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', 'W11017087', 'W11017087', 'UTIHC01', NULL, 'Lisa', 'E', 'Giles', 'MD', 'Mental Health', 'Pediatric Psychiatry', '', NULL, 'o', '675 E 500 S Ste 300', 'Salt Lake City', 'Salt Lake', 'UT', '84113', '8016626755', NULL, '675 E 500 S Ste 300', 'Salt Lake City', 'Salt Lake', 'UT', '84113', '8016626755', '', '', NULL, '', '0.00', '10.00', '0.00', 8, '2008-09-01', NULL, 0, 0, 0, 'Primary Childrens Medical Center', '', '', '', 'HCFA|UB|', '1841408309', 0, 'Y', 0, '2014-05-08', NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W11017088', 'W11017088', 'UTIHC01', NULL, 'Mannix', 'G', 'Glines', 'LCSW', 'Mental Health', 'Social Worker', '', NULL, 'o', '5770 S 1500 W Ste G', 'Taylorsville', 'Salt Lake', 'UT', '84123', '8012653000', NULL, '5770 S 1500 W Ste G', 'Taylorsville', 'Salt Lake', 'UT', '84123', '8012653000', '', '', NULL, NULL, '0.00', '10.00', '0.00', 8, '2006-07-01', '2008-05-29', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1386606358', 0, 'Y', 0, '2013-02-27', NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W11017089', 'W11017089', 'UTIHC01', NULL, 'Theresa', 'A', 'Golley', 'OT', 'Occupational Therapy', NULL, NULL, NULL, 'o', '3845 W 4700 S', 'Taylorsville', 'Salt Lake', 'UT', '84118', '8018404360', NULL, NULL, NULL, 'Salt Lake', NULL, NULL, NULL, NULL, '', NULL, NULL, '0.00', '10.00', '0.00', 8, '2009-03-02', NULL, NULL, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1558502385', 0, 'Y', 0, '2009-04-15', NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W11017090', 'W11017090', 'UTIHC01', NULL, 'Marsha', '', 'Hardman-Lundell', 'LCSW', 'Mental Health', 'Social Worker', '', NULL, 'o', '100 N Medical Dr', 'Salt Lake City', 'Salt Lake', 'UT', '84113', '8015882000', NULL, '100 N Medical Dr', 'Salt Lake City', 'Salt Lake', 'UT', '84113', '8015882000', '', '', NULL, NULL, '0.00', '10.00', '0.00', 8, '2006-01-01', '2008-05-29', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1245248368', 0, 'Y', 0, '2014-04-14', NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W11017091', 'W11017091', 'UTIHC01', NULL, 'Fritzie', NULL, 'Hicks', 'LCSW', 'Mental Health', 'Social Worker', NULL, NULL, 'o', '100 N Medical Dr', 'Salt Lake City', 'Salt Lake', 'UT', '84113', '8015882000', NULL, NULL, NULL, 'Salt Lake', NULL, NULL, NULL, NULL, '', NULL, NULL, '0.00', '10.00', '0.00', 8, '2006-01-01', '2008-05-29', NULL, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1316955404', 0, 'Y', 0, '2010-01-12', NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W11017092', 'W11017092', 'UTIHC01', '', 'William', 'Daniel', 'Jackson', 'MD', 'Pediatric Gastroenterology', '', '', NULL, 'o', '100 N Mario Capecchi Dr', 'Salt Lake City', 'Salt Lake', 'UT', '84113', '8016622900', NULL, '100 N Mario Capecchi Dr', 'Salt Lake City', 'Salt Lake', 'UT', '84113', '8016622900', '          ', '', '', '', '0.00', '10.00', '0.00', 8, '2008-05-01', '2013-07-01', 0, 0, 0, 'Primary Childrens Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1417036088', 0, 'N', 0, '2013-08-29', NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W11017093', 'W11017093', 'UTIHC01', NULL, 'Julie', 'A', 'Jones', 'SLP', 'Speech Therapy', NULL, NULL, NULL, 'o', '3903 Harrison Blvd Ste 400', 'Ogden', 'Weber', 'UT', '84403', '8013872080', NULL, NULL, NULL, 'Weber', NULL, NULL, NULL, NULL, '', NULL, NULL, '0.00', '10.00', '0.00', 8, '2008-05-13', '2008-06-06', NULL, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1225045008', 0, 'Y', 0, '2009-04-15', NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W11017094', 'W11017094', 'UTIHC01', NULL, 'Kurtis', 'R', 'Kendell', 'MD', 'Radiologist', '', '', NULL, 'o', '1000 N Mail St', 'Richfield', 'Sevier', 'UT', '84701', '4358968271', NULL, '1000 N Mail St', 'Richfield', 'Sevier', 'UT', '84701', '4358968271', '', '', NULL, NULL, '0.00', '15.00', '0.00', 8, '2006-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1427092469', 0, 'N', 0, '2010-12-28', NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W11017095', 'W11017095', 'UTIHC01', '', 'Richard', 'D', 'Martini', 'MD', 'Mental Health', 'Pediatric Psychiatry', '', NULL, 'o', '675 E 500 S Ste 300', 'Salt Lake City', 'Salt Lake', 'UT', '84113', '8016626750', NULL, '675 E 500 S Ste 300', 'Salt Lake City', 'Salt Lake', 'UT', '84113', '8016626750', '          ', '', '', '', '0.00', '10.00', '0.00', 8, '2008-09-01', '2013-07-01', 0, 0, 0, 'Primary Childrens Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1104995380', 0, 'Y', 0, '2013-08-29', NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W11017096', 'W11017096', 'UTIHC01', '', 'Deborah', 'L', 'Mennenga', 'MD', 'Mental Health', 'Psychiatry', '', NULL, 'o', '5770 S 1500 W Ste G', 'Taylorsville', 'Salt Lake', 'UT', '84123', '8013137770', '          ', '5770 S 1500 W Ste G', 'Taylorsville', 'Salt Lake', 'UT', '84123', '8013137770', '          ', '', '', '', '0.00', '10.00', '0.00', 8, '2006-07-01', '2013-12-31', 0, 0, 0, 'Primary Childrens Medical Center', '', '', '', 'HCFA|UB|', '1669493920', 0, 'Y', 0, '2014-06-18', NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W11017097', 'W11017097', 'UTIHC01', '', 'Deborah', 'L', 'Mennenga', 'MD', 'Mental Health', 'Psychiatry', '', NULL, 'o', '100 N Mario Capecchi Dr', 'Salt Lake City', 'Salt Lake', 'UT', '84113', '8012653008', '          ', '100 N Mario Capecchi Dr', 'Salt Lake City', 'Salt Lake', 'UT', '84113', '8012653008', '          ', '', '', '', '0.00', '10.00', '0.00', 8, '2008-05-01', '2013-12-31', 0, 0, 0, 'Primary Childrens Medical Center', '', '', '', 'HCFA|UB|', '1669493920', 0, 'N', 0, '2014-06-18', NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W11017098', 'W11017098', 'UTIHC01', NULL, 'Anne', 'M', 'O''Melia', 'MD', 'Mental Health', 'Pediatric Psychiatry', 'Pediatric Psychiatry', NULL, 'o', '100 N Mario Capecchi Dr', 'Salt Lake City', 'Salt Lake', 'UT', '84113', '8015883938', NULL, NULL, NULL, 'Salt Lake', NULL, NULL, NULL, NULL, '', NULL, NULL, '0.00', '10.00', '0.00', 8, '2008-05-01', '2009-03-18', NULL, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1619022738', 0, 'N', 0, '2010-01-12', NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W11017099', 'W11017099', 'UTIHC01', NULL, 'John', 'Dee', 'Owens', 'LCSW', 'Mental Health', 'Social Worker', NULL, NULL, 'o', '1380 E Medical Center Dr', 'St George', 'Washington', 'UT', '84790', '4352511000', NULL, NULL, NULL, 'Washington', NULL, NULL, NULL, NULL, '', NULL, NULL, '0.00', '15.00', '0.00', 8, '2006-01-01', '2009-01-20', NULL, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1730214420', 0, 'N', 0, '2010-01-12', NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W11017100', 'W11017100', 'UTIHC01', NULL, 'P', 'Brent', 'Petersen', 'MD', 'Mental Health', 'Psychiatry', '', NULL, 'o', '100 N Mario Capecchi Dr', 'Salt Lake City', 'Salt Lake', 'UT', '84113', '8016621000', NULL, '100 N Mario Capecchi Dr', 'Salt Lake City', 'Salt Lake', 'UT', '84113', '8016621000', '', '', NULL, NULL, '0.00', '10.00', '0.00', 8, '2008-05-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1306824628', 0, 'Y', 0, '2013-02-27', NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W11017101', 'W11017101', 'UTIHC01', NULL, 'P', 'Brent', 'Petersen', 'MD', 'Mental Health', 'Psychiatry', '', NULL, 'o', '5770 S 1500 W Ste G', 'Taylorsville', 'Salt Lake', 'UT', '84123', '8012653000', NULL, '5770 S 1500 W Ste G', 'Taylorsville', 'Salt Lake', 'UT', '84123', '8012653000', '', '', NULL, NULL, '0.00', '10.00', '0.00', 8, '2006-07-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1306824628', 0, 'Y', 0, '2013-02-27', NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W11017102', 'W11017102', 'UTIHC01', NULL, 'Rodney', 'C', 'Petersen', 'MD', 'Radiologist', NULL, NULL, NULL, 'o', '1000 N Main St', 'Richfield', 'Sevier', 'UT', '84701', '4358968271', NULL, NULL, NULL, 'Sevier', NULL, NULL, NULL, NULL, '', NULL, NULL, '0.00', '15.00', '0.00', 8, '2006-01-01', NULL, NULL, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1548216765', 0, 'N', 0, '2010-01-12', NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W11017103', 'W11017103', 'UTIHC01', NULL, 'LeAnn', '', 'Chlarson', 'SLP', 'Speech Therapy', 'Speech Language Pathology', NULL, NULL, 'o', '1400 N 500 E', 'Logan', 'Cache', 'UT', '84341', '4357161000', NULL, NULL, NULL, 'Cache', NULL, NULL, NULL, NULL, '', NULL, NULL, '0.00', '15.00', '0.00', 8, '2006-01-01', '2008-07-01', NULL, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1881615797', 0, 'Y', 0, '2010-01-12', NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W11017104', 'W11017104', 'UTIHC01', '', 'Mark', 'G', 'Schwei', 'MD PHD', 'Mental Health', 'Psychiatry', '', NULL, 'o', '5770 S 1500 W Ste G', 'Taylorsville', 'Salt Lake', 'UT', '84123', '8013137770', '          ', '5770 S 1500 W Ste G', 'Taylorsville', 'Salt Lake', 'UT', '84123', '8013137770', '          ', '', '', '', '0.00', '10.00', '0.00', 8, '2006-07-01', '2013-12-31', 0, 0, 0, 'Primary Childrens Medical Center', '', '', '', 'HCFA|UB|', '1639199110', 0, 'Y', 0, '2014-06-18', NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W11017105', 'W11017105', 'UTIHC01', '', 'Mark', 'G', 'Schwei', 'MD PHD', 'Mental Health', 'Psychiatry', '', NULL, 'o', '100 N Mario Capecchi Dr', 'Salt Lake City', 'Salt Lake', 'UT', '84113', '8016621000', '          ', '100 N Mario Capecchi Dr', 'Salt Lake City', 'Salt Lake', 'UT', '84113', '8016621000', '          ', '', '', '', '0.00', '10.00', '0.00', 8, '2008-05-01', '2013-12-31', 0, 0, 0, 'Primary Childrens Medical Center', '', '', '', 'HCFA|UB|', '1639199110', 0, 'N', 0, '2014-06-18', NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W11017106', 'W11017106', 'UTIHC01', NULL, 'L', 'Kristin H', 'Shadow', 'MD', 'Mental Health', 'Pediatric Psychiatry', NULL, NULL, 'o', '100 N Mario Capecchi Dr', 'Salt Lake City', 'Salt Lake', 'UT', '84113', '8015883938', NULL, NULL, NULL, 'Salt Lake', NULL, NULL, NULL, NULL, '', NULL, NULL, '0.00', '10.00', '0.00', 8, '2008-05-01', '2009-03-18', NULL, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1922028497', 0, 'N', 0, '2010-01-12', NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W11017107', 'W11017107', 'UTIHC01', NULL, 'Katherin', 'F', 'Sherry', 'MD', 'Pediatric Psychiatry', NULL, NULL, NULL, 'o', '100 N Medical Dr', 'Salt Lake City', 'Salt Lake', 'UT', '84113', '8015883938', NULL, NULL, NULL, 'Salt Lake', NULL, NULL, NULL, NULL, '', NULL, NULL, '0.00', '10.00', '0.00', 8, '2006-10-01', '2008-05-29', NULL, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1669446472', 0, 'Y', 0, '2010-01-12', NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W11017108', 'W11017108', 'UTIHC01', '', 'Kirk', 'A', 'Simon', 'MD', 'Mental Health', 'Psychiatry', '', NULL, 'o', '5770 S 1500 W Ste G', 'Taylorsville', 'Salt Lake', 'UT', '84123', '8013137770', NULL, '5770 S 1500 W Ste G', 'Taylorsville', 'Salt Lake', 'UT', '84123', '8013137770', '', '', '', '', '0.00', '10.00', '0.00', 8, '2006-07-01', '2009-03-18', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1043399611', 0, 'Y', 0, '2014-06-18', NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W11017109', 'W11017109', 'UTIHC01', NULL, 'Kirk', 'A', 'Simon', 'MD', 'Mental Health', 'Psychiatry', NULL, NULL, 'o', '100 N Mario Capecchi Dr', 'Salt Lake City', 'Salt Lake', 'UT', '84113', '8016621000', NULL, NULL, NULL, 'Salt Lake', NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '10.00', NULL, 8, '2000-01-01', '2000-01-01', NULL, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1043399611', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W11017110', 'W11017110', 'UTIHC01', NULL, 'Kirk', 'A', 'Simon', 'MD', 'Mental Health', 'Psychiatry', '', NULL, 'o', '497 Colorow Way', 'Salt Lake City', 'Salt Lake', 'UT', '84108', '8016626400', NULL, '497 Colorow Way', 'Salt Lake City', 'Salt Lake', 'UT', '84108', '8016626400', '', '', NULL, '', '0.00', '10.00', '0.00', 8, '2006-07-01', '2009-03-18', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1043399611', 0, 'Y', 0, '2014-06-18', NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W11017111', 'W11017111', 'UTIHC01', NULL, 'Kirk', 'A', 'Simon', 'MD', 'Mental Health', 'Psychiatry', NULL, NULL, 'o', '100 N Mario Capecchi Dr', 'Salt Lake City', 'Salt Lake', 'UT', '84113', '8015883938', NULL, NULL, NULL, 'Salt Lake', NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '10.00', NULL, 8, '2000-01-01', '2000-01-01', NULL, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1043399611', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W11017112', 'W11017112', 'UTIHC01', NULL, 'Kimball', 'Bruce', 'Taylor', 'MD', 'Radiologist', '', '', NULL, 'o', '1000 N Main St', 'Richfield', 'Sevier', 'UT', '84701', '4358968271', NULL, '1000 N Main St', 'Richfield', 'Sevier', 'UT', '84701', '4358968271', '', '', NULL, NULL, '0.00', '15.00', '0.00', 8, '2006-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1760420996', 0, 'N', 0, '2010-12-28', NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W11017113', 'W11017113', 'UTIHC01', NULL, 'Mehm', 'T', 'Thaung', 'MD', 'General Surgery', '', '', NULL, 'o', '1000 N Main', 'Richfield', 'Sevier', 'UT', '84701', '4358934100', NULL, '1000 N Main', 'Richfield', 'Sevier', 'UT', '84701', '4358934100', '', '', NULL, NULL, '0.00', '15.00', '0.00', 8, '2008-04-01', '2009-03-11', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1669455861', 0, 'Y', 0, '2013-08-27', NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W11017114', 'W11017114', 'UTIHC01', NULL, 'Howard', 'R', 'Weeks', 'MD', 'Mental Health', 'Pediatric Psychiatry', '', NULL, 'o', '100 N Mario Capecchi Dr', 'Salt Lake City', 'Salt Lake', 'UT', '84113', '8015883938', NULL, '100 N Mario Capecchi Dr', 'Salt Lake City', 'Salt Lake', 'UT', '84113', '8015883938', '', '', NULL, NULL, '0.00', '10.00', '0.00', 8, '2008-05-01', '2009-03-18', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1760570915', 0, 'N', 0, '2012-01-26', NULL, NULL, 0, 0, NULL, NULL),
('621801973', 'W11017115', 'W11017115', 'UT01', 'Copper Canyon Womens Center', 'Gay', 'J', 'Meyers', 'PA', 'Obstetrics and Gynecology', 'Family Practice', NULL, NULL, 'O', '3336 S Pioneer Pkwy Ste 310', 'West Valley', 'Salt Lake', 'UT', '84120', '8019643865', NULL, '406 W S Jordan Pkwy', 'Sout Jordan', 'Salt Lake', 'UT', '84095', NULL, NULL, 'WUSTDINT5', 'WUSTDHCPC5', NULL, '0.00', '35.00', '0.00', 6, '2009-04-09', '2010-04-15', NULL, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1215099155', 0, 'Y', 0, '2009-04-09', NULL, NULL, 0, 0, NULL, NULL),
('621801973', 'W11017116', 'W11017116', 'UT01', 'Copper Canyon Womens Center', 'Gay', 'J', 'Meyers', 'PA', 'Obstetrics and Gynecology', 'Family Practice', NULL, NULL, 'B', '406 W South Jordan Pkwy Ste 500', 'South Jordan', 'Salt Lake', 'UT', '84095', '8019643865', NULL, '406 W S Jordan Pkwy', 'Sout Jordan', 'Fulton', 'UT', '84095', NULL, NULL, 'WUSTDINT5', 'WUSTDHCPC5', NULL, '0.00', '35.00', '0.00', 6, '2009-04-09', '2010-04-15', NULL, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1215099155', 0, 'y', 0, '2009-04-09', NULL, NULL, 0, 0, NULL, NULL),
('870678064', 'W11017118', 'W11017118', 'UTMH1', 'Axis-One Inc', 'Cheryl', '', 'Kelstrom-Smith', 'LCSW', 'Mental Health', 'Social Worker', '', NULL, 'O', '60 S Main', 'Brigham City', 'Box Elder', 'UT', '84302', '4352576999', NULL, '60 S Main', 'Brigham City', 'Box Elder', 'UT', '84302', '4352576999', '', 'MA', '', '', '0.00', '35.00', '0.00', 6, '2009-03-23', '2011-06-30', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1740335850', 0, 'N', 0, '2014-05-08', NULL, NULL, 0, 0, NULL, NULL),
('870678064', 'W11017119', 'W11017119', 'UTMH1', 'Axis-One Inc', 'B', 'S', 'Harmon', 'LCSW', 'Mental Health', 'Social Worker', '', NULL, 'O', '60 S Main', 'Brigham City', 'Box Elder', 'UT', '84302', '4352576999', NULL, '60 S Main', 'Brigham City', 'Box Elder', 'UT', '84302', '4352576999', '', 'MA', '', '', '0.00', '35.00', '0.00', 6, '2009-03-23', '2011-06-30', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1700882172', 0, 'N', 0, '2014-05-06', NULL, NULL, 0, 0, NULL, NULL),
('870678064', 'W11017120', 'W11017120', 'UTMH1', 'Axis-One Inc', 'Paula', '', 'Sever', 'LCSW', 'Mental Health', 'Social Worker', '', NULL, 'O', '60 S Main', 'Brigham City', 'Box Elder', 'UT', '84302', '4352576999', NULL, '60 S Main', 'Brigham City', 'Box Elder', 'UT', '84302', '4352576999', '          ', 'MA', '', '', '0.00', '35.00', '0.00', 6, '2009-03-23', '2011-08-01', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1154300234', 0, 'N', 0, '2011-05-11', NULL, NULL, 0, 0, NULL, NULL),
('870678064', 'W11017121', 'W11017121', 'UTMH1', 'Axis-One Inc', 'Larry', 'K', 'Jacobson', 'LPC', 'Mental Health', 'Counseling', '', NULL, 'O', '60 S Main', 'Brigham City', 'Box Elder', 'UT', '84302', '4352576999', NULL, '60 S Main', 'Brigham City', 'Box Elder', 'UT', '84302', '4352576999', '          ', 'MA', '', '', '0.00', '35.00', '0.00', 6, '2009-03-23', '2011-08-01', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1124127766', 0, 'N', 0, '2011-05-11', NULL, NULL, 0, 0, NULL, NULL),
('870678064', 'W11017122', 'W11017122', 'UTMH1', 'Axis-One Inc', 'Theresa', 'S', 'Kay', 'PHD', 'Mental Health', 'Psychology', '', NULL, 'O', '60 S Main', 'Brigham City', 'Box Elder', 'UT', '84302', '4352576999', NULL, '60 S Main', 'Brigham City', 'Box Elder', 'UT', '84302', '4352576999', '', 'PHD', NULL, NULL, '0.00', '35.00', '0.00', 6, '2009-03-23', '2010-03-01', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1053466169', 0, 'N', 0, '2013-02-27', NULL, NULL, 0, 0, NULL, NULL),
('870678064', 'W11017123', 'W11017123', 'UTMH1', 'Axis-One Inc', 'Teresa', '', 'Ramos', 'LCSW', 'Mental Health', 'Social Worker', '', NULL, 'O', '60 S Main', 'Brigham City', 'Box Elder', 'UT', '84302', '4352576999', NULL, '60 S Main', 'Brigham City', 'Box Elder', 'UT', '84302', '4352576999', '          ', 'MA', '', '', '0.00', '35.00', '0.00', 6, '2009-03-23', '2011-08-01', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1922004209', 0, 'N', 0, '2011-05-11', NULL, NULL, 0, 0, NULL, NULL),
('621801973', 'W11017124', 'W11017124', 'UT01', 'Pioneer Valley Hospital', 'Scott', 'K', 'Aberegg', 'MD', 'Pulmonary', 'Critical Care', '', NULL, 'O', '3460 S Pioneer Pkwy', 'West Valley', 'Salt Lake', 'UT', '84120', '8019643100', NULL, '3460 S Pioneer Pkwy', 'West Valley', 'Salt Lake', 'UT', '84120', '8019643100', '', 'WUSTDSURG5', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 6, '2009-04-09', '2010-10-31', 0, 0, 0, 'St Marks Hospital', '', '', '', 'HCFA|UB|', '1164434486', 0, 'N', 0, '2014-06-16', NULL, NULL, 0, 0, NULL, NULL),
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('621801973', 'W11017132', 'W11017132', 'UT01', 'Gero - Psych', 'Sajid', '', 'Faizi', 'MD', 'Mental Health', 'Psychiatry', '', NULL, 'B', '406 W South Jordan Pkwy Ste 500', 'South Jordan', 'Salt Lake', 'UT', '84095', '8013504111', NULL, '406 W South Jordan Pkwy Ste 500', 'South Jordan', 'Salt Lake', 'UT', '84095', '8013504111', '', 'WUSTDINT5', 'WUSTDHCPC5', NULL, '0.00', '35.00', '0.00', 6, '2009-04-09', '2014-04-30', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1659386357', 0, 'Y', 0, '2013-08-14', NULL, NULL, 0, 0, NULL, NULL),
('205764098', 'W11017133', 'W11017133', 'TX01', 'Boerne Pediarics', 'Sheralyn', 'D', 'Wood', 'MD', 'Pediatrics', '', '', NULL, 'O', '124 E Bandera Rd Ste 304', 'Boerne', 'Kendall', 'TX', '78006', '8308165055', NULL, '124 E Bandera Rd Ste 304', 'Boerne', 'Kendall', 'TX', '78006', '8308165055', '', 'TXPED', 'TXHCPCS', NULL, '0.00', '50.00', '0.00', 3, '2009-04-15', '2012-08-19', 0, 0, 0, 'Baptist Medical Center', '', '', '', 'HCFA|UB|', '1902830318', 0, 'n', 0, '2012-07-18', NULL, NULL, 29.7808, -98.7276, NULL, NULL),
('742915297', 'W11017134', 'W11017134', 'TX01', 'South Texas Oncology and Hematology', 'Muralidhar', '', 'Beeram', 'MD', 'Hematology and Oncology', '', '', NULL, 'O', '4383 Medical Dr', 'San Antonio', 'Bexar', 'TX', '78229', '2105935700', NULL, '4383 Medical Dr', 'San Antonio', 'Bexar', 'TX', '78229', '2105935700', '', 'TXONCOL', 'TXHCPCS', NULL, '0.00', '50.00', '0.00', 3, '2009-04-15', '2012-08-19', 0, 0, 0, 'Baptist Medical Center', '', '', '', 'HCFA|UB|', '1265426282', 0, 'N', 0, '2013-05-24', NULL, NULL, 29.5109, -98.5711, NULL, NULL),
('742915297', 'W11017135', 'W11017135', 'TX01', 'South Texas Oncology and Hematology', 'Muralidhar', '', 'Beeram', 'MD', 'Hematology and Oncology', '', '', NULL, 'B', 'PO Box 268', 'San Antonio', 'Bexar', 'TX', '78229', '2105935700', NULL, 'PO Box 268', 'San Antonio', 'Bexar', 'TX', '78229', '2105935700', '', 'TXONCOL', 'TXHCPCS', NULL, '0.00', '50.00', '0.00', 3, '2009-04-15', '2012-08-19', 0, 0, 0, 'Baptist Medical Center', '', '', '', 'HCFA|UB|', '1265426282', 0, 'y', 0, '2013-05-24', NULL, NULL, 0, 0, NULL, NULL),
('742915297', 'W11017136', 'W11017136', 'TX01', 'South Texas Oncology and Hematology', 'Kyriakos', 'P', 'Papadopoulos', 'MD', 'Oncology', '', '', NULL, 'B', 'PO Box 268', 'San Antonio', 'Bexar', 'TX', '78229', '2105935700', NULL, 'PO Box 268', 'San Antonio', 'Bexar', 'TX', '78229', '2105935700', '', 'TXONCOL', 'TXHCPCS', NULL, '0.00', '50.00', '0.00', 3, '2009-04-15', '2012-08-19', 0, 0, 0, 'North East Baptist Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1376546861', 0, 'y', 0, '2014-02-03', NULL, NULL, 0, 0, NULL, NULL),
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('870566149', 'W11017138', 'W11017138', 'UT01', 'Pediatrix Medical Group', 'James', '', 'Berger', 'MD', 'Neonatology', '', '', NULL, 'O', '5475 S 500 E', 'Ogden', 'Weber', 'UT', '84405', '8014764280', NULL, '5475 S 500 E', 'Ogden', 'Weber', 'UT', '84405', '8014764280', '', '', NULL, NULL, '0.00', '20.00', '0.00', 3, '2009-04-15', NULL, 0, 0, 0, 'Ogden Regional Medical Center', '', '', '', 'HCFA|UB|', '1700849676', 0, 'n', 0, '2014-02-07', NULL, NULL, 41.1635, -111.969, NULL, NULL),
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('870566149', 'W11017140', 'W11017140', 'UT01', 'Pediatrix Medical Group', 'James', '', 'Berger', 'MD', 'Neonatology', '', '', NULL, 'B', 'PO Box 840532', 'Dallas', 'Dallas', 'TX', '75284', '8014764280', NULL, 'PO Box 840532', 'Dallas', 'Dallas', 'TX', '75284', '8014764280', '', '', NULL, NULL, '0.00', '20.00', '0.00', 3, '2009-04-15', NULL, 0, 0, 0, 'Ogden Regional Medical Center', '', '', '', 'HCFA|UB|', '1700849676', 0, 'y', 0, '2014-02-07', NULL, NULL, 0, 0, NULL, NULL),
