', '', '', '', 'HCFA|UB|', '1134238207', 0, 'N', 0, '2013-10-25', NULL, NULL, 0, 0, NULL, NULL),
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