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('263541782', 'W11017148', 'W11017148', 'UT01', 'Ogden Pulmonary Associates', 'Charles', 'T', 'Ivester', 'MD', 'Pulmonary', 'Internal Medicine', '', NULL, 'O', '4403 Harrison Blvd Ste 3815', 'Ogden', 'Weber', 'UT', '84403', '8013872575', '8013872585', '4403 Harrison Blvd Ste 3815', 'Ogden', 'Weber', 'UT', '84403', '8013872575', '8013872585', 'WiseSTD', 'WUSTDHCPC5', NULL, '0.00', '35.00', '0.00', 3, '2009-01-01', NULL, 0, 0, 0, 'Ogden Regional Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1376585372', 0, 'N', 0, '2013-09-13', NULL, NULL, 41.1828, -111.949, NULL, NULL),
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('621801973', 'W11017153', 'W11017153', 'UT01', 'Jordan Valley Hospital', 'Ann', 'E', 'Dargan - McDonald', 'MD', 'Internal Medicine', NULL, NULL, NULL, 'B', '406 W South Jordan Pkwy Ste 500', 'South Jordan', 'Salt Lake', 'UT', '84095', '8015618888', NULL, '406 W S Jordan Pkwy', 'South Jordan', 'Salt Lake', 'UT', '84095', '8015618888', '          ', 'WUSTDINT5', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 6, '2009-04-09', '2009-06-30', NULL, 0, NULL, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1558479519', 0, 'N', 0, '2009-04-14', NULL, NULL, 0, 0, NULL, NULL),
('820463459', 'W11017154', 'W11017154', 'ID01', 'Horizon Home Health & Hospice Inc', '', '', 'Horizon Home Health & Hospice Inc', 'GROUP', 'Home Health Agency', 'Hospice', '', NULL, 'O', '900 N Linder Rd', 'Meridian', 'Ada', 'ID', '83642', '2088887877', NULL, '900 N Linder Rd', 'Meridian', 'Ada', 'ID', '83642', '2088887877', '          ', '', '', 'IDHORZHH', '0.00', '35.00', '0.00', 3, '2009-04-15', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1043215395', 0, 'N', 0, '2013-02-12', NULL, NULL, 43.613, -116.414, NULL, NULL),
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('942854057', 'W11017183', 'W11017183', 'UTIHC03', NULL, 'Julie', 'A', 'Jones', 'SLP', 'Speech Therapy', NULL, NULL, NULL, 'o', '3903 Harrison Blvd Ste 400', 'Ogden', 'Weber', 'UT', '84403', '8013872080', NULL, NULL, NULL, 'Weber', NULL, NULL, NULL, NULL, '', NULL, NULL, '0.00', '10.00', '0.00', 8, '2008-05-13', NULL, NULL, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1225045008', 0, 'Y', 0, '2009-04-15', NULL, NULL, 0, 0, NULL, NULL);
INSERT INTO `providers_new` (`Provider_Tax_ID`, `Provider_Suffix`, `Provider_Network_ID`, `Provider_Region`, `Provider_Name`, `Provider_Doctor_First_Name`, `Provider_Doctor_Middle_Name`, `Provider_Doctor_Last_Name`, `Provider_Doctor_Degree`, `Provider_Specialty_1`, `Provider_Specialty_2`, `Provider_Specialty_3`, `Provider_Specialty_4`, `Provider_Address_Type`, `Provider_Address`, `Provider_City`, `Provider_County`, `Provider_State`, `Provider_Zip`, `Provider_Phone`, `Provider_Fax`, `Provider_Mailing_Address`, `Provider_Mailing_City`, `Provider_Mailing_County`, `Provider_Mailing_State`, `Provider_Mailing_Zip`, `Provider_Mailing_Phone`, `Provider_Mailing_Fax`, `Provider_Primary_Schedule`, `Provider_Secondary_Schedule`, `Provider_Rate_Sheet`, `Provider_Anes_Rate`, `Provider_Default_Rate`, `Provider_Max_DOS`, `Provider_Min_Match_Value`, `Provider_Effective_Date`, `Provider_Term_Date`, `Provider_Pend`, `Provider_Anes_Minutes`, `Provider_PPO`, `Provider_Hospital_1`, `Provider_Hospital_2`, `Provider_Hospital_3`, `Provider_Hospital_4`, `Provider_Type`, `Provider_NPI`, `Provider_Check_Override`, `Exclude_Dir`, `Audit_Status`, `Last_Change_Date`, `Medicare_ID`, `Provider_Lang`, `Provider_Latitude`, `Provider_Longitude`, `Provider_school`, `Provider_cert`) VALUES
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('942854057', 'W11017185', 'W11017185', 'UTIHC03', '', 'Deborah', 'L', 'Mennenga', 'MD', 'Mental Health', 'Psychiatry', '', NULL, 'o', '5770 S 1500 W Ste G', 'Taylorsville', 'Salt Lake', 'UT', '84123', '8013137770', '          ', '5770 S 1500 W Ste G', 'Taylorsville', 'Salt Lake', 'UT', '84123', '8013137770', '          ', '', '', '', '0.00', '10.00', '0.00', 8, '2006-07-01', '2013-12-31', 0, 0, 0, 'Primary Childrens Medical Center', '', '', '', 'HCFA|UB|', '1669493920', 0, 'Y', 0, '2014-06-18', NULL, NULL, 0, 0, NULL, NULL),
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('621801973', 'W11017252', 'W11017252', 'UT01', 'Salt Lake Regional Family Practice Sports Medicine', 'Joseph', 'J', 'Albano', 'MD', 'Sports Medicine', '', '', NULL, 'O', '4888 S Highland Dr', 'Salt Lake City', 'Salt Lake', 'UT', '84117', '8014245042', NULL, '4888 S Highland Dr', 'Salt Lake City', 'Salt Lake', 'UT', '84117', '8014245042', '          ', 'WUSTDINT5', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 6, '2009-05-01', '2014-04-30', 0, 0, 0, 'Salt Lake Regional Medical Center', 'St Marks Hospital', NULL, NULL, 'HCFA|UB|', '1003836636', 0, 'N', 0, '2013-03-27', NULL, NULL, 40.6633, -111.838, NULL, NULL),
('010901954', 'W11017271', 'W11017271', 'ID02', 'Balance Psychological Associates PLLC', 'Diana', 'A', 'Menchaca', 'PHD', 'Mental Health', 'Psychology', '', NULL, 'B', 'PO Box 888', 'Meridian', 'Ada', 'ID', '83680', '2088980926', NULL, 'PO Box 888', 'Meridian', 'Ada', 'ID', '83680', '2088980926', '', 'IDPHD', NULL, NULL, '0.00', '35.00', '0.00', 3, '2009-04-15', '2013-02-14', 0, 0, 1, '', '', '', '', 'HCFA|UB|', '1184787764', 0, 'y', 0, '2013-02-27', NULL, NULL, 0, 0, NULL, NULL),
('870638151', 'W11017272', 'W11017272', 'UT01', 'Rock Canyon Family Medicine', NULL, NULL, 'Rock Canyon Family Medicine', 'Group', 'Family Practice', NULL, NULL, NULL, 'O', '811 N 900 W', 'Orem', 'Utah', 'UT', '84057', '8018123200', '8018121500', 'PO Box 95970', 'South Jordan', 'Utah', 'UT', '840950970', NULL, NULL, 'WISESTD', 'WUSTDHCPC5', NULL, '0.00', '35.00', '0.00', 3, '2009-04-29', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '0000008434', 0, 'N', 0, '2009-04-22', NULL, NULL, 40.3122, -111.717, NULL, NULL),
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('870638151', 'W11017274', 'W11017274', 'UT01', 'Rock Canyon Family Medicine', NULL, NULL, 'Rock Canyon Family Medicine', 'Group', 'Family Practice', NULL, NULL, NULL, 'O', '3200 N Canyon Rd Ste E', 'Provo', 'Utah', 'UT', '84604', '8018123200', NULL, 'PO Box 95970', 'South Jordan', 'Utah', 'UT', '840950970', NULL, NULL, 'WISESTD', 'WUSTDHCPC5', NULL, '0.00', '35.00', '0.00', 3, '2006-09-01', '2009-04-29', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '0000008434', 0, 'N', 0, '2009-04-22', NULL, NULL, 0, 0, NULL, NULL),
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('870638151', 'W11017277', 'W11017277', 'UT01', 'Rock Canyon Family Medicine', 'Heather', 'H', 'Christensen', 'PA-C', 'Family Practice', '', '', NULL, 'O', '811 N 900 W', 'Orem', 'Utah', 'UT', '84057', '8018123200', '8018121500', '811 N 900 W', 'Orem', 'Utah', 'UT', '84057', '8018123200', '8018121500', 'WISESTD', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 3, '2009-04-29', '2008-11-01', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1447325055', 0, 'N', 0, '2014-06-20', NULL, NULL, 0, 0, NULL, NULL),
('870638151', 'W11017278', 'W11017278', 'UT01', 'Rock Canyon Family Medicine', 'Kenneth', 'L', 'Crump', 'MD', 'Family Practice', '', '', NULL, 'O', '811 N 900 W', 'Orem', 'Utah', 'UT', '84057', '8018123200', '8018121500', '811 N 900 W', 'Orem', 'Utah', 'UT', '84057', '8018123200', '8018121500', 'WISESTD', 'WUSTDHCPC5', NULL, '0.00', '35.00', '0.00', 3, '2009-04-29', NULL, 0, 0, 0, 'Timpanogos Regional Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1891719308', 0, 'N', 0, '2013-03-11', NULL, NULL, 40.3122, -111.717, 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
('870638151', 'W11017279', 'W11017279', 'UT01', 'Rock Canyon Family Medicine', 'Janice', 'H', 'Robinson', 'FNP', 'Family Practice', '', '', NULL, 'O', '811 N 900 W', 'Orem', 'Utah', 'UT', '84057', '8018123200', '8018121500', '811 N 900 W', 'Orem', 'Utah', 'UT', '84057', '8018123200', '8018121500', 'WISESTD', 'WUSTDHCPC5', NULL, '0.00', '35.00', '0.00', 3, '2009-04-29', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1184800047', 0, 'N', 0, '2013-07-02', NULL, NULL, 40.3122, -111.717, NULL, NULL),
('870638151', 'W11017280', 'W11017280', 'UT01', 'Rock Canyon Family Medicine', 'Change', NULL, 'Change', 'Group', 'Family Practice', NULL, NULL, NULL, 'O', '811 N 900 W', 'Orem', 'Utah', 'UT', '84057', '8018123200', NULL, 'PO Box 95970', 'South Jordan', 'Utah', 'UT', '840950970', NULL, NULL, 'WISESTD', 'WUSTDHCPC5', NULL, '0.00', '35.00', '0.00', 3, '2009-04-29', '2009-04-29', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '0000005646', 0, 'N', 0, '2009-04-22', NULL, NULL, 0, 0, NULL, NULL),
('264166796', 'W11017281', 'W11017281', 'UTMH1', '', 'Susan', 'M', 'Reynolds', 'LPC', 'Mental Health', 'Counseling', '', NULL, 'O', '286 S 600 E Ste C', 'Provo', 'Utah', 'UT', '84606', '8014279309', NULL, '286 S 600 E Ste C', 'Provo', 'Utah', 'UT', '84606', '8014279309', '', 'MA', '', '', '0.00', '35.00', '0.00', 3, '2009-03-13', '2011-07-31', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1982751301', 0, 'N', 0, '2014-05-08', NULL, NULL, 0, 0, NULL, NULL),
('264166796', 'W11017282', 'W11017282', 'UTMH1', '', 'Susan', 'M', 'Reynolds', 'LPC', 'Mental Health', 'Counseling', '', NULL, 'B', 'PO Box 900245', 'Sandy', 'Salt Lake', 'UT', '84090', '8016348727', NULL, 'PO Box 900245', 'Sandy', 'Salt Lake', 'UT', '84090', '8016348727', '', 'MA', '', '', '0.00', '35.00', '0.00', 3, '2009-03-13', '2011-08-01', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1982751301', 0, 'N', 0, '2014-05-08', NULL, NULL, 0, 0, NULL, NULL),
('743003947', 'W11017283', 'W11017283', 'TX01', 'The San Antonio Orthopaedic Group', 'Richard', 'L', 'Ursone', 'MD', 'Orthopedic Surgery', '', '', NULL, 'B', 'PO Box 2516', 'San Antonio', 'Bexar', 'TX', '78299', '8004454263', NULL, 'PO Box 2516', 'San Antonio', 'Bexar', 'TX', '78299', '8004454263', '', 'TXORTHO', 'TXHCPCS', NULL, '0.00', '50.00', '0.00', 3, '2009-04-15', '2012-08-19', 0, 0, 0, 'Baptist Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1528059722', 0, 'Y', 0, '2013-05-06', NULL, NULL, 0, 0, NULL, NULL),
('743003947', 'W11017284', 'W11017284', 'TX01', 'The San Antonio Orthopaedic Group', 'Richard', 'L', 'Ursone', 'MD', 'Orthopedic Surgery', '', '', NULL, 'B', '2829 Babcock Rd Ste 700', 'San Antonio', 'Bexar', 'TX', '78229', '2106144263', NULL, '2829 Babcock Rd Ste 700', 'San Antonio', 'Bexar', 'TX', '78229', '2106144263', '', 'TXORTHO', 'TXHCPCS', NULL, '0.00', '50.00', '0.00', 3, '2009-04-15', '2012-08-19', 0, 0, 0, 'Baptist Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1528059722', 0, 'Y', 0, '2013-05-06', NULL, NULL, 29.5138, -98.5907, NULL, NULL),
('743003947', 'W11017285', 'W11017285', 'TX01', 'The San Antonio Orthopaedic Group', 'Richard', 'L', 'Ursone', 'MD', 'Orthopedic Surgery', '', '', NULL, 'B', '150 E Sonterra Blvd Ste 300', 'San Antonio', 'Bexar', 'TX', '78258', '2104942297', NULL, '150 E Sonterra Blvd Ste 300', 'San Antonio', 'Bexar', 'TX', '78258', '2104942297', '', 'TXORTHO', 'TXHCPCS', NULL, '0.00', '50.00', '0.00', 3, '2009-04-15', '2012-08-19', 0, 0, 0, 'Baptist Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1528059722', 0, 'Y', 0, '2013-05-06', NULL, NULL, 29.6152, -98.4924, NULL, NULL),
('743003947', 'W11017286', 'W11017286', 'TX01', 'The San Antonio Orthopaedic Group', 'Richard', 'L', 'Ursone', 'MD', 'Orthopedic Surgery', '', '', NULL, 'B', '400 Concord Plaza Dr Ste 300', 'San Antonio', 'Bexar', 'TX', '78216', '2108045400', NULL, '400 Concord Plaza Dr Ste 300', 'San Antonio', 'Bexar', 'TX', '78216', '2108045400', '', 'TXORTHO', 'TXHCPCS', NULL, '0.00', '50.00', '0.00', 3, '2009-04-15', '2012-08-19', 0, 0, 0, 'Baptist Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1528059722', 0, 'Y', 0, '2013-05-06', NULL, NULL, 29.5058, -98.4805, NULL, NULL),
('743003947', 'W11017287', 'W11017287', 'TX01', 'The San Antonio Orthopaedic Group', 'Richard', 'L', 'Ursone', 'MD', 'Orthopedic Surgery', '', '', NULL, 'B', '1200 Brooklyn Ste 320', 'San Antonio', 'Bexar', 'TX', '78212', '2102255741', NULL, '1200 Brooklyn Ste 320', 'San Antonio', 'Bexar', 'TX', '78212', '2102255741', '', 'TXORTHO', 'TXHCPCS', NULL, '0.00', '50.00', '0.00', 3, '2009-04-15', '2012-08-19', 0, 0, 0, 'Baptist Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1528059722', 0, 'Y', 0, '2013-05-06', NULL, NULL, 29.4403, -98.4903, NULL, NULL),
('743003947', 'W11017288', 'W11017288', 'TX01', 'The San Antonio Orthopaedic Group', 'Richard', 'L', 'Ursone', 'MD', 'Orthopedic Surgery', '', '', NULL, 'B', '11212 Hwy 151 Ste 150', 'San Antonio', 'Bexar', 'TX', '78251', '2108045400', NULL, '11212 Hwy 151 Ste 150', 'San Antonio', 'Bexar', 'TX', '78251', '2108045400', '          ', 'TXORTHO', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2009-04-15', '2012-08-19', 0, 0, 0, 'Baptist Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1528059722', 0, 'Y', 0, '2013-05-06', NULL, NULL, 29.4666, -98.6958, NULL, NULL),
('743003947', 'W11017289', 'W11017289', 'TX01', 'The San Antonio Orthopaedic Group', 'Richard', 'L', 'Ursone', 'MD', 'Orthopedic Surgery', '', '', NULL, 'B', '4243 E Southcross Blvd Ste 204', 'San Antonio', 'Bexar', 'TX', '78222', '2103375785', NULL, '4243 E Southcross Blvd Ste 204', 'San Antonio', 'Bexar', 'TX', '78222', '2103375785', '          ', 'TXORTHO', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2009-04-15', '2011-06-01', 0, 0, 0, 'Baptist Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1528059722', 0, 'Y', 0, '2013-05-06', NULL, NULL, 0, 0, NULL, NULL),
('900448097', 'W11017290', 'W11017290', 'UT01', 'Lakeview Urology & General Surgery LLC', 'David', 'J', 'Henderson', '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', NULL, '0.00', '35.00', '0.00', 3, '2009-04-01', '2010-08-31', 0, 0, 0, 'Davis Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1417933284', 0, 'N', 0, '2013-04-11', NULL, NULL, 0, 0, NULL, NULL),
('900448097', 'W11017291', 'W11017291', 'UT01', 'Lakeview Urology & General Surgery LLC', 'David', 'J', 'Henderson', 'MD', 'Urology', '', '', NULL, 'B', 'PO Box 405831', 'Atlanta', 'Fulton', 'GA', '30384', '8006613365', NULL, 'PO Box 405831', 'Atlanta', 'Fulton', 'GA', '30384', '8006613365', '', 'WiseSTD', 'WUSTDHCPC5', NULL, '0.00', '35.00', '0.00', 3, '2009-04-01', '2010-08-31', 0, 0, 0, 'Davis Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1417933284', 0, 'y', 0, '2013-04-11', NULL, NULL, 0, 0, NULL, NULL),
('870358019', 'W11017292', 'W11017292', 'UT01', 'Cottonwood Eye & Laser Clinic', 'Michael', 'M', 'Judkins', 'OD', 'Optometry', '', '', NULL, 'O', '201 E 5900 S Ste 101', 'Salt Lake City', 'Salt Lake', 'UT', '84107', '8012686600', NULL, '201 E 5900 S Ste 101', 'Salt Lake City', 'Salt Lake', 'UT', '84107', '8012686600', '          ', 'WiseSTD', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 3, '2009-04-22', '2010-07-01', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1699774026', 0, 'N', 0, '2011-10-05', NULL, NULL, 0, 0, NULL, NULL),
('450465804', 'W11017293', 'W11017293', 'UT01', 'Promontory Family Vision', 'Michael', 'M', 'Judkins', 'OD', 'Optometry', '', '', NULL, 'O', '5331 S Adams Ave Ste B', 'Ogden', 'Weber', 'UT', '84405', '8014797850', NULL, '5331 S Adams Ave Ste B', 'Ogden', 'Weber', 'UT', '84405', '8014797850', '', 'WUTALBERT5', 'WUSTDHCPC5', NULL, '0.00', '35.00', '0.00', 3, '2009-04-22', '2009-04-22', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1699774026', 0, 'N', 0, '2011-10-05', NULL, NULL, 0, 0, NULL, NULL),
('870299862', 'W11017294', 'W11017294', 'UTMH1', 'LDS Family Services', 'W', 'Dean', 'Belnap', 'MD', 'Mental Health', 'Psychiatry', NULL, NULL, 'B', '930 W Hillfield Rd Ste A', 'Layton', 'Davis', 'UT', '84041', '8013363040', '8013363041', '930 W Hillfield Rd', 'Layton', 'Davis', 'UT', '84041', NULL, NULL, 'MD-3', NULL, NULL, '0.00', '35.00', '0.00', 8, '2009-04-21', '2009-11-12', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1386776672', 0, 'y', 0, '2009-04-22', NULL, NULL, 0, 0, NULL, NULL),
('770633673', 'W11017295', 'W11017295', 'UT01', 'Respir Tech', '', '', 'Respir Tech', 'GROUP', 'Durable Medical Equipment', '', '', NULL, 'O', 'Phone Number Only', '', '', 'UT', '', '8007931261', NULL, 'Phone Number Only', '', '', 'UT', '', '8007931261', '          ', 'RESPIRTECH', '', '', '0.00', '0.00', '0.00', 3, '2009-04-10', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '0000008361', 0, 'N', 0, '2012-11-05', NULL, NULL, 0, 0, NULL, NULL),
('204040088', 'W11017339', 'W11017339', 'ID02', 'Idaho Sleep and Neurology', 'Wade', 'S', 'Harris', 'MD', 'Sleep Medicine', 'Neurology', NULL, NULL, 'O', '211 E Logan Ste 105', 'Caldwell', 'Canyon', 'ID', '83605', '2084540567', '2084551449', '211 E Logan Ste 105', 'Caldwell', 'Canyon', 'ID', '83605', '2084540567', '2084551449', 'IDACN', '', '', '0.00', '15.00', '0.00', 3, '2009-04-27', '2012-03-29', 0, 0, 1, 'West Valley Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1134227945', 0, 'N', 0, '2012-03-29', NULL, NULL, 0, 0, NULL, NULL),
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('870578948', 'W11017329', 'W11017329', 'UTDT01', 'Wendover Dental', 'Aaron', '', 'Wright', 'DMD', 'Dentist', '', '', NULL, 'O', '399 Aria Blvd', 'Wendover', 'Tooele', 'UT', '84083', '4356652962', NULL, '399 Aria Blvd', 'Wendover', 'Tooele', 'UT', '84083', '4356652962', '          ', 'UT000A', '', '', '0.00', '20.00', '0.00', 8, '2009-04-01', '2011-04-01', 0, 0, 0, '', '', '', '', 'DEN|', '0000009681', 0, 'N', 0, '2011-05-16', NULL, NULL, 0, 0, NULL, NULL),
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('942854057', 'W11017332', 'W11017332', 'UTPEHP', 'Sevier Valley Family Practice', 'Mehm', 'T', 'Thaung', 'MD', 'General Surgery', '', '', NULL, 'O', '70 E 1100 N', 'Richfield', 'Sevier', 'UT', '84701', '4358968254', NULL, '70 E 1100 N', 'Richfield', 'Sevier', 'UT', '84701', '4358968254', '', 'IHCPEHP', NULL, NULL, '0.00', '30.00', '0.00', 8, '2009-05-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1669455861', 0, 'N', 0, '2013-08-27', NULL, NULL, 0, 0, NULL, NULL),
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('810231784', 'W11017368', 'W11017368', 'WY01', 'West Park Hospital', 'James', 'M', 'Burke', 'MD', 'Oncology', 'Hematology and Oncology', NULL, NULL, 'O', '707 Sheridan Ave', 'Cody', 'Park', 'WY', '82414', '3075277501', NULL, NULL, NULL, 'Park', NULL, NULL, NULL, NULL, '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2008-02-01', '2009-04-30', NULL, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1578586418', 0, 'N', 0, '2010-01-15', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11017369', 'W11017369', 'WY01', 'West Park Hospital', 'Roger', 'G', 'Santala', 'MD', 'Oncology', 'Hematology and Oncology', NULL, NULL, 'O', '707 Sheridan Ave', 'Cody', 'Park', 'WY', '82414', '3075277501', NULL, NULL, NULL, 'Park', NULL, NULL, NULL, NULL, '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2008-02-01', '2009-04-30', NULL, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1396828059', 0, 'N', 0, '2010-01-15', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11017370', 'W11017370', 'WY01', 'Billings Clinic Cody ', 'Roger', 'G', 'Santala', 'MD', 'Oncology', 'Hematology and Oncology', NULL, NULL, 'O', '201 W Yellowstone', 'Cody', 'Park', 'WY', '82414', '3075277561', NULL, NULL, NULL, 'Park', NULL, NULL, NULL, NULL, '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2008-02-01', '2009-04-30', NULL, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1396828059', 0, 'N', 0, '2010-01-15', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11017371', 'W11017371', 'WY01', 'Billings Clinic Cody ', 'James', 'M', 'Burke', 'MD', 'Oncology', 'Hematology and Oncology', NULL, NULL, 'O', '201 W Yellowstone', 'Cody', 'Park', 'WY', '82414', '3075277561', NULL, NULL, NULL, 'Park', NULL, NULL, NULL, NULL, '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2008-02-01', '2009-04-30', NULL, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1578586418', 0, 'N', 0, '2010-01-15', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11017372', 'W11017372', 'WY01', 'Billings Clinic Cody ', 'Fred', NULL, 'Gunville', 'MD', 'Pediatrics', NULL, NULL, NULL, 'O', '201 W Yellowstone', 'Cody', 'Park', 'WY', '82414', '3075277561', NULL, NULL, NULL, 'Park', NULL, NULL, NULL, NULL, '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2008-02-01', '2009-04-30', NULL, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1912019969', 0, 'N', 0, '2009-05-04', NULL, NULL, 0, 0, NULL, NULL);
INSERT INTO `providers_new` (`Provider_Tax_ID`, `Provider_Suffix`, `Provider_Network_ID`, `Provider_Region`, `Provider_Name`, `Provider_Doctor_First_Name`, `Provider_Doctor_Middle_Name`, `Provider_Doctor_Last_Name`, `Provider_Doctor_Degree`, `Provider_Specialty_1`, `Provider_Specialty_2`, `Provider_Specialty_3`, `Provider_Specialty_4`, `Provider_Address_Type`, `Provider_Address`, `Provider_City`, `Provider_County`, `Provider_State`, `Provider_Zip`, `Provider_Phone`, `Provider_Fax`, `Provider_Mailing_Address`, `Provider_Mailing_City`, `Provider_Mailing_County`, `Provider_Mailing_State`, `Provider_Mailing_Zip`, `Provider_Mailing_Phone`, `Provider_Mailing_Fax`, `Provider_Primary_Schedule`, `Provider_Secondary_Schedule`, `Provider_Rate_Sheet`, `Provider_Anes_Rate`, `Provider_Default_Rate`, `Provider_Max_DOS`, `Provider_Min_Match_Value`, `Provider_Effective_Date`, `Provider_Term_Date`, `Provider_Pend`, `Provider_Anes_Minutes`, `Provider_PPO`, `Provider_Hospital_1`, `Provider_Hospital_2`, `Provider_Hospital_3`, `Provider_Hospital_4`, `Provider_Type`, `Provider_NPI`, `Provider_Check_Override`, `Exclude_Dir`, `Audit_Status`, `Last_Change_Date`, `Medicare_ID`, `Provider_Lang`, `Provider_Latitude`, `Provider_Longitude`, `Provider_school`, `Provider_cert`) VALUES
('810231784', 'W11017373', 'W11017373', 'WY01', 'Billings Clinic Cody', 'Lawrence', 'W', 'Klee', 'MD', 'Urology', '', '', NULL, 'O', '201 W Yellowstone', 'Cody', 'Park', 'WY', '82414', '3075277561', NULL, '201 W Yellowstone', 'Cody', 'Park', 'WY', '82414', '3075277561', '', '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2008-02-01', '2009-04-30', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1568557080', 0, 'N', 0, '2011-08-22', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11017374', 'W11017374', 'WY01', 'Billings Clinic Cody ', 'Sarah', 'A', 'Ryan', 'MD', 'Urology', NULL, NULL, NULL, 'O', '201 W Yellowstone', 'Cody', 'Park', 'WY', '82414', '3075277561', NULL, NULL, NULL, 'Park', NULL, NULL, NULL, NULL, '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2008-02-01', '2009-04-30', NULL, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1659328391', 0, 'N', 0, '2010-01-15', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11017375', 'W11017375', 'WY01', 'Billings Clinic Cody', 'Richard', 'B', 'Melzer', 'MD', 'Urology', '', '', NULL, 'O', '201 W Yellowstone', 'Cody', 'Park', 'WY', '82414', '3075277561', NULL, '201 W Yellowstone', 'Cody', 'Park', 'WY', '82414', '3075277561', '', '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2008-02-01', '2009-04-30', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1407953086', 0, 'N', 0, '2011-08-22', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11017376', 'W11017376', 'WY01', 'North Big Horn Hospital', 'Fernando', NULL, 'Boschini', 'MD', 'Cardiovascular Disease', NULL, NULL, NULL, 'O', '1115 Lane 12', 'Lovell', 'Big Horn', 'WY', '82431', '3075482771', NULL, NULL, NULL, 'Big Horn', NULL, NULL, NULL, NULL, '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2008-02-01', '2009-04-30', NULL, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1891714770', 0, 'N', 0, '2009-05-04', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11017377', 'W11017377', 'WY01', 'North Big Horn Hospital', 'Barbara', '', 'Dudczak', 'MD', 'Cardiovascular Disease', '', '', NULL, 'O', '1115 Lane 12', 'Lovell', 'Big Horn', 'WY', '82431', '3075482771', NULL, NULL, NULL, 'Big Horn', NULL, NULL, NULL, NULL, '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2008-02-01', '2009-04-30', NULL, 0, 0, '', '', '', '', 'HCFA|UB|', '1821026246', 0, 'N', 0, '2009-05-04', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11017378', 'W11017378', 'WY01', 'North Big Horn Hospital', 'Alan', '', 'Thometz', 'MD', 'Cardiovascular Disease', 'Electrophysiology', '', NULL, 'O', '1115 Lane 12', 'Lovell', 'Big Horn', 'WY', '82431', '3075482771', NULL, '1115 Lane 12', 'Lovell', 'Big Horn', 'WY', '82431', '3075482771', '', '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2008-02-01', '2009-04-30', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1104925098', 0, 'N', 0, '2014-04-09', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11017379', 'W11017379', 'WY01', 'North Big Horn Hospital', 'Robert', NULL, 'Zirpoli', 'MD', 'Cardiovascular Disease', NULL, NULL, NULL, 'O', '1115 Lane 12', 'Lovell', 'Big Horn', 'WY', '82431', '3075482771', NULL, NULL, NULL, 'Big Horn', NULL, NULL, NULL, NULL, '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2008-02-01', '2009-04-30', NULL, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '0000009750', 0, 'N', 0, '2009-05-04', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11017380', 'W11017380', 'WY01', 'North Big Horn Hospital', 'Whitney', NULL, 'Robinson', 'MD', 'Orthopedic Surgery', NULL, NULL, NULL, 'O', '1115 Lane 12', 'Lovell', 'Big Horn', 'WY', '82431', '3075482771', NULL, NULL, NULL, 'Big Horn', NULL, NULL, NULL, NULL, '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2008-02-01', '2009-04-30', NULL, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1578632717', 0, 'N', 0, '2009-05-04', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11017381', 'W11017381', 'WY01', 'North Big Horn Hospital', 'Lawrence', 'W', 'Klee', 'MD', 'Urology', '', '', NULL, 'O', ' 1115 Lane 12', 'Lovell', 'Big Horn', 'WY', '82431', '3075482771', NULL, ' 1115 Lane 12', 'Lovell', 'Big Horn', 'WY', '82431', '3075482771', '', '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2008-02-01', '2009-04-30', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1568557080', 0, 'N', 0, '2011-08-22', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11017382', 'W11017382', 'WY01', 'North Big Horn Hospital', 'Richard', 'B', 'Melzer', 'MD', 'Urology', '', '', NULL, 'O', '1115 Lane 12', 'Lovell', 'Big Horn', 'WY', '82431', '3075482771', NULL, '1115 Lane 12', 'Lovell', 'Big Horn', 'WY', '82431', '3075482771', '', '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2008-02-01', '2009-04-30', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1407953086', 0, 'N', 0, '2011-08-22', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11017383', 'W11017383', 'WY01', 'North Big Horn Hospital', 'Sarah', 'A', 'Ryan', 'MD', 'Urology', NULL, NULL, NULL, 'O', '1115 Lane 12', 'Lovell', 'Big Horn', 'WY', '82431', '3075482771', NULL, NULL, NULL, 'Big Horn', NULL, NULL, NULL, NULL, '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2008-02-01', '2009-04-30', NULL, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1659328391', 0, 'N', 0, '2010-01-15', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11017384', 'W11017384', 'WY01', 'Powell Valley Health Care Inc', 'Sarah', 'A', 'Ryan', 'MD', 'Urology', NULL, NULL, NULL, 'O', '777 Ave H', 'Powell', 'Park', 'WY', '82435', '3077542267', NULL, NULL, NULL, 'Park', NULL, NULL, NULL, NULL, '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2008-02-01', '2009-04-30', NULL, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1659328391', 0, 'N', 0, '2010-01-15', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11017385', 'W11017385', 'WY01', 'Powell Valley Health Care Inc', 'Richard', 'B', 'Melzer', 'MD', 'Urology', '', '', NULL, 'O', '777 Ave H', 'Powell', 'Park', 'WY', '82435', '3077542267', NULL, '777 Ave H', 'Powell', 'Park', 'WY', '82435', '3077542267', '', '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2008-02-01', '2009-04-30', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1407953086', 0, 'N', 0, '2011-08-22', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11017386', 'W11017386', 'WY01', 'Powell Valley Health Care Inc', 'Lawrence', 'W', 'Klee', 'MD', 'Urology', '', '', NULL, 'O', '777 Ave H', 'Powell', 'Park', 'WY', '82435', '3077542267', NULL, '777 Ave H', 'Powell', 'Park', 'WY', '82435', '3077542267', '', '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2008-02-01', '2009-04-30', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1568557080', 0, 'N', 0, '2011-08-22', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11017387', 'W11017387', 'WY01', 'Sheridan Memorial Hospital ', 'Fernando', NULL, 'Boschini', 'MD', 'Cardiovascular Disease', NULL, NULL, NULL, 'O', '1401 W 5th St', 'Sheridan', 'Sheridan', 'WY', '82801', '3076721000', NULL, NULL, NULL, 'Sheridan', NULL, NULL, NULL, NULL, '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2008-02-01', '2009-04-30', NULL, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1891714770', 0, 'N', 0, '2009-05-04', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11017388', 'W11017388', 'WY01', 'Sheridan Memorial Hospital ', 'Walter', NULL, 'Degnan', 'MD', 'Cardiovascular Disease', NULL, NULL, NULL, 'O', '1401 W 5th St', 'Sheridan', 'Sheridan', 'WY', '82801', '3076721000', NULL, NULL, NULL, 'Sheridan', NULL, NULL, NULL, NULL, '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2008-02-01', '2009-04-28', NULL, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1558384404', 0, 'N', 0, '2009-05-04', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11017389', 'W11017389', 'WY01', 'Sheridan Memorial Hospital ', 'Scott', '', 'Sample', 'DO', 'Cardiovascular Disease', '', '', NULL, 'O', '1401 W 5th St', 'Sheridan', 'Sheridan', 'WY', '82801', '3076721000', NULL, NULL, NULL, 'Sheridan', NULL, NULL, NULL, NULL, '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2008-02-01', '2009-04-30', NULL, 0, 0, '', '', '', '', 'HCFA|UB|', '1558444216', 0, 'N', 0, '2009-05-04', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11017390', 'W11017390', 'WY01', 'Sheridan Memorial Hospital ', 'James', 'D', 'Knostman', 'MD', 'Nephrology', NULL, NULL, NULL, 'O', '1401 W 5th St', 'Sheridan', 'Sheridan', 'WY', '82801', '3076721000', NULL, NULL, NULL, 'Sheridan', NULL, NULL, NULL, NULL, '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2008-02-01', '2009-04-28', NULL, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1306929377', 0, 'N', 0, '2010-01-15', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11017391', 'W11017391', 'WY01', 'Sheridan Memorial Hospital ', 'Heather', 'L', 'McGuire', 'MD', 'Nephrology', NULL, NULL, NULL, 'O', '1401 W 5th St', 'Sheridan', 'Sheridan', 'WY', '82801', '3076721000', NULL, NULL, NULL, 'Sheridan', NULL, NULL, NULL, NULL, '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2008-02-01', '2009-04-30', NULL, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1508806100', 0, 'N', 0, '2010-01-15', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11017392', 'W11017392', 'WY01', 'Sheridan Memorial Hospital ', 'Gregory', NULL, 'Mock', 'MD', 'Nephrology', NULL, NULL, NULL, 'O', '1401 W 5th St', 'Sheridan', 'Sheridan', 'WY', '82801', '3076721000', NULL, NULL, NULL, 'Sheridan', NULL, NULL, NULL, NULL, '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2008-02-01', '2009-04-30', NULL, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1942308101', 0, 'N', 0, '2009-05-04', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11017393', 'W11017393', 'WY01', 'Wyoming Radiology & MRI', 'Michael', 'A', 'Morone', 'MD', 'Neurosurgery', '', '', NULL, 'O', '1458 West 5th St', 'Sheridan', 'Sheridan', 'WY', '82801', '3076739729', NULL, '1458 West 5th St', 'Sheridan', 'Sheridan', 'WY', '82801', '3076739729', '', '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2008-02-01', '2009-04-30', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1407954456', 0, 'N', 0, '2012-04-16', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11017394', 'W11017394', 'WY01', 'Wyoming Radiology & MRI', 'James', 'M', 'Burke', 'MD', 'Oncology', 'Hematology and Oncology', NULL, NULL, 'O', '1458 West 5th St', 'Sheridan', 'Sheridan', 'WY', '82801', '3076739729', NULL, NULL, NULL, 'Sheridan', NULL, NULL, NULL, NULL, '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2008-02-01', '2009-04-30', NULL, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1578586418', 0, 'N', 0, '2010-01-15', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11017395', 'W11017395', 'WY01', 'Hot Springs Co Memorial Hosp', 'Gail', 'A', 'Kleman', 'MD', 'Dermatology', NULL, NULL, NULL, 'O', ' 150 East Arapahoe', 'Thermopolis', 'Hot Springs', 'WY', '82443', '3078643121', NULL, NULL, NULL, 'Hot Springs', NULL, NULL, NULL, NULL, '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2008-02-01', '2009-04-30', NULL, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1932292414', 0, 'N', 0, '2010-01-15', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11017396', 'W11017396', 'WY01', 'Hot Springs Co Memorial Hosp', 'James', 'M', 'Burke', 'MD', 'Oncology', 'Hematology and Oncology', NULL, NULL, 'O', '150 East Arapahoe', 'Thermopolis', 'Hot Springs', 'WY', '82443', '3078643121', NULL, NULL, NULL, 'Hot Springs', NULL, NULL, NULL, NULL, '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2008-02-01', '2009-04-30', NULL, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1578586418', 0, 'N', 0, '2010-01-15', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11017397', 'W11017397', 'WY01', 'Hot Springs Co Memorial Hosp', 'Roger', 'G', 'Santala', 'MD', 'Oncology', 'Hematology and Oncology', NULL, NULL, 'O', '150 East Arapahoe', 'Thermopolis', 'Hot Springs', 'WY', '82443', '3078643121', NULL, NULL, NULL, 'Hot Springs', NULL, NULL, NULL, NULL, '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2008-02-01', '2009-04-30', NULL, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1396828059', 0, 'N', 0, '2010-01-15', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11017398', 'W11017398', 'WY01', 'Hot Springs Co Memorial Hosp', 'Stephen', NULL, 'Mainini', 'MD', 'Internal Medicine', 'Pulmonary', NULL, NULL, 'O', '150 East Arapahoe', 'Thermopolis', 'Hot Springs', 'WY', '82443', '3078643121', NULL, NULL, NULL, 'Hot Springs', NULL, NULL, NULL, NULL, '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2008-02-01', '2009-04-28', NULL, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1336242114', 0, 'N', 0, '2009-05-04', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11017399', 'W11017399', 'WY01', 'Washakie Medical Center Outreach Clinic', 'Michael', 'A', 'Morone', 'MD', 'Neurosurgery', '', '', NULL, 'O', '1106 Big Horn Ave', 'Worland', 'Washakie', 'WY', '82401', '3073478801', NULL, '1106 Big Horn Ave', 'Worland', 'Washakie', 'WY', '82401', '3073478801', '          ', '', '', '', '0.00', '17.00', '0.00', 3, '2008-02-01', '2009-04-30', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1407954456', 0, 'N', 0, '2012-05-01', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11017400', 'W11017400', 'WY01', 'Washakie Medical Center Outreach Clinic', 'Stephen', NULL, 'Mainini', 'MD', 'Internal Medicine', 'Pulmonary', NULL, NULL, 'O', '1106 Big Horn Ave', 'Worland', 'Washakie', 'WY', '82401', '3073478801', NULL, NULL, NULL, 'Washakie', NULL, NULL, NULL, NULL, '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2008-02-01', '2009-04-30', NULL, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1336242114', 0, 'N', 0, '2009-05-04', NULL, NULL, 0, 0, NULL, NULL),
('870358019', 'W11017402', 'W11017402', 'UT01', 'Cottonwood Eye & Laser Clinic', 'Robert', 'H', 'Meek', 'OD', 'Optometry', '', '', NULL, 'O', '201 E 5900 S', 'Murray', 'Salt Lake', 'UT', '84107', '8012686600', NULL, '201 E 5900 S', 'Murray', 'Salt Lake', 'UT', '84107', '8012686600', '          ', 'WiseSTD', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 3, '2009-04-29', '2011-10-05', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1356310940', 0, 'N', 0, '2012-05-22', NULL, NULL, 0, 0, NULL, NULL),
('870358019', 'W11017403', 'W11017403', 'UT01', 'Jordan Vision Clinic', 'Robert', 'H', 'Meek', 'OD', 'Optometry', '', '', NULL, 'O', '9237 S Redwood Rd Ste 5A', 'West Jordan', 'Salt Lake', 'UT', '84088', '8015612020', NULL, '9237 S Redwood Rd Ste 5A', 'West Jordan', 'Salt Lake', 'UT', '84088', '8015612020', '', 'WiseSTD', 'WUSTDHCPC5', NULL, '0.00', '35.00', '0.00', 3, '2009-04-29', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1356310940', 0, 'N', 0, '2012-05-22', NULL, NULL, 40.5835, -111.939, NULL, NULL),
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('942938348', 'W11017441', 'W11017441', 'UTMH1', ' Valley Mental Health Inc', 'Eleanor', 'M', 'Ulibarri', 'LCSW', 'Mental Health', 'Social Worker', '', NULL, 'B', '5965 S 900 E Ste 430', 'Salt Lake City', 'Salt Lake', 'UT', '84121', '8012637100', NULL, '5965 S 900 E Ste 430', 'Salt Lake City', 'Salt Lake', 'UT', '84121', '8012637100', '          ', 'UTVMHMA', '', '', '0.00', '35.00', '0.00', 6, '2008-08-06', '2013-02-14', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1447237136', 0, 'Y', 0, '2013-02-27', NULL, NULL, 0, 0, NULL, NULL),
('942938348', 'W11017442', 'W11017442', 'UTMH1', ' Valley Mental Health Inc', 'Paul', NULL, 'Flack', 'MFT', 'Mental Health', 'Marriage and Family Therapy', '', NULL, 'B', '5965 S 900 E Ste 430', 'Salt Lake City', 'Salt Lake', 'UT', '84121', '8012637100', NULL, '5965 S 900 E Ste 430', 'Salt Lake City', 'Salt Lake', 'UT', '84121', '8012637100', '', 'UTVMHMA', NULL, NULL, '0.00', '35.00', '0.00', 6, '2009-01-22', '2013-02-14', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1124234349', 0, 'Y', 0, '2013-02-27', NULL, NULL, 0, 0, NULL, NULL),
('942938348', 'W11017443', 'W11017443', 'UTMH1', ' Valley Mental Health Inc', 'Andrea', '', 'Lunt', '', 'Mental Health', '', '', NULL, 'B', '5965 S 900 E Ste 430', 'Salt Lake City', 'Salt Lake', 'UT', '84121', '8012637100', NULL, '5965 S 900 E Ste 430', 'Salt Lake City', 'Salt Lake', 'UT', '84121', '8012637100', '', 'UTVMHMA', NULL, NULL, '0.00', '35.00', '0.00', 6, '2009-03-23', '2013-02-14', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1588899074', 0, 'Y', 0, '2013-02-27', NULL, NULL, 0, 0, NULL, NULL),
('942938348', 'W11017444', 'W11017444', 'UTMH1', ' Valley Mental Health Inc', 'Michael', 'C', 'Desjardins', 'APRN', 'Mental Health', 'Adult Psychiatric Nurse Practitioner', 'Psychiatry', NULL, 'B', '5965 S 900 E Ste 430', 'Salt Lake City', 'Salt Lake', 'UT', '84121', '8012637100', NULL, '5965 S 900 E Ste 430', 'Salt Lake City', 'Salt Lake', 'UT', '84121', '8012637100', '', 'UTVMHARNP', NULL, NULL, '0.00', '35.00', '0.00', 6, '2009-02-19', '2013-02-14', 0, 0, 0, 'St Marks Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1801924766', 0, 'Y', 0, '2013-02-27', NULL, NULL, 0, 0, NULL, NULL),
('942938348', 'W11017445', 'W11017445', 'UTMH1', ' Valley Mental Health Inc', 'Patricia', NULL, 'Dulle', 'APRN/NP', 'Mental Health', 'Psychiatry', '', NULL, 'B', '5965 S 900 E Ste 430', 'Salt Lake City', 'Salt Lake', 'UT', '84121', '8012637100', NULL, '5965 S 900 E Ste 430', 'Salt Lake City', 'Salt Lake', 'UT', '84121', '8012637100', '', 'UTVMHARNP', NULL, NULL, '0.00', '35.00', '0.00', 6, '2009-04-14', '2013-02-14', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1245292648', 0, 'Y', 0, '2013-02-27', NULL, NULL, 0, 0, NULL, NULL),
('942938348', 'W11017446', 'W11017446', 'UTMH1', ' Valley Mental Health Inc', 'Marilyn', NULL, 'Little', 'APRN/NP', 'Mental Health', 'Psychiatry', '', NULL, 'B', '5965 S 900 E Ste 430', 'Salt Lake City', 'Salt Lake', 'UT', '84121', '8012637100', NULL, '5965 S 900 E Ste 430', 'Salt Lake City', 'Salt Lake', 'UT', '84121', '8012637100', '', 'UTVMHARNP', NULL, NULL, '0.00', '35.00', '0.00', 6, '2008-11-06', '2013-02-14', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1467606228', 0, 'Y', 0, '2013-02-27', NULL, NULL, 0, 0, NULL, NULL),
('942938348', 'W11017447', 'W11017447', 'UTMH1', ' Valley Mental Health Inc', 'Kenneth', NULL, 'Brown', 'LPC', 'Mental Health', 'Counseling', '', NULL, 'B', '5965 S 900 E Ste 430', 'Salt Lake City', 'Salt Lake', 'UT', '84121', '8012637100', NULL, '5965 S 900 E Ste 430', 'Salt Lake City', 'Salt Lake', 'UT', '84121', '8012637100', '', 'UTVMHMA', NULL, NULL, '0.00', '35.00', '0.00', 6, '2008-11-06', '2013-02-14', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1730334574', 0, 'Y', 0, '2013-02-27', NULL, NULL, 0, 0, NULL, NULL),
('942938348', 'W11017448', 'W11017448', 'UTMH1', ' Valley Mental Health Inc', 'Rhonda', NULL, 'Busch', 'LPC', 'Mental Health', 'Counseling', '', NULL, 'B', '5965 S 900 E Ste 430', 'Salt Lake City', 'Salt Lake', 'UT', '84121', '8012637100', NULL, '5965 S 900 E Ste 430', 'Salt Lake City', 'Salt Lake', 'UT', '84121', '8012637100', '', 'UTVMHMA', NULL, NULL, '0.00', '35.00', '0.00', 6, '2008-11-03', '2013-02-14', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1902051741', 0, 'Y', 0, '2013-02-27', NULL, NULL, 0, 0, NULL, NULL),
('942938348', 'W11017449', 'W11017449', 'UTMH1', ' Valley Mental Health Inc', 'Frank', 'G', 'Clayton', 'LPC', 'Mental Health', 'Counseling', '', NULL, 'B', '5965 S 900 E Ste 430', 'Salt Lake City', 'Salt Lake', 'UT', '84121', '8012637100', NULL, '5965 S 900 E Ste 430', 'Salt Lake City', 'Salt Lake', 'UT', '84121', '8012637100', '', 'UTVMHMA', NULL, NULL, '0.00', '35.00', '0.00', 6, '2008-10-02', '2013-02-14', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1700944741', 0, 'Y', 0, '2013-02-27', NULL, NULL, 0, 0, NULL, NULL),
('942938348', 'W11017450', 'W11017450', 'UTMH1', ' Valley Mental Health Inc', 'Loren', '', 'Mitchell', 'LPC', 'Mental Health', 'Counseling', '', NULL, 'B', '5965 S 900 E Ste 430', 'Salt Lake City', 'Salt Lake', 'UT', '84121', '8012637100', NULL, '5965 S 900 E Ste 430', 'Salt Lake City', 'Salt Lake', 'UT', '84121', '8012637100', '', 'UTVMHMA', NULL, NULL, '0.00', '35.00', '0.00', 6, '2009-04-16', '2013-02-14', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1932342516', 0, 'Y', 0, '2013-02-27', NULL, NULL, 0, 0, NULL, NULL),
('942938348', 'W11017451', 'W11017451', 'UTMH1', ' Valley Mental Health Inc', 'Margaret', '', 'Tan', 'LPC', 'Mental Health', 'Counseling', '', NULL, 'B', '5965 S 900 E Ste 430', 'Salt Lake City', 'Salt Lake', 'UT', '84121', '8012637100', NULL, '5965 S 900 E Ste 430', 'Salt Lake City', 'Salt Lake', 'UT', '84121', '8012637100', '          ', 'UTVMHMA', '', '', '0.00', '35.00', '0.00', 6, '2008-06-13', '2011-11-11', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1003062811', 0, 'Y', 0, '2013-08-01', NULL, NULL, 0, 0, NULL, NULL),
('364100874', 'W11017452', 'W11017452', 'TX01', 'Walgreens Home Care Inc', '', '', 'Walgreens Home Care Inc', 'GROUP', 'Durable Medical Equipment', 'Infusion Agency', NULL, NULL, 'O', '14220 Northbrook Dr Ste 100B', 'San Antonio', 'Bexar', 'TX', '78232', '2106157211', NULL, '1411 Lake Cook Rd', 'Dearfield', 'Bexar', 'IL', '60015', NULL, NULL, 'DME80', NULL, NULL, '0.00', '50.00', NULL, 8, '2000-01-01', '2000-01-01', 1, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1124033196', 0, 'n', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('364100874', 'W11017453', 'W11017453', 'TX01', 'Walgreens Home Care Inc.', '', '', 'Walgreens Home Care Inc', 'GROUP', 'Infusion Agency', 'Infusion Agency', NULL, NULL, 'O', '14220 Northbrook Dr Ste 100B', 'San Antonio', 'Bexar', 'TX', '78232', '2106157211', NULL, '14220 Northbrook Dr Ste 100B', 'San Antonio', 'Bexar', 'TX', '78232', '2106157211', '          ', 'DME80', '', 'TX2', '0.00', '50.00', '0.00', 8, '2009-05-01', '2012-06-30', 1, 0, 0, '', '', '', '', 'HCFA|UB|', '1124033196', 0, 'N', 0, '2012-07-03', NULL, NULL, 0, 0, NULL, NULL),
('364100874', 'W11017454', 'W11017454', 'TX01', 'Walgreens Home Care Inc.', '', '', 'Walgreens Home Care Inc', 'GROUP', 'Infusion Agency', 'Infusion Agency', NULL, NULL, 'B', '9361 Paysphere Cir', 'Chicago', 'Cook', 'IL', '60674', '2104049259', NULL, '9361 Paysphere Cir', 'Chicago', 'Cook', 'IL', '60674', '2104049259', '          ', 'DME80', '', 'TX2', '0.00', '50.00', '0.00', 8, '2009-05-01', '2012-06-30', 1, 0, 0, '', '', '', '', 'HCFA|UB|', '1124033196', 0, 'N', 0, '2012-07-03', NULL, NULL, 0, 0, NULL, NULL),
('364100874', 'W11017455', 'W11017455', 'TX01', 'Walgreens Home Care Inc', '', '', 'Walgreens Home Care Inc', 'GROUP', 'Durable Medical Equipment', 'Infusion Agency', NULL, NULL, 'B', '9361 Paysphere Cir', 'Chicago', 'Cook', 'IL', '60674', '2104049259', NULL, '1411 Lake Cook Rd', 'Dearfield', 'Cook', 'IL', '60015', NULL, NULL, 'DME80', NULL, NULL, '0.00', '50.00', NULL, 8, '2000-01-01', '2000-01-01', 1, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1124033196', 0, 'y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('061642941', 'W11017456', 'W11017456', 'TX01', 'Corinthian Care Group', '', '', 'Corinthian Care Group LLC', 'GROUP', 'Infusion Agency', '', '', NULL, 'O', '11550 I H 10 W Ste 120', 'San Antonio', 'Bexar', 'TX', '78230', '2106970673', NULL, '11550 I H 10 W Ste 120', 'San Antonio', 'Bexar', 'TX', '78230', '2106970673', '          ', '', '', 'TX2', '0.00', '100.00', '0.00', 8, '2009-05-01', '2012-06-30', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1043380983', 0, 'N', 0, '2012-07-03', NULL, NULL, 0, 0, NULL, NULL),
('061642941', 'W11017457', 'W11017457', 'TX01', 'Corinthian Care Group LLC', '', '', 'Corinthian Care Group LLC', 'GROUP', 'Infusion Agency', '', '', NULL, 'B', '16358 Collections Center Dr', 'Chicago', 'Cook', 'TX', '60696', '2106970673', NULL, '16358 Collections Center Dr', 'Chicago', 'Cook', 'TX', '60696', '2106970673', '          ', '', '', 'TX2', '0.00', '100.00', '0.00', 8, '2009-05-01', '2012-06-30', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1043380983', 0, 'N', 0, '2012-07-03', NULL, NULL, 0, 0, NULL, NULL),
('870218917', 'W11017458', 'W11017458', 'UT01', 'Tanner Memorial Clinic', 'John', 'B', 'Bitner', 'MD', 'Ear, Nose and Throat', '', '', NULL, 'B', 'PO Box 337', 'Layton', 'Davis', 'UT', '84041', '8017734840', '8017749219', 'PO Box 337', 'Layton', 'Davis', 'UT', '84041', '8017734840', '8017749219', 'WUTANNER5', 'WUSTDHCPC5', NULL, '0.00', '35.00', '0.00', 3, '2009-05-01', NULL, 0, 0, 0, 'Davis Hospital', '', '', '', 'HCFA|UB|', '1336129543', 0, 'Y', 0, '2014-04-17', NULL, NULL, 0, 0, NULL, NULL),
('870218917', 'W11017459', 'W11017459', 'UT01', 'Tanner Memorial Clinic', 'John', 'B', 'Bitner', 'MD', 'Ear, Nose and Throat', '', '', NULL, 'O', '2121 N 1700 W', 'Layton', 'Davis', 'UT', '84041', '8017734840', '8017749219', '2121 N 1700 W', 'Layton', 'Davis', 'UT', '84041', '8017734840', '8017749219', 'WUTANNER5', 'WUSTDHCPC5', NULL, '0.00', '35.00', '0.00', 3, '2009-05-01', NULL, 0, 0, 0, 'Davis Hospital', '', '', '', 'HCFA|UB|', '1336129543', 0, 'N', 0, '2014-04-17', NULL, NULL, 41.0893, -111.997, NULL, NULL),
('870218917', 'W11017460', 'W11017460', 'UT01', 'Tanner Memorial Clinic', 'John', 'B', 'Bitner', 'MD', 'Ear, Nose and Throat', '', '', NULL, 'O', '380 N 400 W', 'Kaysville', 'Davis', 'UT', '84037', '8017734840', '8017749219', '380 N 400 W', 'Kaysville', 'Davis', 'UT', '84037', '8017734840', '8017749219', 'WUTANNER5', 'WUSTDHCPC5', NULL, '0.00', '35.00', '0.00', 3, '2009-05-01', NULL, 0, 0, 0, 'Davis Hospital', '', '', '', 'HCFA|UB|', '1336129543', 0, 'N', 0, '2014-04-17', NULL, NULL, 41.0412, -111.946, NULL, NULL),
('870218917', 'W11017461', 'W11017461', 'UT01', 'Tanner Memorial Clinic', 'John', 'B', 'Bitner', 'MD', 'Ear, Nose and Throat', '', '', NULL, 'O', '2038 W 1900 S', 'Syracuse', 'Davis', 'UT', '84075', '8017734840', '8017749219', '2038 W 1900 S', 'Syracuse', 'Davis', 'UT', '84075', '8017734840', '8017749219', 'WUTANNER5', 'WUSTDHCPC5', NULL, '0.00', '35.00', '0.00', 3, '2009-05-01', NULL, 0, 0, 0, 'Davis Hospital', '', '', '', 'HCFA|UB|', '1336129543', 0, 'N', 0, '2014-04-17', NULL, NULL, 41.0863, -112.065, NULL, NULL),
('870673066', 'W11017462', 'W11017462', 'UT01', 'Northern Utah Pathology', 'Jonathan', 'F', 'Koehler', 'MD', 'Family Practice', 'Pathology', '', NULL, 'O', '1400 N 500 E', 'Logan', 'Cache', 'UT', '84341', '4357165375', NULL, '1400 N 500 E', 'Logan', 'Cache', 'UT', '84341', '4357165375', '          ', 'WUSTDPATH5', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 3, '2009-05-01', '2010-06-30', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1144250705', 0, 'Y', 0, '2010-11-05', NULL, NULL, 0, 0, NULL, NULL),
('870673066', 'W11017463', 'W11017463', 'UT01', 'Northern Utah Pathology', 'Jonathan', 'F', 'Koehler', 'MD', 'Family Practice', 'Pathology', '', NULL, 'B', 'PO Box 30309', 'Charleston', 'Charleston', 'SC', '29417', '8436644300', NULL, 'PO Box 30309', 'Charleston', 'Charleston', 'SC', '29417', '8436644300', '          ', 'WUSTDPATH5', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 3, '2009-05-01', '2010-06-30', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1144250705', 0, 'Y', 0, '2010-11-05', NULL, NULL, 0, 0, NULL, NULL),
('820452136', 'W11017464', 'W11017464', 'ID01', 'McKim Chiropractic', 'Keith', '', 'McKim', 'DC', 'Chiropractic', '', '', NULL, 'O', '2023 12th Ave Rd', 'Nampa', 'Canyon', 'ID', '83686', '2084675756', NULL, '2023 12th Ave Rd', 'Nampa', 'Canyon', 'ID', '83686', '2084675756', '', 'IDCHIRO1', NULL, NULL, '0.00', '35.00', '0.00', 3, '2009-05-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1477516169', 0, 'n', 0, '2013-04-16', NULL, NULL, 43.5492, -116.573, NULL, NULL),
('352332742', 'W11017465', 'W11017465', 'ID01', 'Healthy Habits Wellness Clinic', 'Kimball', 'T', 'Lundahl', 'DC', 'Chiropractic', '', '', NULL, 'O', '5216 E Cleveland Blvd Ste G', 'Caldwell', 'Canyon', 'ID', '83607', '2084548111', NULL, '5216 E Cleveland Blvd Ste G', 'Caldwell', 'Canyon', 'ID', '83607', '2084548111', '          ', 'IDCHIRO1', '', '', '0.00', '35.00', '0.00', 6, '2009-05-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1760598478', 0, 'N', 0, '2013-04-10', NULL, NULL, 43.6321, -116.642, NULL, NULL),
('352332742', 'W11017466', 'W11017466', 'ID01', 'Healthy Habits Wellness Clinic', 'Kimball', 'T', 'Lundahl', 'DC', 'Chiropractic', '', '', NULL, 'O', '27 E Fairview Ave', 'Meridian', 'Ada', 'ID', '83642', '2088874872', NULL, '27 E Fairview Ave', 'Meridian', 'Ada', 'ID', '83642', '2088874872', '          ', 'IDCHIRO1', '', '', '0.00', '35.00', '0.00', 3, '2009-05-01', '2010-01-03', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1760598478', 0, 'N', 0, '2013-04-10', NULL, NULL, 0, 0, NULL, NULL),
('202962026', 'W11017467', 'W11017467', 'UT01', 'The Oral and Facial Surgery Center', 'Mark', 'L', 'Newey', 'DDS', 'Oral/Maxillofacial Surgery', 'Oral Surgeon', '', NULL, 'B', 'PO Box 1847', 'Layton', 'Davis', 'UT', '84041', '8018251116', '8017794344', 'PO Box 1847', 'Layton', 'Davis', 'UT', '84041', '8018251116', '8017794344', 'WiseSTD', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 6, '2009-05-01', '2010-10-10', 0, 0, 0, '', '', '', '', 'HCFA|UB|DEN|', '1619074259', 0, 'Y', 0, '2012-04-13', NULL, NULL, 0, 0, NULL, NULL),
('202962026', 'W11017468', 'W11017468', 'UT01', 'The Oral and Facial Surgery Center', 'Mark', 'L', 'Newey', 'DDS', 'Oral/Maxillofacial Surgery', 'Oral Surgeon', '', NULL, 'O', '938 S University Park Blvd Ste 100', 'Clearfield', 'Davis', 'UT', '84015', '8018251116', '8018251310', '938 S University Park Blvd Ste 100', 'Clearfield', 'Davis', 'UT', '84015', '8018251116', '8018251310', 'WiseSTD', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 6, '2009-05-01', '2010-10-10', 0, 0, 0, '', '', '', '', 'HCFA|UB|DEN|', '1619074259', 0, 'Y', 0, '2012-04-13', NULL, NULL, 0, 0, NULL, NULL);
INSERT INTO `providers_new` (`Provider_Tax_ID`, `Provider_Suffix`, `Provider_Network_ID`, `Provider_Region`, `Provider_Name`, `Provider_Doctor_First_Name`, `Provider_Doctor_Middle_Name`, `Provider_Doctor_Last_Name`, `Provider_Doctor_Degree`, `Provider_Specialty_1`, `Provider_Specialty_2`, `Provider_Specialty_3`, `Provider_Specialty_4`, `Provider_Address_Type`, `Provider_Address`, `Provider_City`, `Provider_County`, `Provider_State`, `Provider_Zip`, `Provider_Phone`, `Provider_Fax`, `Provider_Mailing_Address`, `Provider_Mailing_City`, `Provider_Mailing_County`, `Provider_Mailing_State`, `Provider_Mailing_Zip`, `Provider_Mailing_Phone`, `Provider_Mailing_Fax`, `Provider_Primary_Schedule`, `Provider_Secondary_Schedule`, `Provider_Rate_Sheet`, `Provider_Anes_Rate`, `Provider_Default_Rate`, `Provider_Max_DOS`, `Provider_Min_Match_Value`, `Provider_Effective_Date`, `Provider_Term_Date`, `Provider_Pend`, `Provider_Anes_Minutes`, `Provider_PPO`, `Provider_Hospital_1`, `Provider_Hospital_2`, `Provider_Hospital_3`, `Provider_Hospital_4`, `Provider_Type`, `Provider_NPI`, `Provider_Check_Override`, `Exclude_Dir`, `Audit_Status`, `Last_Change_Date`, `Medicare_ID`, `Provider_Lang`, `Provider_Latitude`, `Provider_Longitude`, `Provider_school`, `Provider_cert`) VALUES
('810231784', 'W11017469', 'W11017469', 'WYBILLINGS', 'Billings Clinic - Gen Surg', 'Kirk', 'R', 'Kenfield', 'PA-C', 'General Surgery', NULL, NULL, NULL, 'O', '2825 8th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4062382501', '4062382848', 'PO Box 37000', 'Billings', 'Yellowstone', 'MT', '59107', NULL, NULL, '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2009-05-01', '2010-03-01', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1003070202', 0, 'N', 0, '2010-01-15', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11017470', 'W11017470', 'WYBILLINGS', 'Billings Clinic - Internal Medicine', 'Eric', NULL, 'Saberhagen', 'MD', 'Internal Medicine', NULL, NULL, NULL, 'O', '2825 8th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4062382501', '4062382413', 'PO Box 37000', 'Billings', 'Yellowstone', 'MT', '59107', NULL, NULL, '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2009-05-01', '2010-03-01', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1528012184', 0, 'N', 0, '2009-05-04', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11017471', 'W11017471', 'WYBILLINGS', 'Billings Clinic - Peds', 'Kimberly', 'L', 'Ackerman', 'FNP', 'Endocrinology', 'Pediatrics', NULL, NULL, 'O', '2800 10th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4066574150', '4066574349', 'PO Box 37000', 'Billings', 'Yellowstone', 'MT', '59107', NULL, NULL, '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2009-05-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1922032861', 0, 'N', 0, '2010-01-15', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11017472', 'W11017472', 'WYBILLINGS', 'Billings Clinic - Peds', 'Deborah', NULL, 'Agnew', 'MD', 'Pediatrics', NULL, NULL, NULL, 'O', '2800 10th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4066574150', '4066574349', 'PO Box 37000', 'Billings', 'Yellowstone', 'MT', '59107', NULL, NULL, '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2009-05-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1134178072', 0, 'N', 0, '2009-05-04', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11017473', 'W11017473', 'WYBILLINGS', 'Billings Clinic - Internal Medicine', 'Jessica', 'M', 'Amsden', 'PA-C', 'Hospitalist', '', '', NULL, 'O', '2825 8th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4062382501', '4062382771', '2825 8th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4062382501', '4062382771', '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2009-05-01', '2010-03-01', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1053351411', 0, 'N', 0, '2013-10-03', NULL, NULL, 0, 0, NULL, NULL),
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('810231784', 'W11017497', 'W11017497', 'WYBILLINGS', 'Billings Clinic - Neurology', 'Patrick', NULL, 'Cahill', 'MD', 'Neurology', NULL, NULL, NULL, 'O', '2825 8th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4062382501', '4062382805', 'PO Box 37000', 'Billings', 'Yellowstone', 'MT', '59107', NULL, NULL, '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2009-05-01', '2010-03-01', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1235248907', 0, 'N', 0, '2009-05-04', NULL, NULL, 0, 0, NULL, NULL),
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('810231784', 'W11017500', 'W11017500', 'WYBILLINGS', 'Billings Clinic - Heights Clinic', 'Stephanie', NULL, 'Canty', 'MD', 'Family Practice', NULL, NULL, NULL, 'O', '760 Wicks Ln', 'Billings', 'Yellowstone', 'MT', '59105', '4062562575', '4062382586', 'PO Box 37000', 'Billings', 'Yellowstone', 'MT', '59107', NULL, NULL, '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2009-05-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1093824773', 0, 'N', 0, '2009-05-04', NULL, NULL, 0, 0, NULL, NULL),
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('810231784', 'W11017502', 'W11017502', 'WYBILLINGS', 'Billings Clinic - Geriatrics', 'Carolin', '', 'Cassel', 'FNP', 'Mental Health', 'Psychiatry', '', NULL, 'O', '2825 8th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4062382501', '4062382413', '2825 8th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4062382501', '4062382413', '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2010-06-14', '2008-02-01', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1154330397', 0, 'N', 0, '2010-07-12', NULL, NULL, 0, 0, NULL, NULL),
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('810231784', 'W11017505', 'W11017505', 'WYBILLINGS', 'Billings Clinic - Occupational Therapy', 'Carmalen', 'C', 'Chimenti', 'OT', 'Occupational Therapy', NULL, NULL, NULL, 'O', '2825 8th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4062382501', NULL, 'PO Box 37000', 'Billings', 'Yellowstone', 'MT', '59107', NULL, NULL, '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2009-05-01', '2010-03-01', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1174706675', 0, 'N', 0, '2010-01-15', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11017506', 'W11017506', 'WYBILLINGS', 'Billings Clinic - Geriatrics', 'Patricia', 'J', 'Coon', 'MD', 'Geriatrics', NULL, NULL, NULL, 'O', '2825 8th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4062382501', '4062382413', 'PO Box 37000', 'Billings', 'Yellowstone', 'MT', '59107', NULL, NULL, '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2009-05-01', '2010-03-01', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1467561431', 0, 'N', 0, '2010-01-15', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11017507', 'W11017507', 'WYBILLINGS', 'Billings Clinic - Ophthalmology', 'James', 'P', 'Cornetet', 'MD', 'Ophthalmology', NULL, NULL, NULL, 'O', '2825 8th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4062382501', '4062382871', 'PO Box 37000', 'Billings', 'Yellowstone', 'MT', '59107', NULL, NULL, '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2009-05-01', '2010-03-01', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1306868153', 0, 'N', 0, '2010-01-15', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11017508', 'W11017508', 'WYBILLINGS', 'Billings Clinic - Gen Surg', 'John', 'R', 'Craig', 'MD', 'Vascular Surgery', '', '', NULL, 'O', '2825 8th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4062382501', '4062382848', '2825 8th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4062382501', '4062382848', '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2009-05-01', '2010-03-01', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1013957695', 0, 'N', 0, '2014-04-10', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11017509', 'W11017509', 'WYBILLINGS', 'Billings Clinic - Emergency', 'Barbara', NULL, 'Curry', 'MD', 'Emergency Medicine', NULL, NULL, NULL, 'O', '2800 10th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4066574150', '4066574349', 'PO Box 37000', 'Billings', 'Yellowstone', 'MT', '59107', NULL, NULL, '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2009-05-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1649381203', 0, 'N', 0, '2009-05-04', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11017510', 'W11017510', 'WYBILLINGS', 'Billings Clinic - OB/GYN', 'Dana', 'P', 'Damron', 'MD', 'Maternal Fetal Medicine', NULL, NULL, NULL, 'O', '2825 8th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4062382501', '4062382806', 'PO Box 37000', 'Billings', 'Yellowstone', 'MT', '59107', NULL, NULL, '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2009-05-01', '2010-03-01', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1093826828', 0, 'N', 0, '2010-01-15', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11017511', 'W11017511', 'WYBILLINGS', 'Billings Clinic - Radiology', 'Ronald', NULL, 'Darby', 'MD', 'Radiologist', NULL, NULL, NULL, 'O', '2800 10th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4066574150', '4066574349', 'PO Box 37000', 'Billings', 'Yellowstone', 'MT', '59107', NULL, NULL, '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2009-05-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1992816722', 0, 'N', 0, '2009-05-04', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11017512', 'W11017512', 'WYBILLINGS', 'Billings Clinic - Hospitalist', 'Andrea', '', 'Darilek', 'MD', 'Hospitalist', '', '', NULL, 'O', '2800 10th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4066574150', '4062382572', '2800 10th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4066574150', '4062382572', '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2009-05-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1053334904', 0, 'N', 0, '2014-02-04', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11017513', 'W11017513', 'WYBILLINGS', 'Billings Clinic - Allergy', 'Kathleen', 'C', 'Davis', 'MD', 'Allergy and Immunology', '', '', NULL, 'O', '2825 8th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4062382501', '4062382805', '2825 8th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4062382501', '4062382805', '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2009-05-01', '2010-03-01', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1407959489', 0, 'N', 0, '2010-08-18', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11017514', 'W11017514', 'WYBILLINGS', 'Billings Clinic - Orthopedics & Sports Medicine', 'Stuart', NULL, 'Davis', 'MD', 'Orthopedic Surgery', NULL, NULL, NULL, 'O', '2702 8th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4062382501', '4062385218', 'PO Box 37000', 'Billings', 'Yellowstone', 'MT', '59107', NULL, NULL, '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2009-05-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1053321158', 0, 'N', 0, '2009-05-04', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11017515', 'W11017515', 'WYBILLINGS', 'Billings Clinic - Geriatrics', 'Gabriella', '', 'Decke', 'PA-C', 'Hospitalist', '', '', NULL, 'O', '2825 8th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4062382501', '4062382413', '2825 8th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4062382501', '4062382413', '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2009-05-01', '2010-03-01', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1578665683', 0, 'N', 0, '2014-01-03', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11017516', 'W11017516', 'WYBILLINGS', 'Billings Clinic - Cardiology', 'Walter', NULL, 'Degnan', 'MD', 'Cardiovascular Disease', NULL, NULL, NULL, 'O', '1020 N 27th St', 'Billings', 'Yellowstone', 'MT', '59101', '4062382000', '4062382066', 'PO Box 37000', 'Billings', 'Yellowstone', 'MT', '59107', NULL, NULL, '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2009-05-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1558384404', 0, 'N', 0, '2009-05-04', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11017517', 'W11017517', 'WYBILLINGS', 'Billings Clinic - Geriatrics', 'Jack', NULL, 'DeLeonardo', 'PA-C', 'Geriatrics', NULL, NULL, NULL, 'O', '2825 8th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4062382501', '4062382413', 'PO Box 37000', 'Billings', 'Yellowstone', 'MT', '59107', NULL, NULL, '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2009-05-01', '2009-11-01', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1417068248', 0, 'N', 0, '2009-05-04', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11017518', 'W11017518', 'WYBILLINGS', 'Billings Clinic - Gastro', 'Mark', NULL, 'Dell Aglio', 'MD', 'Gastroenterology', NULL, NULL, NULL, 'O', '2825 8th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4062382501', '4062382763', 'PO Box 37000', 'Billings', 'Yellowstone', 'MT', '59107', NULL, NULL, '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2009-05-01', '2010-03-01', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1477656460', 0, 'N', 0, '2009-05-04', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11017519', 'W11017519', 'WYBILLINGS', 'Behavioral Health Clinic', 'John', NULL, 'DeNegre', 'MD', 'Mental Health', NULL, NULL, NULL, 'O', '1020 N 27th St', 'Billings', 'Yellowstone', 'MT', '59101', '4062558550', '4062525430', 'PO Box 37000', 'Billings', 'Yellowstone', 'MT', '59107', NULL, NULL, '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2009-05-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1134230972', 0, 'N', 0, '2009-05-04', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11017520', 'W11017520', 'WYBILLINGS', 'Billings Clinic - Dietary', 'Lindsey', NULL, 'Diemert', 'RD', 'Dietician', '', '', NULL, 'B', '2800 10th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4066574150', '4066574349', '2800 10th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4066574150', '4066574349', '', '', '', '0.00', '17.00', '0.00', 3, '2009-05-01', '2010-07-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1831387075', 0, 'Y', 0, '2009-05-04', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11017521', 'W11017521', 'WYBILLINGS', 'Billings Clinic - Neurosurgery', 'Eugen', 'J', 'Dolan', 'MD', 'Neurosurgery', NULL, NULL, NULL, 'O', '2825 8th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4062382501', '4062385809', 'PO Box 37000', 'Billings', 'Yellowstone', 'MT', '59107', NULL, NULL, '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2009-05-01', '2010-03-01', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1659455129', 0, 'N', 0, '2010-01-15', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11017522', 'W11017522', 'WYBILLINGS', 'Billings Clinic - Orthopedics & Sports Medicine', 'William', NULL, 'Dolan', 'PT', 'Physical Therapy', NULL, NULL, NULL, 'O', '2702 8th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4062382501', '4066573782', 'PO Box 37000', 'Billings', 'Yellowstone', 'MT', '59107', NULL, NULL, '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2009-05-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1508919275', 0, 'N', 0, '2009-05-04', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11017523', 'W11017523', 'WYBILLINGS', 'Billings Clinic - Cardiology', 'Barbara', '', 'Dudczak', 'MD', 'Cardiovascular Disease', '', '', NULL, 'O', '1020 N 27th St', 'Billings', 'Yellowstone', 'MT', '59101', '4062382000', '4062382066', '1020 N 27th St', 'Billings', 'Yellowstone', 'MT', '59101', '4062382000', '4062382066', '', '', '', '0.00', '17.00', '0.00', 3, '2009-05-01', '2014-03-31', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1821026246', 0, 'N', 0, '2014-03-13', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11017524', 'W11017524', 'WYBILLINGS', 'Billings Clinic - Gen Surg', 'Scott', 'H', 'Dull', 'MD', 'General Surgery', NULL, NULL, NULL, 'O', '2825 8th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4062382501', '4062382848', 'PO Box 37000', 'Billings', 'Yellowstone', 'MT', '59107', NULL, NULL, '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2009-05-01', '2010-03-01', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1174634919', 0, 'N', 0, '2010-01-15', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11017525', 'W11017525', 'WYBILLINGS', 'Billings Clinic - Internal Medicine', 'Baskar', 'S', 'DuVal', 'MD', 'Internal Medicine', NULL, NULL, NULL, 'O', '2825 8th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4062382501', '4062382771', 'PO Box 37000', 'Billings', 'Yellowstone', 'MT', '59107', NULL, NULL, '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2009-05-01', '2010-03-01', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1346289758', 0, 'N', 0, '2010-01-15', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11017526', 'W11017526', 'WYBILLINGS', 'Billings Clinic - Orthopedics & Sports Medicine', 'Randi', NULL, 'Ellis', 'PA-C', 'Orthopedic Surgery', NULL, NULL, NULL, 'O', '2702 8th Ave N', 'Billings', 'Yellowstone', 'MT', '59102', '4062382501', '4062385218', 'PO Box 37000', 'Billings', 'Yellowstone', 'MT', '59107', NULL, NULL, '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2009-05-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1750301289', 0, 'N', 0, '2009-05-04', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11017527', 'W11017527', 'WYBILLINGS', 'Billings Clinic - Pulmonary', 'Walter', 'R', 'Fairfax', 'MD', 'Pulmonary', NULL, NULL, NULL, 'O', '2825 8th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4062382501', '4062382813', 'PO Box 37000', 'Billings', 'Yellowstone', 'MT', '59107', NULL, NULL, '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2009-05-01', '2010-03-01', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1124170170', 0, 'N', 0, '2010-01-15', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11017528', 'W11017528', 'WYBILLINGS', 'Billings Clinic - Endocrinology', 'Laura', '', 'Ferries', 'MD', 'Endocrinology', '', '', NULL, 'O', '2825 8th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4062382501', '4062382413', '2825 8th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4062382501', '4062382413', '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2009-05-01', '2010-05-01', 0, 0, 0, 'Sheridan Memorial Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1700827557', 0, 'N', 0, '2012-04-27', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11017529', 'W11017529', 'WYBILLINGS', 'Billings Clinic - Gastro', 'Michael', 'C', 'Fischer', 'MD', 'Gastroenterology', NULL, NULL, NULL, 'O', '2825 8th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4062382501', '4062382763', 'PO Box 37000', 'Billings', 'Yellowstone', 'MT', '59107', NULL, NULL, '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2009-05-01', '2010-03-01', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1710098579', 0, 'N', 0, '2010-01-15', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11017530', 'W11017530', 'WYBILLINGS', 'Billings Clinic - Orthopedics & Sports Medicine', 'Steven', NULL, 'Fischer', 'MD', 'Orthopedic Surgery', NULL, NULL, NULL, 'O', '2702 8th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4062382501', '4062385218', 'PO Box 37000', 'Billings', 'Yellowstone', 'MT', '59107', NULL, NULL, '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2009-05-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1710098587', 0, 'N', 0, '2009-05-04', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11017531', 'W11017531', 'WYBILLINGS', 'Billings Clinic - West End', 'Cheryl', NULL, 'Fletcher', 'FNP', 'Obstetrics and Gynecology', NULL, NULL, NULL, 'O', '2675 Central Ave', 'Billings', 'Yellowstone', 'MT', '59102', '4062382501', '4062382978', 'PO Box 37000', 'Billings', 'Yellowstone', 'MT', '59107', NULL, NULL, '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2009-05-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1528179397', 0, 'N', 0, '2009-05-04', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11017532', 'W11017532', 'WYBILLINGS', 'Billings Clinic - Cardiology', 'Laura', '', 'Ford Mukkamala', 'DO', 'Cardiovascular Disease', NULL, NULL, NULL, 'O', '1020 N 27th St', 'Billings', 'Yellowstone', 'MT', '59101', '4062382000', '4062382066', 'PO Box 37000', 'Billings', 'Yellowstone', 'MT', '59107', '4062382000', '4062382066', '', '', '', '0.00', '17.00', '0.00', 3, '2009-05-01', '2010-10-01', NULL, 0, NULL, '', '', '', '', 'HCFA|UB|', '1306950001', 0, 'N', 0, '2010-05-26', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11017533', 'W11017533', 'WYBILLINGS', 'Billings Clinic - ENT', 'Kristy', NULL, 'Foss Stone', 'Aud', 'Audiology', NULL, NULL, NULL, 'O', '2825 8th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4062382501', '4062382765', 'PO Box 37000', 'Billings', 'Yellowstone', 'MT', '59107', NULL, NULL, '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2009-05-01', '2010-03-01', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1790896561', 0, 'N', 0, '2010-01-15', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11017534', 'W11017534', 'WYBILLINGS', 'Billings Clinic - PMR', 'Patricia Lyn', NULL, 'Francisco', 'PA', 'Physical Medicine and Rehabilitation', NULL, NULL, NULL, 'O', '2825 8th Ave N', 'Billings', 'Yellowstone', 'Mt', '59101', '4062382501', '4062382723', 'PO Box 37000', 'Billings', 'Yellowstone', 'MT', '59107', NULL, NULL, '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2009-05-01', '2009-11-15', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1790870384', 0, 'N', 0, '2009-05-04', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11017535', 'W11017535', 'WYBILLINGS', 'Billings Clinic - Neurosurgery', 'Herbert', NULL, 'Fried', 'MD', 'Neurosurgery', NULL, NULL, NULL, 'O', '2825 8th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4062382501', '4062385809', 'PO Box 37000', 'Billings', 'Yellowstone', 'MT', '59107', NULL, NULL, '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2009-05-01', '2009-07-16', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1417060419', 0, 'N', 0, '2009-05-04', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11017536', 'W11017536', 'WYBILLINGS', 'Billings Clinic - Hospitalist', 'Brian', '', 'Fullerton', 'MD', 'Hospitalist', '', '', NULL, 'O', '2800 10th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4066574150', '4062382413', '2800 10th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4066574150', '4062382413', '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2009-05-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1063435949', 0, 'N', 0, '2014-02-04', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11017537', 'W11017537', 'WYBILLINGS', 'Billings Clinic - Neurology', 'Mary', 'D', 'Gaddy', 'MD', 'Neurology', NULL, NULL, NULL, 'O', '2825 8th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4062382501', '4062382805', 'PO Box 37000', 'Billings', 'Yellowstone', 'MT', '59107', NULL, NULL, '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2009-05-01', '2010-03-01', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1982716551', 0, 'N', 0, '2010-01-15', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11017538', 'W11017538', 'WYBILLINGS', 'Billings Clinic - Cardiology', 'Christian', NULL, 'Gaissmaier', 'MD', 'Cardovascular Disease', NULL, NULL, NULL, 'O', '1020 N 27th St', 'Billings', 'Yellowstone', 'MT', '59101', '4062382000', '4062382066', 'PO Box 37000', 'Billings', 'Yellowstone', 'MT', '59107', NULL, NULL, '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2009-05-01', '2009-12-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1255445607', 0, 'N', 0, '2009-05-04', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11017539', 'W11017539', 'WYBILLINGS', 'Billings Clinic - Internal Medicine', 'Steven', 'J', 'Gerstner', 'MD', 'Internal Medicine', NULL, NULL, NULL, 'O', '2825 8th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4062382501', '4062382771', 'PO Box 37000', 'Billings', 'Yellowstone', 'MT', '59107', NULL, NULL, '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2009-05-01', '2010-03-01', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1124130695', 0, 'N', 0, '2010-01-15', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11017540', 'W11017540', 'WYBILLINGS', 'Billings Clinic - GYN Oncology', 'Randall', 'K', 'Gibb', 'MD', 'Gynecologic Oncology', NULL, NULL, NULL, 'O', '2827 Fort Missoula Rd', 'Missoula', 'Petroleum', 'MT', '59084', '4062382501', '4062382394', 'PO Box 37000', 'Billings', 'Petroleum', 'MT', '59107', NULL, NULL, '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2009-05-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1639195944', 0, 'N', 0, '2010-01-15', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11017541', 'W11017541', 'WYBILLINGS', 'Billings Clinic - Outreach Services', 'Derek', '', 'Gilbert', 'MD', 'Family Practice', '', '', NULL, 'O', '2825 8th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4062558441', '4062558405', '2825 8th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4062558441', '4062558405', '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2009-05-01', '2008-08-01', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1477665925', 0, 'N', 0, '2012-04-27', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11017542', 'W11017542', 'WYBILLINGS', 'Billings Clinic - Same Day Care', 'James', 'F', 'Girolami', 'MD', 'Family Practice', NULL, NULL, NULL, 'O', '2825 8th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4062382501', '4062382868', 'PO Box 37000', 'Billings', 'Yellowstone', 'MT', '59107', NULL, NULL, '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2009-05-01', '2010-03-01', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1730286261', 0, 'N', 0, '2010-01-15', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11017543', 'W11017543', 'WYBILLINGS', 'Billings Clinic - Internal Medicine', 'Julian', NULL, 'Gnecco', 'MD', 'Internal Medicine', NULL, NULL, NULL, 'O', '2825 8th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4062382501', NULL, 'PO Box 37000', 'Billings', 'Yellowstone', 'MT', '59107', NULL, NULL, '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2009-05-01', '2010-03-01', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1831383678', 0, 'N', 0, '2010-01-15', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11017544', 'W11017544', 'WYBILLINGS', 'Behavioral Health Clinic', 'Diane D', NULL, 'Goedde', 'NP', 'Nurse Practitioner', NULL, NULL, NULL, 'O', '1020 N 27th St', 'Billings', 'Yellowstone', 'MT', '59101', '4066574150', '4062525430', 'PO Box 37000', 'Billings', 'Yellowstone', 'MT', '59107', NULL, NULL, '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2009-05-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1922110998', 0, 'N', 0, '2009-05-04', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11017545', 'W11017545', 'WYBILLINGS', 'Billings Clinic - Orthopedics & Sports Medicine', 'Mark', NULL, 'Goldy', 'PT', 'Physical Therapy', NULL, NULL, NULL, 'O', '2702 8th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4062382501', '4062385218', 'PO Box 37000', 'Billings', 'Yellowstone', 'MT', '59107', NULL, NULL, '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2009-05-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1588776470', 0, 'N', 0, '2009-05-04', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11017546', 'W11017546', 'WYBILLINGS', 'Billings Clinic - Ophthalmology', 'James', 'S', 'Good', 'MD', 'Ophthalmology', NULL, NULL, NULL, 'O', '2825 8th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4062382501', '4062382871', 'PO Box 37000', 'Billings', 'Yellowstone', 'MT', '59107', '4062382501', '4062382871', '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2009-05-01', '2010-03-01', NULL, 0, 0, '', '', '', '', 'HCFA|UB|', '1154433662', 0, 'N', 0, '2010-05-26', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11017547', 'W11017547', 'WYBILLINGS', 'Billings Clinic - Radiation  Oncology', 'Christopher', 'C', 'Goulet', 'MD', 'Radiation Oncology', NULL, NULL, NULL, 'O', '2825 8th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4062382501', '4062382572', 'PO Box 37000', 'Billings', 'Yellowstone', 'MT', '59107', NULL, NULL, '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2009-05-01', '2010-03-01', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1437137155', 0, 'N', 0, '2010-01-15', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11017548', 'W11017548', 'WYBILLINGS', 'Billings Clinic - Radiology', 'Jonathan', NULL, 'Graeve', 'MD', 'Radiologist', NULL, NULL, NULL, 'O', '2800 10th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4066574150', '4066574349', 'PO Box 37000', 'Billings', 'Yellowstone', 'MT', '59107', NULL, NULL, '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2009-05-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1538271507', 0, 'N', 0, '2009-05-04', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11017549', 'W11017549', 'WYBILLINGS', 'Billings Clinic - Infectious Disease', 'David', 'M', 'Graham', 'MD', 'Infectious Disease', '', '', NULL, 'O', '2825 8th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4062382501', '4062382253', 'PO Box 37000', 'Billings', 'Yellowstone', 'MT', '59107', NULL, NULL, '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2009-05-01', '2010-03-01', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1962425868', 0, 'N', 0, '2010-01-15', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11017550', 'W11017550', 'WYBILLINGS', 'Billings Clinic - Geriatrics', 'Marilyn', '', 'Grams', 'MD', 'Geriatrics', 'Hospitalist', '', NULL, 'O', '2825 8th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4062382501', '4062382413', '2825 8th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4062382501', '4062382413', '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2009-05-01', '2010-03-01', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1669492104', 0, 'N', 0, '2010-09-01', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11017551', 'W11017551', 'WYBILLINGS', 'Billings Clinic - Gen Surg', 'John', 'R', 'Gregory', 'MD', 'General Surgery', NULL, NULL, NULL, 'O', '2825 8th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4062382501', '4062382848', 'PO Box 37000', 'Billings', 'Yellowstone', 'MT', '59107', NULL, NULL, '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2009-05-01', '2010-03-01', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1861504847', 0, 'N', 0, '2010-01-15', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11017552', 'W11017552', 'WYBILLINGS', 'Billings Clinic - Gen Surg', 'Paul', 'F', 'Grmoljez', 'MD', 'General Surgery', NULL, NULL, NULL, 'O', '2825 8th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4062382501', '4062382848', 'PO Box 37000', 'Billings', 'Yellowstone', 'MT', '59107', NULL, NULL, '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2009-05-01', '2010-03-01', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1831241785', 0, 'N', 0, '2010-01-15', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11017553', 'W11017553', 'WYBILLINGS', 'Billings Clinic - Dietary', 'Kandis', NULL, 'Grose', 'RD', 'Dietician', '', '', NULL, 'B', '2800 10th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4066574150', '4066574349', '2800 10th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4066574150', '4066574349', '', '', '', '0.00', '17.00', '0.00', 3, '2009-05-01', '2010-08-20', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1205905221', 0, 'Y', 0, '2009-05-04', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11017554', 'W11017554', 'WYBILLINGS', 'Billings Clinic - Peds', 'Fred', NULL, 'Gunville', 'MD', 'Pediatrics', NULL, NULL, NULL, 'O', '2800 10th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4066574150', '4066574349', 'PO Box 37000', 'Billings', 'Yellowstone', 'MT', '59107', NULL, NULL, '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2009-05-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1912019969', 0, 'N', 0, '2009-05-04', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11017555', 'W11017555', 'WYBILLINGS', 'Billings Clinic - Dietary', 'Beth', NULL, 'Hall', 'RD', 'Dietician', NULL, NULL, NULL, 'B', '2800 10th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4066574150', '4066574349', 'PO Box 37000', 'Billings', 'Yellowstone', 'MT', '59107', NULL, NULL, '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2009-05-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1245300490', 0, 'Y', 0, '2009-05-04', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11017556', 'W11017556', 'WYBILLINGS', 'Billings Clinic - Outreach Services', 'Roger', 'H', 'Halterman', 'MD', 'Internal Medicine', NULL, NULL, NULL, 'O', '2825 8th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4062558441', '4062558405', 'PO Box 37000', 'Billings', 'Yellowstone', 'MT', '59107', NULL, NULL, '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2009-05-01', '2010-03-01', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1194827758', 0, 'N', 0, '2010-01-15', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11017557', 'W11017557', 'WYBILLINGS', 'Billings Clinic - Same Day Care', 'Beth', 'S', 'Hamilton', 'PA-C', 'Family Practice', NULL, NULL, NULL, 'O', '2825 8th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4062382501', '4062382868', 'PO Box 37000', 'Billings', 'Yellowstone', 'MT', '59107', NULL, NULL, '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2009-05-01', '2010-03-01', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1518069145', 0, 'N', 0, '2010-01-15', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11017558', 'W11017558', 'WYBILLINGS', 'Billings Clinic - Orthopedics & Sports Medicine', 'Teresa', NULL, 'Hamm', 'PT', 'Physical Therapy', NULL, NULL, NULL, 'O', '2702 8th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4062382501', '4066573782', 'PO Box 37000', 'Billings', 'Yellowstone', 'MT', '59107', NULL, NULL, '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2009-05-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1205019445', 0, 'N', 0, '2009-05-04', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11017559', 'W11017559', 'WYBILLINGS', 'Billings Clinic - Gastro', 'Steven', 'W', 'Hammond', 'MD', 'Gastroenterology', NULL, NULL, NULL, 'O', '2825 8th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4062382501', '4062382763', 'PO Box 37000', 'Billings', 'Yellowstone', 'MT', '59107', NULL, NULL, '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2009-05-01', '2010-03-01', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1588766117', 0, 'N', 0, '2010-01-15', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11017560', 'W11017560', 'WYBILLINGS', 'Billings Clinic - Occupational Health & Wellness', 'Ronald', '', 'Handlos', 'PA-C', 'Occupational Medicine', '', '', NULL, 'O', '2675 Central Ave', 'Billings', 'Yellowstone', 'MT', '59102', '4062382900', '4062382978', '2675 Central Ave', 'Billings', 'Yellowstone', 'MT', '59102', '4062382900', '4062382978', '', NULL, '', '0.00', '17.00', '0.00', 3, '2009-05-01', '2009-04-15', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1679685192', 0, 'N', 0, '2014-05-30', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11017561', 'W11017561', 'WYBILLINGS', 'Billings Clinic - OB/GYN', 'James', 'R', 'Harris', 'MD', 'Obstetrics and Gynecology', NULL, NULL, NULL, 'O', '2825 8th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4062382501', '4062382806', 'PO Box 37000', 'Billings', 'Yellowstone', 'MT', '59107', NULL, NULL, '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2009-05-01', '2010-03-01', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1477649986', 0, 'N', 0, '2010-01-15', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11017562', 'W11017562', 'WYBILLINGS', 'Billings Clinic - Dietary', 'Emily', NULL, 'Heggem', 'RD', 'Dietician', NULL, NULL, NULL, 'B', '2800 10th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4066574150', '4066574349', 'PO Box 37000', 'Billings', 'Yellowstone', 'MT', '59107', NULL, NULL, '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2009-05-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1790896884', 0, 'Y', 0, '2009-05-04', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11017563', 'W11017563', 'WYBILLINGS', 'Billings Clinic - Dietary', 'Jill', NULL, 'Henley', 'RD', 'Dietician', NULL, NULL, NULL, 'B', '2800 10th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4066574150', '4066574349', 'PO Box 37000', 'Billings', 'Yellowstone', 'MT', '59107', NULL, NULL, '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2009-05-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1821270414', 0, 'Y', 0, '2009-05-04', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11017564', 'W11017564', 'WYBILLINGS', 'Billings Clinic - Radiology', 'Lawrence', NULL, 'Herbert', 'MD', 'Radiologist', NULL, NULL, NULL, 'O', '2800 10th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4066574150', '4066574349', 'PO Box 37000', 'Billings', 'Yellowstone', 'MT', '59107', NULL, NULL, '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2009-05-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1528170925', 0, 'N', 0, '2009-05-04', NULL, NULL, 0, 0, NULL, NULL);
INSERT INTO `providers_new` (`Provider_Tax_ID`, `Provider_Suffix`, `Provider_Network_ID`, `Provider_Region`, `Provider_Name`, `Provider_Doctor_First_Name`, `Provider_Doctor_Middle_Name`, `Provider_Doctor_Last_Name`, `Provider_Doctor_Degree`, `Provider_Specialty_1`, `Provider_Specialty_2`, `Provider_Specialty_3`, `Provider_Specialty_4`, `Provider_Address_Type`, `Provider_Address`, `Provider_City`, `Provider_County`, `Provider_State`, `Provider_Zip`, `Provider_Phone`, `Provider_Fax`, `Provider_Mailing_Address`, `Provider_Mailing_City`, `Provider_Mailing_County`, `Provider_Mailing_State`, `Provider_Mailing_Zip`, `Provider_Mailing_Phone`, `Provider_Mailing_Fax`, `Provider_Primary_Schedule`, `Provider_Secondary_Schedule`, `Provider_Rate_Sheet`, `Provider_Anes_Rate`, `Provider_Default_Rate`, `Provider_Max_DOS`, `Provider_Min_Match_Value`, `Provider_Effective_Date`, `Provider_Term_Date`, `Provider_Pend`, `Provider_Anes_Minutes`, `Provider_PPO`, `Provider_Hospital_1`, `Provider_Hospital_2`, `Provider_Hospital_3`, `Provider_Hospital_4`, `Provider_Type`, `Provider_NPI`, `Provider_Check_Override`, `Exclude_Dir`, `Audit_Status`, `Last_Change_Date`, `Medicare_ID`, `Provider_Lang`, `Provider_Latitude`, `Provider_Longitude`, `Provider_school`, `Provider_cert`) VALUES
('810231784', 'W11017565', 'W11017565', 'WYBILLINGS', 'Billings Clinic - Gastro', 'Keri', 'L', 'Hill', 'MD', 'Gastroenterology', NULL, NULL, NULL, 'O', '2825 8th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4062382501', '4062382763', 'PO Box 37000', 'Billings', 'Yellowstone', 'MT', '59107', NULL, NULL, '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2009-05-01', '2010-03-01', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1528095155', 0, 'N', 0, '2010-01-15', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11017566', 'W11017566', 'WYBILLINGS', 'Billings Clinic - Urology', 'Michael', 'H', 'Hines', 'PA-C', 'Urology', NULL, NULL, NULL, 'O', '2825 8th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4062382501', '4062382881', 'PO Box 37000', 'Billings', 'Yellowstone', 'MT', '59107', NULL, NULL, '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2009-05-01', '2010-03-01', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1205947397', 0, 'N', 0, '2010-01-15', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11017567', 'W11017567', 'WYBILLINGS', 'Billings Clinic - Rehab', 'Roxanna', NULL, 'Hoch', 'PT', 'Physical Therapy', NULL, NULL, NULL, 'O', '2825 8th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4062382501', '4062382978', 'PO Box 37000', 'Billings', 'Yellowstone', 'MT', '59107', NULL, NULL, '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2009-05-01', '2010-03-01', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '0116460675', 0, 'N', 0, '2009-05-04', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11017568', 'W11017568', 'WYBILLINGS', 'Billings Clinic - ENT', 'Robin', 'S', 'Horrell', 'MD', 'Ear, Nose and Throat', NULL, NULL, NULL, 'O', '2825 8th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4062382501', '4062385043', 'PO Box 37000', 'Billings', 'Yellowstone', 'MT', '59107', NULL, NULL, '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2009-05-01', '2010-03-01', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1497778302', 0, 'N', 0, '2010-01-15', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11017569', 'W11017569', 'WYBILLINGS', 'Billings Clinic - Gen Surg', 'Terry', 'A', 'Housinger', 'MD', 'General Surgery', NULL, NULL, NULL, 'O', '2825 8th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4062382501', '4062382848', 'PO Box 37000', 'Billings', 'Yellowstone', 'MT', '59107', NULL, NULL, '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2009-05-01', '2010-03-01', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1790705234', 0, 'N', 0, '2010-01-15', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11017570', 'W11017570', 'WYBILLINGS', 'Billings Clinic - Orthopedics & Sports Medicine', 'Willard', NULL, 'Hull', 'MD', 'Orthopedic Surgery', '', '', NULL, 'O', '2702 8th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4062382501', '4062385218', '2702 8th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4062382501', '4062385218', '', '', '', '0.00', '17.00', '0.00', 3, '2009-05-01', '2010-10-13', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1700938651', 0, 'N', 0, '2009-05-04', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11017571', 'W11017571', 'WYBILLINGS', 'Billings Clinic - Dietary', 'Regina', NULL, 'Hultin', 'RD', 'Dietician', NULL, NULL, NULL, 'B', '2800 10th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4066574150', '4066574349', 'PO Box 37000', 'Billings', 'Yellowstone', 'MT', '59107', NULL, NULL, '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2009-05-01', '2008-06-09', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1467531871', 0, 'Y', 0, '2009-05-04', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11017572', 'W11017572', 'WYBILLINGS', 'Billings Clinic - Gen Surg', 'John', NULL, 'Huntington', 'PAC', 'General Surgery', NULL, NULL, NULL, 'O', '2825 8th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4062382501', '4062382848', 'PO Box 37000', 'Billings', 'Yellowstone', 'MT', '59107', NULL, NULL, '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2009-05-01', '2009-06-20', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1558312652', 0, 'N', 0, '2009-05-04', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11017573', 'W11017573', 'WYBILLINGS', 'Billings Clinic - Gen Surg', 'Robert', 'N', 'Hurd', 'MD', 'General Surgery', NULL, NULL, NULL, 'O', '2825 8th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4062382501', '4062382848', 'PO Box 37000', 'Billings', 'Yellowstone', 'MT', '59107', NULL, NULL, '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2009-05-01', '2010-03-01', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1376626291', 0, 'N', 0, '2010-01-15', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11017574', 'W11017574', 'WYBILLINGS', 'Billings Clinic - Internal Medicine', 'Lucinda', 'M', 'Husby', 'MD', 'Internal Medicine', NULL, NULL, NULL, 'O', '2825 8th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4062382501', '4062382771', 'PO Box 37000', 'Billings', 'Yellowstone', 'MT', '59107', NULL, NULL, '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2009-05-01', '2010-03-01', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1063432516', 0, 'N', 0, '2010-01-15', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11017575', 'W11017575', 'WYBILLINGS', 'Billings Clinic - Employee Assistance Program', 'Cheryl', '', 'Ikeda', 'LCSW', 'Employee Assistance Program', '', '', NULL, 'O', '1020 N 27th St', 'Billings', 'Yellowstone', 'MT', '59101', '4062382501', '4062476240', '1020 N 27th St', 'Billings', 'Yellowstone', 'MT', '59101', '4062382501', '4062476240', '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2009-05-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1013029842', 0, 'N', 0, '2014-02-04', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11017576', 'W11017576', 'WYBILLINGS', 'Behavioral Health Clinic', 'Kendall', NULL, 'Jackson', 'LCPC', 'Counseling', NULL, NULL, NULL, 'O', '1020 N 27th St', 'Billings', 'Yellowstone', 'MT', '59101', '4062558550', '4062525430', 'PO Box 37000', 'Billings', 'Yellowstone', 'MT', '59107', NULL, NULL, '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2009-05-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1861537078', 0, 'N', 0, '2009-05-04', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11017577', 'W11017577', 'WYBILLINGS', 'Billings Clinic - ENT', 'Janice', NULL, 'Johnson', 'AUD', 'Audiology', NULL, NULL, NULL, 'O', '2825 8th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4062382501', '4062382765', 'PO Box 37000', 'Billings', 'Yellowstone', 'MT', '59107', NULL, NULL, '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2009-05-01', '2010-03-01', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1235202839', 0, 'N', 0, '2010-01-15', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11017578', 'W11017578', 'WYBILLINGS', 'Billings Clinic - Internal Medicine', 'Julie', NULL, 'Johnson', 'MD', 'Internal Medicine', NULL, NULL, NULL, 'O', '2825 8th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4062382501', '4062382771', 'PO Box 37000', 'Billings', 'Yellowstone', 'MT', '59107', NULL, NULL, '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2009-05-01', '2009-11-03', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1164534905', 0, 'N', 0, '2009-05-04', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11017579', 'W11017579', 'WYBILLINGS', 'Billings Clinic - Peds', 'Linda', NULL, 'Johnson', 'MD', 'Pediatrics', NULL, NULL, NULL, 'O', '2800 10th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4066574150', '4066574349', 'PO Box 37000', 'Billings', 'Yellowstone', 'MT', '59107', NULL, NULL, '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2009-05-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1205948064', 0, 'N', 0, '2009-05-04', NULL, NULL, 0, 0, NULL, NULL),
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('810231784', 'W11017610', 'W11017610', 'WYBILLINGS', 'Billings Clinic - Emergency', 'Peter', '', 'Light', 'MD', 'Emergency Medicine', '', '', NULL, 'O', '2800 10th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4066574150', '4066574349', '2800 10th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4066574150', '4066574349', '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2009-05-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1174676845', 0, 'N', 0, '2014-02-04', NULL, NULL, 0, 0, NULL, NULL),
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('810231784', 'W11017612', 'W11017612', 'WYBILLINGS', 'Billings Clinic- Reserved Staffing', 'Mary', NULL, 'Louder', 'DO', 'Family Practice', NULL, NULL, NULL, 'O', '2825 8th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4062558441', '4062558405', 'PO Box 37000', 'Billings', 'Yellowstone', 'MT', '59107', NULL, NULL, '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2009-05-01', '2008-03-26', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1437220241', 0, 'N', 0, '2009-05-04', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11017613', 'W11017613', 'WYBILLINGS', 'Billings Clinic - OB/GYN', 'Maureen', 'C', 'Lucas', 'MD', 'Obstetrics and Gynecology', NULL, NULL, NULL, 'O', '2825 8th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4062382501', '4062382806', 'PO Box 37000', 'Billings', 'Yellowstone', 'MT', '59107', NULL, NULL, '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2009-05-01', '2010-03-01', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1376521583', 0, 'N', 0, '2010-01-15', NULL, NULL, 0, 0, NULL, NULL),
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('810231784', 'W11017615', 'W11017615', 'WYBILLINGS', 'Billings Clinic - Endocrinology', 'James', 'A', 'Mack', 'MD', 'Endocrinology', NULL, NULL, NULL, 'O', '2825 8th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4062382501', '4062382413', 'PO Box 37000', 'Billings', 'Yellowstone', 'MT', '59107', NULL, NULL, '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2009-05-01', '2010-03-01', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1669575445', 0, 'N', 0, '2010-01-15', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11017616', 'W11017616', 'WYBILLINGS', 'Billings Clinic - Emergency', 'Steven', NULL, 'Maertens', 'MD', 'Emergency Medicine', NULL, NULL, NULL, 'O', '2800 10th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4066574150', '4066574349', 'PO Box 37000', 'Billings', 'Yellowstone', 'MT', '59107', NULL, NULL, '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2009-05-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1710198312', 0, 'N', 0, '2009-05-04', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11017617', 'W11017617', 'WYBILLINGS', 'Billings Clinic - Same Day Care', 'Sheryl', 'A', 'Malinowski', 'FNP', 'Family Practice', NULL, NULL, NULL, 'O', '2825 8th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4062382501', '4062382868', 'PO Box 37000', 'Billings', 'Yellowstone', 'MT', '59107', NULL, NULL, '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2009-05-01', '2010-03-01', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1790999878', 0, 'N', 0, '2010-01-15', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11017618', 'W11017618', 'WYBILLINGS', 'Billings Clinic - Neurosurgery', 'Jacob', NULL, 'Mathis', 'MD', 'Neurosurgery', NULL, NULL, NULL, 'O', '2825 8th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4062382501', '4062382805', 'PO Box 37000', 'Billings', 'Yellowstone', 'MT', '59107', NULL, NULL, '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2009-05-01', '2009-12-03', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1952335366', 0, 'N', 0, '2009-05-04', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11017619', 'W11017619', 'WYBILLINGS', 'Billings Clinic - Occupational Health & Wellness', 'Adam', '', 'Mattingly', 'PA-C', 'Occupational Medicine', '', '', NULL, 'O', '1020 N 27th St', 'Billings', 'Yellowstone', 'MT', '59101', '4062382501', '4062476240', '1020 N 27th St', 'Billings', 'Yellowstone', 'MT', '59101', '4062382501', '4062476240', '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2009-05-01', NULL, 0, 0, 0, NULL, '', '', '', 'HCFA|UB|', '1295836831', 0, 'N', 0, '2012-03-10', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11017620', 'W11017620', 'WYBILLINGS', 'Billings Clinic - OB/GYN', 'Clayton', 'H', 'McCracken III', 'MD', 'Obstetrics and Gynecology', NULL, NULL, NULL, 'O', '2825 8th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4062382501', '4062382806', 'PO Box 37000', 'Billings', 'Yellowstone', 'MT', '59107', NULL, NULL, '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2009-05-01', '2010-03-01', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1760589345', 0, 'N', 0, '2010-01-15', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11017621', 'W11017621', 'WYBILLINGS', 'Behavioral Health Clinic', 'Robert', NULL, 'McDermott, Jr', 'MD', 'Mental Health', NULL, NULL, NULL, 'O', '1020 N 27th St', 'Billings', 'Yellowstone', 'MT', '59101', '4062558550', '4062525430', 'PO Box 37000', 'Billings', 'Yellowstone', 'MT', '59107', NULL, NULL, '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2009-05-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1861592438', 0, 'N', 0, '2009-05-04', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11017622', 'W11017622', 'WYBILLINGS', 'Billings Clinic - Emergency', 'Lawrence', NULL, 'McEvoy', 'MD', 'Emergency Medicine', NULL, NULL, NULL, 'O', '2800 10th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4066574150', '4066574349', 'PO Box 37000', 'Billings', 'Yellowstone', 'MT', '59107', NULL, NULL, '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2009-05-01', '2008-02-01', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1699872275', 0, 'N', 0, '2009-05-04', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11017623', 'W11017623', 'WYBILLINGS', 'Billings Clinic - Nephrology', 'Heather', 'L', 'McGuire', 'MD', 'Nephrology', NULL, NULL, NULL, 'O', '2825 8th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4062382501', '4062382590', 'PO Box 37000', 'Billings', 'Yellowstone', 'MT', '59107', NULL, NULL, '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2009-05-01', '2010-03-01', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1508806100', 0, 'N', 0, '2010-01-15', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11017624', 'W11017624', 'WYBILLINGS', 'Billings Clinic - Urology', 'Richard', 'B', 'Melzer', 'MD', 'Urology', '', '', NULL, 'O', '2825 8th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4062382501', '4062382881', '2825 8th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4062382501', '4062382881', '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2009-05-01', '2010-03-01', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1407953086', 0, 'N', 0, '2011-08-22', NULL, NULL, 0, 0, NULL, NULL),
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('810231784', 'W11017627', 'W11017627', 'WYBILLINGS', 'Billings Clinic - Emergency', 'James', NULL, 'Miller', 'DO', 'Emergency Medicine', NULL, NULL, NULL, 'O', '2800 10th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4066574150', '4066574349', 'PO Box 37000', 'Billings', 'Yellowstone', 'MT', '59107', NULL, NULL, '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2009-05-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1578615431', 0, 'N', 0, '2009-05-04', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11017628', 'W11017628', 'WYBILLINGS', 'Billings Clinic - CV Surgery', 'J Scott', 'Scott', 'Millikan', 'MD', 'Cardiovascular Disease', NULL, NULL, NULL, 'O', '2825 8th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4062382501', '4062382848', 'PO Box 37000', 'Billings', 'Yellowstone', 'MT', '59107', NULL, NULL, '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2009-05-01', '2010-03-01', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1841373693', 0, 'N', 0, '2010-01-15', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11017629', 'W11017629', 'WYBILLINGS', 'Billings Clinic - Hospitalist', 'Peter', '', 'Mitchell', 'MD', 'Hospitalist', '', '', NULL, 'O', '2800 10th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4066574150', '4062382978', '2800 10th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4066574150', '4062382978', '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2009-05-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1306944566', 0, 'N', 0, '2014-02-04', NULL, NULL, 0, 0, NULL, NULL),
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('810231784', 'W11017631', 'W11017631', 'WYBILLINGS', 'Billings Clinic - Same Day Care', 'Michael', 'D', 'Monday', 'MD', 'Family Practice', NULL, NULL, NULL, 'O', '2825 8th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4062382501', '4062382868', 'PO Box 37000', 'Billings', 'Yellowstone', 'MT', '59107', NULL, NULL, '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2009-05-01', '2010-03-01', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1013017680', 0, 'N', 0, '2010-01-15', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11017632', 'W11017632', 'WYBILLINGS', 'Billings Clinic - Neurosurgery', 'Michael', 'A', 'Morone', 'MD', 'Neurosurgery', '', '', NULL, 'O', '2825 8th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4062382501', '4062385809', '2825 8th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4062382501', '4062385809', '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2009-05-01', '2010-03-01', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1407954456', 0, 'N', 0, '2012-04-16', NULL, NULL, 0, 0, NULL, NULL),
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('810231784', 'W11017634', 'W11017634', 'WYBILLINGS', 'Billings Clinic - OB/GYN', 'Patrick', NULL, 'Muffley', 'DO', 'Obstetrics and Gynecology', NULL, NULL, NULL, 'O', '2825 8th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4062382501', '4062382806', 'PO Box 37000', 'Billings', 'Yellowstone', 'MT', '59107', NULL, NULL, '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2009-05-01', '2008-02-27', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1528015260', 0, 'N', 0, '2009-05-04', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11017635', 'W11017635', 'WYBILLINGS', 'Billings Clinic - Pathology', 'Trudie', '', 'Muir', 'MD', 'Pathology', '', '', NULL, 'O', '2800 10th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4066574150', '4066574349', '2800 10th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4066574150', '4066574349', '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2009-05-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1073558110', 0, 'N', 0, '2014-02-04', NULL, NULL, 0, 0, NULL, NULL),
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('810231784', 'W11017637', 'W11017637', 'WYBILLINGS', 'Billings Clinic - Neurology', 'Melody', 'A', 'Murter', 'FNP', 'Neurology', NULL, NULL, NULL, 'O', '2825 8th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4062382501', '4062382805', 'PO Box 37000', 'Billings', 'Yellowstone', 'MT', '59107', NULL, NULL, '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2009-05-01', '2010-03-01', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1306896444', 0, 'N', 0, '2010-01-15', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11017638', 'W11017638', 'WYBILLINGS', 'Billings Clinic - CV Surgery', 'Charles', 'Scott', 'Needham', 'MD', 'Cardiovascular Disease', '', '', NULL, 'O', '2825 8th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4062382501', '4062382848', 'PO Box 37000', 'Billings', 'Yellowstone', 'MT', '59107', NULL, NULL, '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2009-05-01', '2010-03-01', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1063435899', 0, 'N', 0, '2010-01-15', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11017639', 'W11017639', 'WYBILLINGS', 'Billings Clinic - Dietary', 'Krystie', NULL, 'Nelson', 'RD', 'Dietician', NULL, NULL, NULL, 'B', '2800 10th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4066574150', '4066574349', 'PO Box 37000', 'Billings', 'Yellowstone', 'MT', '59107', NULL, NULL, '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2009-05-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1053419002', 0, 'Y', 0, '2009-05-04', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11017640', 'W11017640', 'WYBILLINGS', 'Billings Clinic - Internal Medicine', 'Laurie', 'K', 'Neubauer', 'PA-C', 'Internal Medicine', NULL, NULL, NULL, 'O', '2825 8th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4062382501', '4062382413', 'PO Box 37000', 'Billings', 'Yellowstone', 'MT', '59107', '4062382501', '4062382413', '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2009-05-01', '2010-03-01', NULL, 0, 0, '', '', '', '', 'HCFA|UB|', '1326146374', 0, 'N', 0, '2010-05-26', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11017641', 'W11017641', 'WYBILLINGS', 'Billings Clinic - Cancer Center', 'Jorge', 'J', 'Nieva', 'MD', 'Oncology', 'Hematology and Oncology', '', NULL, 'O', '2825 8th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4062382501', '4062382469', '2825 8th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4062382501', '4062382469', '', NULL, '', '0.00', '17.00', '0.00', 3, '2009-05-01', '2010-03-01', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1497717672', 0, 'N', 0, '2014-05-08', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11017642', 'W11017642', 'WYBILLINGS', 'Billings Clinic - Emergency', 'David', NULL, 'Nigh', 'MD', 'Emergency Medicine', '', '', NULL, 'O', '2800 10th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4066574150', '4066574349', '2800 10th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4066574150', '4066574349', '', '', '', '0.00', '17.00', '0.00', 3, '2009-05-01', '2010-06-22', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1790876514', 0, 'N', 0, '2009-05-04', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11017643', 'W11017643', 'WYBILLINGS', 'Billings Clinic - Occupational Health & Wellness', 'Diana', '', 'Notis', 'PT', 'Physical Therapy', '', '', NULL, 'O', '1020 N 27th St', 'Billings', 'Yellowstone', 'MT', '59101', '4062382501', '4062476240', '1020 N 27th St', 'Billings', 'Yellowstone', 'MT', '59101', '4062382501', '4062476240', '', '', '', '0.00', '17.00', '0.00', 3, '2009-05-01', '2013-07-01', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1386744951', 0, 'N', 0, '2013-10-03', NULL, NULL, 0, 0, NULL, NULL),
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('810231784', 'W11017645', 'W11017645', 'WYBILLINGS', 'Billings Clinic - Neurology', 'Dennis', 'K', 'O Brien', 'MD', 'Neurology', NULL, NULL, NULL, 'O', '2825 8th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4062382501', '4062382805', 'PO Box 37000', 'Billings', 'Yellowstone', 'MT', '59107', NULL, NULL, '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2009-05-01', '2010-03-01', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1811981699', 0, 'N', 0, '2010-01-15', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11017646', 'W11017646', 'WYBILLINGS', 'Billings Clinic - Research', 'Thomas', NULL, 'Olson', 'MD', 'Obstetrics and Gynecology', NULL, NULL, NULL, 'O', '1045 N 30th St', 'Billings', 'Yellowstone', 'MT', '59101', '4062558470', '4062558479', 'PO Box 37000', 'Billings', 'Yellowstone', 'MT', '59107', NULL, NULL, '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2009-05-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '0000007966', 0, 'N', 0, '2009-05-04', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11017647', 'W11017647', 'WYBILLINGS', 'Billings Clinic - OB/GYN', 'Camille', 'S', 'Osborn', 'MD', 'Obstetrics and Gynecology', '', '', NULL, 'O', '2825 8th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4062382501', '4062382806', 'PO Box 37000', 'Billings', 'Yellowstone', 'MT', '59107', NULL, NULL, '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2009-05-01', '2010-03-01', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1245338292', 0, 'N', 0, '2010-01-15', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11017648', 'W11017648', 'WYBILLINGS', 'Billings Clinic - Cardiology', 'Janet', '', 'Otto', 'MD', 'Electrophysiology', '', '', NULL, 'O', '1020 N 27th St', 'Billings', 'Yellowstone', 'MT', '59101', '4062382000', '4062382066', '1020 N 27th St', 'Billings', 'Yellowstone', 'MT', '59101', '4062382000', '4062382066', '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2009-05-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1063510220', 0, 'N', 0, '2014-02-04', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11017649', 'W11017649', 'WYBILLINGS', 'Behavioral Health Clinic', 'James', NULL, 'Peak', 'MD', 'Mental Health', NULL, NULL, NULL, 'O', '1020 N 27th St', 'Billings', 'Yellowstone', 'MT', '59101', '4062558550', '4062525430', 'PO Box 37000', 'Billings', 'Yellowstone', 'MT', '59107', NULL, NULL, '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2009-05-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1801994264', 0, 'N', 0, '2009-05-04', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11017650', 'W11017650', 'WYBILLINGS', 'Billings Clinic - Neurosurgery', 'Randal', 'W', 'Pearson', 'PA-C', 'Neurosurgery', NULL, NULL, NULL, 'O', '2825 8th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4062382501', '4062382805', 'PO Box 37000', 'Billings', 'Yellowstone', 'MT', '59107', NULL, NULL, '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2009-05-01', '2010-03-01', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1649370362', 0, 'N', 0, '2010-01-15', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11017651', 'W11017651', 'WYBILLINGS', 'Billings Clinic - Dietary', 'Jodie', NULL, 'Pekovich', '"RD, LN"', 'Dietician', NULL, NULL, NULL, 'B', '2800 10th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4066574150', '4066574349', 'PO Box 37000', 'Billings', 'Yellowstone', 'MT', '59107', NULL, NULL, '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2009-05-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1871659078', 0, 'Y', 0, '2009-05-04', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11017652', 'W11017652', 'WYBILLINGS', 'Billings Clinic - Internal Medicine', 'Rebecca', 'L', 'Pestle', 'PA-C', 'Internal Medicine', '', '', NULL, 'O', '2825 8th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4062382501', '4062382771', '2825 8th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4062382501', '4062382771', '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2009-05-01', '2010-03-01', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1144240615', 0, 'N', 0, '2013-10-03', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11017653', 'W11017653', 'WYBILLINGS', 'Billings Clinic - Neurology', 'Dale', 'M', 'Peterson', 'MD', 'Neurology', NULL, NULL, NULL, 'O', '2825 8th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4062382501', '4062382805', 'PO Box 37000', 'Billings', 'Yellowstone', 'MT', '59107', NULL, NULL, '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2009-05-01', '2010-03-01', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1093815672', 0, 'N', 0, '2010-01-15', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11017654', 'W11017654', 'WYBILLINGS', 'Billings Clinic - Occupational Health & Wellness', 'John', NULL, 'Petrisko', 'MD', 'Occupational Medicine', NULL, NULL, NULL, 'O', '1020 N 27th St', 'Billings', 'Yellowstone', 'MT', '59101', '4062382501', '4062476240', 'PO Box 37000', 'Billings', 'Yellowstone', 'MT', '59107', NULL, NULL, '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2009-05-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1083728448', 0, 'N', 0, '2009-05-04', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11017655', 'W11017655', 'WYBILLINGS', 'Billings Clinic - Dietary', 'Heather', NULL, 'Petty', 'RD', 'Dietician', NULL, NULL, NULL, 'B', '2800 10th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4066574150', '4066574349', 'PO Box 37000', 'Billings', 'Yellowstone', 'MT', '59107', NULL, NULL, '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2009-05-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1093815714', 0, 'Y', 0, '2009-05-04', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11017656', 'W11017656', 'WYBILLINGS', 'Billings Clinic - Hospitalist', 'Jennifer', '', 'Pflug', 'MD', 'Hospitalist', '', '', NULL, 'O', '2800 10th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4066574150', '4062382572', '2800 10th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4066574150', '4062382572', '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2009-05-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1912989542', 0, 'N', 0, '2012-07-23', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11017657', 'W11017657', 'WYBILLINGS', 'Billings Clinic - Cardiology', 'Neil', NULL, 'Phung', 'MD', 'Cardovascular Disease', NULL, NULL, NULL, 'O', '1020 N 27th St', 'Billings', 'Yellowstone', 'MT', '59101', '4062382000', '4062382066', 'PO Box 37000', 'Billings', 'Yellowstone', 'MT', '59107', NULL, NULL, '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2009-05-01', '2008-02-29', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1063523223', 0, 'N', 0, '2009-05-04', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11017658', 'W11017658', 'WYBILLINGS', 'Billings Clinic - Peds', 'Michelle', NULL, 'Pierson', 'MD', 'Pediatrics', NULL, NULL, NULL, 'O', '2675 Central Ave', 'Billings', 'Yellowstone', 'MT', '59102', '4062382501', '2082382978', 'PO Box 37000', 'Billings', 'Yellowstone', 'MT', '59107', NULL, NULL, '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2009-07-02', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1134149602', 0, 'N', 0, '2009-05-04', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11017659', 'W11017659', 'WYBILLINGS', 'Billings Clinic - Radiology', 'Bruce', NULL, 'Pinkerton', 'MD', 'Radiologist', NULL, NULL, NULL, 'O', '2800 10th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4066574150', '4066574349', 'PO Box 37000', 'Billings', 'Yellowstone', 'MT', '59107', NULL, NULL, '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2009-05-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1487737136', 0, 'N', 0, '2009-05-04', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11017660', 'W11017660', 'WYBILLINGS', 'Billings Clinic - Orthopedics & Sports Medicine', 'Rachelle', NULL, 'Prevost', 'PT', 'Physical Therapy', NULL, NULL, NULL, 'O', '2702 8th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4062382501', '4066573782', 'PO Box 37000', 'Billings', 'Yellowstone', 'MT', '59107', NULL, NULL, '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2009-05-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1861675001', 0, 'N', 0, '2009-05-04', NULL, NULL, 0, 0, NULL, NULL);
INSERT INTO `providers_new` (`Provider_Tax_ID`, `Provider_Suffix`, `Provider_Network_ID`, `Provider_Region`, `Provider_Name`, `Provider_Doctor_First_Name`, `Provider_Doctor_Middle_Name`, `Provider_Doctor_Last_Name`, `Provider_Doctor_Degree`, `Provider_Specialty_1`, `Provider_Specialty_2`, `Provider_Specialty_3`, `Provider_Specialty_4`, `Provider_Address_Type`, `Provider_Address`, `Provider_City`, `Provider_County`, `Provider_State`, `Provider_Zip`, `Provider_Phone`, `Provider_Fax`, `Provider_Mailing_Address`, `Provider_Mailing_City`, `Provider_Mailing_County`, `Provider_Mailing_State`, `Provider_Mailing_Zip`, `Provider_Mailing_Phone`, `Provider_Mailing_Fax`, `Provider_Primary_Schedule`, `Provider_Secondary_Schedule`, `Provider_Rate_Sheet`, `Provider_Anes_Rate`, `Provider_Default_Rate`, `Provider_Max_DOS`, `Provider_Min_Match_Value`, `Provider_Effective_Date`, `Provider_Term_Date`, `Provider_Pend`, `Provider_Anes_Minutes`, `Provider_PPO`, `Provider_Hospital_1`, `Provider_Hospital_2`, `Provider_Hospital_3`, `Provider_Hospital_4`, `Provider_Type`, `Provider_NPI`, `Provider_Check_Override`, `Exclude_Dir`, `Audit_Status`, `Last_Change_Date`, `Medicare_ID`, `Provider_Lang`, `Provider_Latitude`, `Provider_Longitude`, `Provider_school`, `Provider_cert`) VALUES
('810231784', 'W11017661', 'W11017661', 'WYBILLINGS', 'Billings Clinic - ENT', 'Scott', 'D', 'Price', 'MD', 'Ear, Nose and Throat', NULL, NULL, NULL, 'O', '2825 8th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4062382501', '4062385043', 'PO Box 37000', 'Billings', 'Yellowstone', 'MT', '59107', NULL, NULL, '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2009-05-01', '2010-03-01', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1275633851', 0, 'N', 0, '2010-01-15', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11017662', 'W11017662', 'WYBILLINGS', 'Billings Clinic - Pulmonary', 'Robert', 'J', 'Pueringer', 'MD', 'Pulmonary', NULL, NULL, NULL, 'O', '2825 8th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4062382501', '4062382813', 'PO Box 37000', 'Billings', 'Yellowstone', 'MT', '59107', NULL, NULL, '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2009-05-01', '2010-03-01', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1457442295', 0, 'N', 0, '2010-01-15', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11017663', 'W11017663', 'WYBILLINGS', 'Billings Clinic - Cancer Center', 'William', 'Thomas', 'Purcell', 'MD', 'Oncology', 'Hematology and Oncology', NULL, NULL, 'O', '2825 8th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4062382501', '4062382469', 'PO Box 37000', 'Billings', 'Yellowstone', 'MT', '59107', NULL, NULL, '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2009-05-01', '2010-03-01', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1336187236', 0, 'N', 0, '2010-01-15', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11017664', 'W11017664', 'WYBILLINGS', 'Behavioral Health Clinic', 'Christina', NULL, 'Quijano', 'MD', 'Mental Health', NULL, NULL, NULL, 'O', '1020 N 27th St', 'Billings', 'Yellowstone', 'MT', '59101', '4062558550', '4062525430', 'PO Box 37000', 'Billings', 'Yellowstone', 'MT', '59107', NULL, NULL, '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2009-05-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1356387112', 0, 'N', 0, '2009-05-04', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11017665', 'W11017665', 'WYBILLINGS', 'Billings Clinic - Cardiology', 'Brian', '', 'Rah', 'MD', 'Cardovascular Disease', '', '', NULL, 'O', '1020 N 27th St', 'Billings', 'Yellowstone', 'MT', '59101', '4062382000', '4062382066', '1020 N 27th St', 'Billings', 'Yellowstone', 'MT', '59101', '4062382000', '4062382066', '', '', '', '0.00', '17.00', '0.00', 3, '2009-05-01', '2014-03-31', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1518995158', 0, 'N', 0, '2014-03-13', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11017666', 'W11017666', 'WYBILLINGS', 'Billings Clinic - OB/GYN', 'Mark', 'E', 'Randak', 'MD', 'Obstetrics and Gynecology', NULL, NULL, NULL, 'O', '2825 8th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4062382501', '4062382806', 'PO Box 37000', 'Billings', 'Yellowstone', 'MT', '59107', NULL, NULL, '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2009-05-01', '2010-03-01', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1952470098', 0, 'N', 0, '2010-01-15', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11017667', 'W11017667', 'WYBILLINGS', 'Billings Clinic - Internal Medicine', 'David', 'L', 'Rawlinson', 'DPM', 'Podiatry', NULL, NULL, NULL, 'O', '2825 8th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4062382501', '4062382771', 'PO Box 37000', 'Billings', 'Yellowstone', 'MT', '59107', NULL, NULL, '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2009-05-01', '2010-03-01', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1386697142', 0, 'N', 0, '2010-01-15', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11017668', 'W11017668', 'WYBILLINGS', 'Billings Clinic - Internal Medicine', 'Dennis', NULL, 'Regan', 'MD', 'Internal Medicine', NULL, NULL, NULL, 'O', '2800 10th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4066574000', '4062382771', 'PO Box 37000', 'Billings', 'Yellowstone', 'MT', '59107', NULL, NULL, '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2009-05-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1568510907', 0, 'N', 0, '2009-05-04', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11017669', 'W11017669', 'WYBILLINGS', 'Billings Clinic - Occupational Health & Wellness', 'John', NULL, 'Repac', 'OTR/L', 'Occupational Therapy', NULL, NULL, NULL, 'O', '1020 N 27th St', 'Billings', 'Yellowstone', 'MT', '59101', '4062382501', '4062476240', 'PO Box 37000', 'Billings', 'Yellowstone', 'MT', '59107', NULL, NULL, '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2009-05-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1720161474', 0, 'N', 0, '2009-05-04', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11017670', 'W11017670', 'WYBILLINGS', 'Billings Clinic - Derm', 'Albert', 'C', 'Reynaud', 'MD', 'Dermatology', NULL, NULL, NULL, 'O', '2825 8th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4062382501', '4062382437', 'PO Box 37000', 'Billings', 'Yellowstone', 'MT', '59107', NULL, NULL, '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2009-05-01', '2010-03-01', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1104924000', 0, 'N', 0, '2010-01-15', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11017671', 'W11017671', 'WYBILLINGS', 'Billings Clinic - Neurology', 'Scott', 'A', 'Riggins', 'MD', 'Neurology', NULL, NULL, NULL, 'O', '2825 8th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4062382501', '4062382805', 'PO Box 37000', 'Billings', 'Yellowstone', 'MT', '59107', NULL, NULL, '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2009-05-01', '2010-03-01', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1679671598', 0, 'N', 0, '2010-01-15', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11017672', 'W11017672', 'WYBILLINGS', 'Billings Clinic - Gen Surg', 'Bradley', 'M', 'Roberts', 'ARNP', 'General Surgery', NULL, NULL, NULL, 'O', '2825 8th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4062382501', '4062382848', 'PO Box 37000', 'Billings', 'Yellowstone', 'MT', '59107', NULL, NULL, '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2009-05-01', '2010-03-01', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1649277237', 0, 'N', 0, '2010-01-15', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11017673', 'W11017673', 'WYBILLINGS', 'Billings Clinic - Cardiology', 'Laura', 'K', 'Robinson', 'PA-C', 'General Surgery', 'Cardovascular Disease', NULL, NULL, 'O', '801 N 29th St', 'Billings', 'Yellowstone', 'MT', '59101', '4062382501', NULL, 'PO Box 37000', 'Billings', 'Yellowstone', 'MT', '59107', NULL, NULL, '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2009-05-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1619075546', 0, 'N', 0, '2009-05-04', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11017674', 'W11017674', 'WYBILLINGS', 'Billings Clinic - Orthopedics & Sports Medicine', 'Whitney', NULL, 'Robinson', 'MD', 'Orthopedic Surgery', NULL, NULL, NULL, 'O', '2702 8th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4062382501', '4062385218', 'PO Box 37000', 'Billings', 'Yellowstone', 'MT', '59107', NULL, NULL, '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2009-05-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1578632717', 0, 'N', 0, '2009-05-04', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11017675', 'W11017675', 'WYBILLINGS', 'Billings Clinic - Neurology', 'Daniel', 'V', 'Rodriguez', 'MD', 'Neurology', '', '', NULL, 'O', '2825 8th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4062382501', '4062382805', 'PO Box 37000', 'Billings', 'Yellowstone', 'MT', '59107', NULL, NULL, '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2009-05-01', '2010-03-01', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1720187651', 0, 'N', 0, '2010-01-15', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11017676', 'W11017676', 'WYBILLINGS', 'Billings Clinic - Pulmonary', 'Robert', 'J', 'Rollins', 'MD', 'Pulmonary', NULL, NULL, NULL, 'O', '2825 8th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4062382501', '4062382813', 'PO Box 37000', 'Billings', 'Yellowstone', 'MT', '59107', NULL, NULL, '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2009-05-01', '2010-03-01', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1427131341', 0, 'N', 0, '2010-01-15', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11017677', 'W11017677', 'WYBILLINGS', 'Billings Clinic - Rehab', 'Sarah', NULL, 'Rongstad', 'ST', 'Speech Therapy', NULL, NULL, NULL, 'O', '2825 8th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4062382501', '4062382978', 'PO Box 37000', 'Billings', 'Yellowstone', 'MT', '59107', NULL, NULL, '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2009-05-01', '2009-06-29', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1780867838', 0, 'N', 0, '2009-05-04', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11017678', 'W11017678', 'WYBILLINGS', 'Billings Clinic - OB/GYN', 'Lisa', 'R', 'Ross', 'MD', 'Obstetrics and Gynecology', '', '', NULL, 'O', '2825 8th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4062382501', '4062382806', 'PO Box 37000', 'Billings', 'Yellowstone', 'MT', '59107', NULL, NULL, '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2009-05-01', '2010-03-01', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1831181924', 0, 'N', 0, '2010-01-15', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11017679', 'W11017679', 'WYBILLINGS', 'Billings Clinic - Occupational Health & Wellness', 'Scott', '', 'Ross', 'MD', 'Occupational Medicine', '', '', NULL, 'O', '1020 N 27th St', 'Billings', 'Yellowstone', 'MT', '59101', '4062382501', '4062476240', '1020 N 27th St', 'Billings', 'Yellowstone', 'MT', '59101', '4062382501', '4062476240', '', '', '', '0.00', '17.00', '0.00', 3, '2009-05-01', '2014-07-01', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1255414900', 0, 'N', 0, '2014-07-14', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11017680', 'W11017680', 'WYBILLINGS', 'Billings Clinic - Gastro', 'Mark', 'C', 'Rumans', 'MD', 'Gastroenterology', NULL, NULL, NULL, 'O', '2825 8th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4062382501', '4062382763', 'PO Box 37000', 'Billings', 'Yellowstone', 'MT', '59107', NULL, NULL, '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2009-05-01', '2010-03-01', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1699858340', 0, 'N', 0, '2010-01-15', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11017681', 'W11017681', 'WYBILLINGS', 'Billings Clinic - Urology', 'Sarah', 'A', 'Ryan', 'MD', 'Urology', NULL, NULL, NULL, 'O', '2825 8th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4062382501', '4062382881', 'PO Box 37000', 'Billings', 'Yellowstone', 'MT', '59107', NULL, NULL, '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2009-05-01', '2010-03-01', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1659328391', 0, 'N', 0, '2010-01-15', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11017682', 'W11017682', 'WYBILLINGS', 'Billings Clinic - Internal Medicine', 'Robert', 'J', 'Sachs', 'MD', 'Internal Medicine', NULL, NULL, NULL, 'O', '2825 8th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4062382501', '4062382771', 'PO Box 37000', 'Billings', 'Yellowstone', 'MT', '59107', NULL, NULL, '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2009-05-01', '2010-03-01', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1033203591', 0, 'N', 0, '2010-01-15', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11017683', 'W11017683', 'WYBILLINGS', 'Billings Clinic - Cardiology', 'Scott', '', 'Sample', 'DO', 'Cardiovascular Disease', '', '', NULL, 'O', '1020 N 27th St', 'Billings', 'Yellowstone', 'MT', '59101', '4062382000', '4062382066', '1020 N 27th St', 'Billings', 'Yellowstone', 'MT', '59101', '4062382000', '4062382066', '', '', '', '0.00', '17.00', '0.00', 3, '2009-05-01', '2014-03-31', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1558444216', 0, 'N', 0, '2014-03-13', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11017684', 'W11017684', 'WYBILLINGS', 'Billings Clinic - Orthopedics & Sports Medicine', 'Timothy', NULL, 'Sanders', 'PA-C', 'Orthopedic Surgery', NULL, NULL, NULL, 'O', '2702 8th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4062382501', '4062385218', 'PO Box 37000', 'Billings', 'Yellowstone', 'MT', '59107', NULL, NULL, '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2009-05-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1770666422', 0, 'N', 0, '2009-05-04', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11017685', 'W11017685', 'WYBILLINGS', 'Billings Clinic - Cardiology', 'Charlotte', NULL, 'Sanderson', 'ACNP-C', 'Cardovascular Disease', NULL, NULL, NULL, 'O', '1020 N 27th St', 'Billings', 'Yellowstone', 'MT', '59101', '4062382000', '4062382066', 'PO Box 37000', 'Billings', 'Yellowstone', 'MT', '59107', NULL, NULL, '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2009-05-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1942499645', 0, 'N', 0, '2009-05-04', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11017686', 'W11017686', 'WYBILLINGS', 'Billings Clinic - Cancer Center', 'Roger', 'G', 'Santala', 'MD', 'Oncology', 'Hematology and Oncology', NULL, NULL, 'O', '2825 8th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4062382501', '4062382469', 'PO Box 37000', 'Billings', 'Yellowstone', 'MT', '59107', NULL, NULL, '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2009-05-01', '2010-03-01', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1396828059', 0, 'N', 0, '2010-01-15', NULL, NULL, 0, 0, NULL, NULL),
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('810231784', 'W11017690', 'W11017690', 'WYBILLINGS', 'Billings Clinic - Neurology', 'Larry', 'G', 'Scharfe', 'PA-C', 'Neurology', NULL, NULL, NULL, 'O', '2825 8th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4062382501', '4062382805', 'PO Box 37000', 'Billings', 'Yellowstone', 'MT', '59107', NULL, NULL, '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2009-05-01', '2010-03-01', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1619050374', 0, 'N', 0, '2010-01-15', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11017691', 'W11017691', 'WYBILLINGS', 'Billings Clinic - Orthopedics & Sports Medicine', 'Guy', NULL, 'Schmidt', 'MD', 'Orthopedic Surgery', NULL, NULL, NULL, 'O', '2702 8th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4062382501', '4062385218', 'PO Box 37000', 'Billings', 'Yellowstone', 'MT', '59107', NULL, NULL, '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2009-05-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1922090604', 0, 'N', 0, '2009-05-04', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11017692', 'W11017692', 'WYBILLINGS', 'Billings Clinic - Orthopedics & Sports Medicine', 'Lanny', NULL, 'Schneider', 'PA-C', 'Orthopedic Surgery', NULL, NULL, NULL, 'O', '2702 8th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4062382501', '4062385218', 'PO Box 37000', 'Billings', 'Yellowstone', 'MT', '59107', NULL, NULL, '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2009-05-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1922071414', 0, 'N', 0, '2009-05-04', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11017693', 'W11017693', 'WYBILLINGS', 'Billings Clinic - Orthopedics & Sports Medicine', 'Robert', NULL, 'Schultz', 'MD', 'Orthopedic Surgery', NULL, NULL, NULL, 'O', '2702 8th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4062382501', '4062385218', 'PO Box 37000', 'Billings', 'Yellowstone', 'MT', '59107', NULL, NULL, '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2009-05-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1609959360', 0, 'N', 0, '2009-05-04', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11017694', 'W11017694', 'WYBILLINGS', 'Billings Clinic - Heights Clinic', 'Andrew', NULL, 'Seddon', 'MD', 'Family Practice', NULL, NULL, NULL, 'O', '760 Wicks Ln', 'Billings', 'Yellowstone', 'MT', '59105', '4062382575', '4062382586', 'PO Box 37000', 'Billings', 'Yellowstone', 'MT', '59107', NULL, NULL, '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2009-05-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1831242510', 0, 'N', 0, '2009-05-04', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11017695', 'W11017695', 'WYBILLINGS', 'Billings Clinic - Pathology', 'Mark', '', 'Sheiko', 'MD', 'Pathology', '', '', NULL, 'O', '2800 10th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4066574150', '4066574349', '2800 10th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4066574150', '4066574349', '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2009-05-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1275612616', 0, 'N', 0, '2014-02-04', NULL, NULL, 0, 0, NULL, NULL),
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('810231784', 'W11017697', 'W11017697', 'WYBILLINGS', 'Billings Clinic - PMR', 'Lynn', 'F', 'Shenk', 'DO', 'Physical Medicine and Rehabilitation', NULL, NULL, NULL, 'O', '2825 8th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4062382501', '4062382723', 'PO Box 37000', 'Billings', 'Yellowstone', 'MT', '59107', NULL, NULL, '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2009-05-01', '2010-03-01', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1134208572', 0, 'N', 0, '2010-01-15', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11017698', 'W11017698', 'WYBILLINGS', 'Billings Clinic - Cardiology', 'Adriana', NULL, 'Slobodova', 'MD', 'Electrophysiology', NULL, NULL, NULL, 'O', '1020 N 27th St', 'Billings', 'Yellowstone', 'MT', '59101', '4062382000', '4062382066', 'PO Box 37000', 'Billings', 'Yellowstone', 'MT', '59107', NULL, NULL, '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2009-05-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1629116397', 0, 'N', 0, '2009-05-04', NULL, NULL, 0, 0, NULL, NULL),
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('810231784', 'W11017700', 'W11017700', 'WYBILLINGS', 'Billings Clinic - Pathology', 'Jeffrey', NULL, 'Smith', 'MD', 'Pathology', NULL, NULL, NULL, 'O', '2800 10th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4066574150', '4066574349', 'PO Box 37000', 'Billings', 'Yellowstone', 'MT', '59107', NULL, NULL, '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2009-05-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1568490845', 0, 'N', 0, '2009-05-04', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11017701', 'W11017701', 'WYBILLINGS', 'Billings Clinic - Infectious Disease', 'Ronald', NULL, 'Smith', 'MD', 'Infectious Disease', NULL, NULL, NULL, 'O', '2825 8th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4062382501', '4062382253', 'PO Box 37000', 'Billings', 'Yellowstone', 'MT', '59107', NULL, NULL, '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2009-05-01', '2009-12-01', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1427237965', 0, 'N', 0, '2009-05-04', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11017702', 'W11017702', 'WYBILLINGS', 'Billings Clinic - Occupational Health & Wellness', 'Matthew', NULL, 'Solka', 'PT', 'Physical Therapy', NULL, NULL, NULL, 'O', '1020 N 27th St', 'Billings', 'Yellowstone', 'MT', '59101', '4062382501', '4062476240', 'PO Box 37000', 'Billings', 'Yellowstone', 'MT', '59107', NULL, NULL, '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2009-05-01', '2008-06-01', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1730237272', 0, 'N', 0, '2009-05-04', NULL, NULL, 0, 0, NULL, NULL),
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('810231784', 'W11017708', 'W11017708', 'WYBILLINGS', 'Billings Clinic - Same Day Care', 'Karen', NULL, 'Stainton', 'FNP', 'Family Practice', NULL, NULL, NULL, 'O', '2825 8th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4062382501', '4062382868', 'PO Box 37000', 'Billings', 'Yellowstone', 'MT', '59107', NULL, NULL, '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2009-05-01', '2010-03-01', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1780763193', 0, 'N', 0, '2010-01-15', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11017709', 'W11017709', 'WYBILLINGS', 'Billings Clinic - Ophthalmology', 'Richard', 'F', 'Stanich', 'OD', 'Optometry', NULL, NULL, NULL, 'O', '2825 8th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4062382501', '4062382871', 'PO Box 37000', 'Billings', 'Yellowstone', 'MT', '59107', NULL, NULL, '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2009-05-01', '2010-03-01', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1316095854', 0, 'N', 0, '2010-01-15', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11017710', 'W11017710', 'WYBILLINGS', 'Billings Clinic - Peds', 'Brian', NULL, 'Starr', 'MD', 'Pediatrics', NULL, NULL, NULL, 'O', '2800 10th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4066574150', '4066574349', 'PO Box 37000', 'Billings', 'Yellowstone', 'MT', '59107', NULL, NULL, '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2009-05-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1316026727', 0, 'N', 0, '2009-05-04', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11017711', 'W11017711', 'WYBILLINGS', 'Billings Clinic - Cardiology', 'Michelle', '', 'Stavnes', 'FNP-C', 'Geriatrics', '', '', NULL, 'O', '1020 N 27th St', 'Billings', 'Yellowstone', 'MT', '59101', '4062382000', '4062382066', '1020 N 27th St', 'Billings', 'Yellowstone', 'MT', '59101', '4062382000', '4062382066', '', '', '', '0.00', '17.00', '0.00', 3, '2009-05-01', '2013-08-20', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1295896611', 0, 'N', 0, '2013-10-04', NULL, NULL, 0, 0, NULL, NULL),
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('810231784', 'W11017713', 'W11017713', 'WYBILLINGS', 'Billings Clinic - Outreach Services', 'Jerome', 'R', 'Stewart', 'DO', 'Family Practice', 'General Practice', NULL, NULL, 'O', '2825 8th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4062558441', '4062558405', 'PO Box 37000', 'Billings', 'Yellowstone', 'MT', '59107', NULL, NULL, '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2009-05-01', '2010-03-01', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1568406429', 0, 'N', 0, '2010-01-15', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11017714', 'W11017714', 'WYBILLINGS', 'Billings Clinic - OBGYN', 'Nancy', 'J', 'Stockman', 'FNP', 'Obstetrics and Gynecology', NULL, NULL, NULL, 'O', '2825 8th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4062382501', '4062382806', 'PO Box 37000', 'Billings', 'Yellowstone', 'MT', '59107', NULL, NULL, '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2009-05-01', '2010-03-01', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1235287673', 0, 'N', 0, '2010-01-15', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11017715', 'W11017715', 'WYBILLINGS', 'Behavioral Health Clinic', 'Melody', NULL, 'Stupey', 'MD', 'Mental Health', NULL, NULL, NULL, 'O', '1020 N 27th St', 'Billings', 'Yellowstone', 'MT', '59101', '4062558550', '4062525430', 'PO Box 37000', 'Billings', 'Yellowstone', 'MT', '59107', NULL, NULL, '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2009-05-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1235218645', 0, 'N', 0, '2009-05-04', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11017716', 'W11017716', 'WYBILLINGS', 'Billings Clinic - Orthopedics & Sports Medicine', 'Brian', NULL, 'Sullivan', 'PA-C', 'Orthopedic Surgery', NULL, NULL, NULL, 'O', '2702 8th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4062382501', '4062385218', 'PO Box 37000', 'Billings', 'Yellowstone', 'MT', '59107', NULL, NULL, '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2009-05-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1881773299', 0, 'N', 0, '2009-05-04', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11017717', 'W11017717', 'WYBILLINGS', 'Billings Clinic - Internal Medicine', 'Laura', NULL, 'Szabo', 'MD', 'Internal Medicine', NULL, NULL, NULL, 'O', '2825 8th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4062382501', '4062382413', 'PO Box 37000', 'Billings', 'Yellowstone', 'MT', '59107', NULL, NULL, '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2009-05-01', '2010-03-01', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1902905870', 0, 'N', 0, '2009-05-04', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11017718', 'W11017718', 'WYBILLINGS', 'Billings Clinic - Orthopedics & Sports Medicine', 'April', NULL, 'Taber', 'PT', 'Physical Therapy', NULL, NULL, NULL, 'O', '2702 8th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4062382501', '4062385218', 'PO Box 37000', 'Billings', 'Yellowstone', 'MT', '59107', NULL, NULL, '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2009-05-01', '2008-07-16', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1871776013', 0, 'N', 0, '2009-05-04', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11017719', 'W11017719', 'WYBILLINGS', 'Billings Clinic - Neurology', 'Don', 'Q', 'Thai', 'MD', 'Neurology', NULL, NULL, NULL, 'O', '2825 8th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4062382501', '4062382805', 'PO Box 37000', 'Billings', 'Yellowstone', 'MT', '59107', NULL, NULL, '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2009-05-01', '2010-03-01', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1992804843', 0, 'N', 0, '2010-01-15', NULL, NULL, 0, 0, NULL, NULL),
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('810231784', 'W11017726', 'W11017726', 'WYBILLINGS', 'Billings Clinic - Orthopedics & Sports Medicine', 'Matthew', NULL, 'Walsh', 'MD', 'Orthopedic Surgery', NULL, NULL, NULL, 'O', '2702 8th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4062382501', '4062385218', 'PO Box 37000', 'Billings', 'Yellowstone', 'MT', '59107', NULL, NULL, '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2009-05-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '0000003028', 0, 'N', 0, '2009-05-04', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11017727', 'W11017727', 'WYBILLINGS', 'Billings Clinic - Ophthalmology', 'Daniel', NULL, 'Weaver', 'MD', 'Ophthalmology', NULL, NULL, NULL, 'O', '2825 8th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4062382501', '4062382871', 'PO Box 37000', 'Billings', 'Yellowstone', 'MT', '59107', NULL, NULL, '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2009-05-01', '2010-03-01', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '0000003065', 0, 'N', 0, '2009-05-04', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11017728', 'W11017728', 'WYBILLINGS', 'Billings Clinic - Internal Medicine', 'Deric', NULL, 'Weiss', 'MD', 'Internal Medicine', NULL, NULL, NULL, 'O', '2825 8th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4062382501', '4062382413', 'PO Box 37000', 'Billings', 'Yellowstone', 'MT', '59107', NULL, NULL, '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2009-05-01', '2010-03-01', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '0000003025', 0, 'N', 0, '2009-05-04', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11017729', 'W11017729', 'WYBILLINGS', 'Billings Clinic - Derm', 'Joseph', NULL, 'Wentzell', 'PA-C', 'Dermatology', NULL, NULL, NULL, 'O', '2825 8th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4062382501', '4062382437', 'PO Box 37000', 'Billings', 'Yellowstone', 'MT', '59107', NULL, NULL, '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2009-05-01', '2010-03-01', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '0000003098', 0, 'N', 0, '2009-05-04', NULL, NULL, 0, 0, NULL, NULL),
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('810231784', 'W11017731', 'W11017731', 'WYBILLINGS', 'Billings Clinic', 'James', '', 'Wiggins', 'MD', 'Pediatric Cardiology', '', '', NULL, 'O', '2825 8th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4062382501', NULL, '2825 8th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4062382501', '', '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2009-05-01', '2010-03-01', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1164478897', 0, 'N', 0, '2012-11-02', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11017732', 'W11017732', 'WYBILLINGS', 'Billings Clinic - Same Day Care', 'Derek', '', 'Williams', 'MD', 'Family Practice', '', '', NULL, 'O', '2825 8th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4062382501', '4062382868', '2825 8th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4062382501', '4062382868', '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2009-05-01', '2010-03-01', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1811907884', 0, 'N', 0, '2012-11-02', NULL, NULL, 0, 0, NULL, NULL),
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('810231784', 'W11017737', 'W11017737', 'WYBILLINGS', 'Billings Clinic - Cancer Center', 'Mary', NULL, 'Deigert', 'PAC', 'Oncology', 'Hematology and Oncology', NULL, NULL, 'O', '2825 8th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4062382501', '4062382469', 'PO Box 37000', 'Billings', 'Yellowstone', 'MT', '59107', NULL, NULL, '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2009-05-01', '2010-03-01', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1578675344', 0, 'N', 0, '2009-05-04', NULL, NULL, 0, 0, NULL, NULL),
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('810231784', 'W11017739', 'W11017739', 'WYBILLINGS', 'Billings Clinic - Same Day Care', 'Chill', NULL, 'Yee', 'MD', 'Family Practice', NULL, NULL, NULL, 'O', '2825 8th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4062382501', '4062382868', 'PO Box 37000', 'Billings', 'Yellowstone', 'MT', '59107', NULL, NULL, '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2009-05-01', '2008-07-15', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1811009699', 0, 'N', 0, '2009-05-04', NULL, NULL, 0, 0, NULL, NULL),
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('810231784', 'W11017745', 'W11017745', 'WYBILLINGS', 'Billings Clinic - Same Day Care', 'Steven', NULL, 'Williamson', 'MD', 'Family Practice', NULL, NULL, NULL, 'O', '2825 8th Ave N', 'Billings', 'Yellowstone', 'MT', '59101', '4062382501', '4062382868', 'PO Box 37000', 'Billings', 'Yellowstone', 'MT', '59107', NULL, NULL, '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2009-05-01', '2010-03-01', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1023197464', 0, 'N', 0, '2009-05-04', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11017746', 'W11017746', 'WYBILLINGS', 'Billings Clinic - Heights Clinic', 'Dale', NULL, 'Emery', 'MD', 'Internal Medicine', NULL, NULL, NULL, 'O', '760 Wicks Ln', 'Billings', 'Yellowstone', 'MT', '59105', '4062562575', '4062382586', 'PO Box 37000', 'Billings', 'Yellowstone', 'MT', '59107', NULL, NULL, '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2009-05-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1164533725', 0, 'N', 0, '2009-05-04', NULL, NULL, 0, 0, NULL, NULL),
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('810231784', 'W11017748', 'W11017748', 'WYBILLINGS', 'Billings Clinic - Heights Clinic', 'Grant', NULL, 'Hammons', 'MD', 'Internal Medicine', NULL, NULL, NULL, 'O', '760 Wicks Ln', 'Billings', 'Yellowstone', 'MT', '59105', '4062382575', '4062382586', 'PO Box 37000', 'Billings', 'Yellowstone', 'MT', '59107', NULL, NULL, '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2009-05-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1740239581', 0, 'N', 0, '2009-05-04', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11017749', 'W11017749', 'WYBILLINGS', 'Billings Clinic - Heights Clinic', 'Laura', NULL, 'Rathe', 'MD', 'Internal Medicine', NULL, NULL, NULL, 'O', '760 Wicks Ln', 'Billings', 'Yellowstone', 'MT', '59101', '4062382575', '4062382586', 'PO Box 37000', 'Billings', 'Yellowstone', 'MT', '59107', NULL, NULL, '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2009-05-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1982702874', 0, 'N', 0, '2009-05-04', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11017750', 'W11017750', 'WYBILLINGS', 'Billings Clinic - Heights Clinic', 'Larry', '', 'Severa', 'MD', 'Family Practice', '', '', NULL, 'O', '760 Wicks Ln', 'Billings', 'Yellowstone', 'MT', '59105', '4062382575', '4062382586', '760 Wicks Ln', 'Billings', 'Yellowstone', 'MT', '59105', '4062382575', '4062382586', '', '', '', '0.00', '17.00', '0.00', 3, '2009-05-01', '2011-09-05', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1770504052', 0, 'N', 0, '2011-07-26', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11017751', 'W11017751', 'WYBILLINGS', 'Billings Clinic - Heights Clinic', 'Chris', NULL, 'Sturdevant', 'PT', 'Physical Therapy', NULL, NULL, NULL, 'O', '760 Wicks Ln', 'Billings', 'Yellowstone', 'MT', '59105', '4062562575', '4062382586', 'PO Box 37000', 'Billings', 'Yellowstone', 'MT', '59107', NULL, NULL, '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2009-05-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1154400562', 0, 'N', 0, '2009-05-04', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11017752', 'W11017752', 'WYBILLINGS', 'Billings Clinic - West End Clinic', 'Leslie', NULL, 'Bennington III', 'OT', 'Occupational Therapy', NULL, NULL, NULL, 'O', '2675 Central Ave', 'Billings', 'Yellowstone', 'MT', '59102', '4062382900', '4062382978', 'PO Box 37000', 'Billings', 'Yellowstone', 'MT', '59107', NULL, NULL, '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2009-05-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1841219706', 0, 'N', 0, '2009-05-04', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11017753', 'W11017753', 'WYBILLINGS', 'Billings Clinic - West End Clinic', 'Shelly', NULL, 'Castles', 'MD', 'Family Practice', NULL, NULL, NULL, 'O', '2675 Central Ave', 'Billings', 'Yellowstone', 'MT', '59102', '4062382900', '4062382978', 'PO Box 37000', 'Billings', 'Yellowstone', 'MT', '59107', NULL, NULL, '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2009-05-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1952410953', 0, 'N', 0, '2009-05-04', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11017754', 'W11017754', 'WYBILLINGS', 'Billings Clinic - West End Clinic', 'Darci', NULL, 'Doyle', 'MSLP', 'Speech Therapy', NULL, NULL, NULL, 'O', '2675 Central Ave', 'Billings', 'Yellowstone', 'MT', '59101', '4062382900', '4062382978', 'PO Box 37000', 'Billings', 'Yellowstone', 'MT', '59107', NULL, NULL, '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2009-05-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1407047376', 0, 'N', 0, '2009-05-04', NULL, NULL, 0, 0, NULL, NULL),
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('810231784', 'W11017756', 'W11017756', 'WYBILLINGS', 'Billings Clinic - West End Clinic', 'Heidi', NULL, 'Duncan', 'MD', 'Family Practice', NULL, NULL, NULL, 'O', '2675 Central Ave', 'Billings', 'Yellowstone', 'MT', '59102', '4062382900', '4062382978', 'PO Box 37000', 'Billings', 'Yellowstone', 'MT', '59107', NULL, NULL, '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2009-05-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1376645341', 0, 'N', 0, '2009-05-04', NULL, NULL, 0, 0, NULL, NULL);
INSERT INTO `providers_new` (`Provider_Tax_ID`, `Provider_Suffix`, `Provider_Network_ID`, `Provider_Region`, `Provider_Name`, `Provider_Doctor_First_Name`, `Provider_Doctor_Middle_Name`, `Provider_Doctor_Last_Name`, `Provider_Doctor_Degree`, `Provider_Specialty_1`, `Provider_Specialty_2`, `Provider_Specialty_3`, `Provider_Specialty_4`, `Provider_Address_Type`, `Provider_Address`, `Provider_City`, `Provider_County`, `Provider_State`, `Provider_Zip`, `Provider_Phone`, `Provider_Fax`, `Provider_Mailing_Address`, `Provider_Mailing_City`, `Provider_Mailing_County`, `Provider_Mailing_State`, `Provider_Mailing_Zip`, `Provider_Mailing_Phone`, `Provider_Mailing_Fax`, `Provider_Primary_Schedule`, `Provider_Secondary_Schedule`, `Provider_Rate_Sheet`, `Provider_Anes_Rate`, `Provider_Default_Rate`, `Provider_Max_DOS`, `Provider_Min_Match_Value`, `Provider_Effective_Date`, `Provider_Term_Date`, `Provider_Pend`, `Provider_Anes_Minutes`, `Provider_PPO`, `Provider_Hospital_1`, `Provider_Hospital_2`, `Provider_Hospital_3`, `Provider_Hospital_4`, `Provider_Type`, `Provider_NPI`, `Provider_Check_Override`, `Exclude_Dir`, `Audit_Status`, `Last_Change_Date`, `Medicare_ID`, `Provider_Lang`, `Provider_Latitude`, `Provider_Longitude`, `Provider_school`, `Provider_cert`) VALUES
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