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
('204585947', 'W77011767', 'W77011767', 'UT01', NULL, 'Ronald', 'C', 'Jones', 'MD', 'Pediatrics', NULL, NULL, NULL, 'O', '3325 N University Ave Ste 100', 'Provo', 'Utah', 'UT', '84604', '8018855622', NULL, NULL, NULL, '', NULL, NULL, '', '', 'USTDPEDE', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2002-04-01', '2006-12-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1245290295', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('260096904', 'W77011768', 'W77011768', 'UT01', 'Millcreek Womens Center', 'Jennifer', 'C', 'Kinghorn', 'MD', 'Obstetrics and Gynecology', NULL, NULL, NULL, 'O', '1140 E 3900 S Ste 410', 'Salt Lake City', 'Salt Lake', 'UT', '84124', '8012628666', NULL, NULL, NULL, '', NULL, NULL, '', '', 'UMILLCRK', NULL, NULL, '0.00', '15.00', NULL, 3, '2004-08-06', '2005-07-31', 0, 0, 0, 'St Marks Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1750359170', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('270093962', 'W77011769', 'W77011769', 'UT01', NULL, 'Angela', 'M', 'Keen', 'MD', 'Plastic Surgery', NULL, NULL, NULL, 'O', '370 9th Ave Ste 200', 'Salt Lake City', 'Salt Lake', 'UT', '84103', '8013643613', '8013221099', NULL, NULL, '', NULL, NULL, '', '', 'USTDPLAS', NULL, NULL, '0.00', '35.00', NULL, 3, '2006-03-24', '2006-11-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1487670881', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('300319696', 'W77011770', 'W77011770', 'UT01', 'Progressive Eyecare', 'Jeffrey', 'L', 'Broadhead', 'OD', 'Optometry', NULL, NULL, NULL, 'O', '3556 W 9800 S Ste 102', 'South Jordan', 'Salt Lake', 'UT', '84095', '8016762020', '8012536591', NULL, NULL, '', NULL, NULL, '', '', 'UTALBERT', NULL, NULL, '0.00', '25.00', NULL, 3, '2006-04-05', '2006-08-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1306829569', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('431804981', 'W77011771', 'W77011771', 'MO05', 'Arterial And Cardiothoracic Surgery', 'Joseph', 'E', 'Graham', 'MD', 'Cardiovascular Disease', 'Thoracic Surgery', 'Vascular Surgery', NULL, 'B', '10004 Kennerly Rd Ste 103', 'Saint Louis', 'Saint Louis', 'MO', '63128', '3148498600', '3148493095', NULL, NULL, '', NULL, NULL, '', '', 'USTDCTHO', NULL, NULL, '0.00', '35.00', NULL, 3, '2005-03-25', '2005-03-25', 0, 0, 0, 'Ogden Regional Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1578638383', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('431804981', 'W77011772', 'W77011772', 'MO05', 'Arterial And Cardiothoracic Surgery', 'Joseph', 'E', 'Graham', 'MD', 'Cardiovascular Disease', 'Thoracic Surgery', 'Vascular Surgery', NULL, 'O', '10004 Kennerly Rd Ste 103A', 'Saint Louis', 'Saint Louis', 'MO', '63128', '3148498600', '3148493095', NULL, NULL, '', NULL, NULL, '', '', 'USTDCTHO', NULL, NULL, '0.00', '35.00', NULL, 3, '2005-03-25', '2005-03-25', 0, 0, 0, 'Ogden Regional Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1578638383', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('432095026', 'W77011773', 'W77011773', 'UT01', 'Lakeview Neurosurgery Clinic', 'Winston', 'T', 'Capel', 'MD', 'Neurosurgery', 'Neurology', NULL, NULL, 'B', 'PO Box 277386', 'Atlanta', 'Fulton', 'GA', '30384', '6153737600', '8012993870', NULL, NULL, '', NULL, NULL, '', '', 'USTDNEUR', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2006-03-01', '2006-10-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '938383', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('432095026', 'W77011774', 'W77011774', 'UT01', 'Lakeview Neurosurgery Clinic', 'Winston', 'T', 'Capel', 'MD', 'Neurosurgery', 'Neurology', NULL, NULL, 'O', '620 Medical Dr Ste 210', 'Bountiful', 'Davis', 'UT', '84010', '8012993871', '8012993870', NULL, NULL, '', NULL, NULL, '', '', 'USTDNEUR', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2006-03-01', '2006-10-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '938383', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('528211959', 'W77011775', 'W77011775', 'UT01', 'Therapeutic Milestones', 'Teri', 'A', 'Miles-Wehrli', 'PT', 'Physical Therapy', NULL, NULL, NULL, 'O', '763 S 1000 W', 'Richfield', 'Sevier', 'UT', '84701', '4358965090', NULL, NULL, NULL, '', NULL, NULL, '', '', 'UDME', 'USTDHCPC', '2293', '0.00', '35.00', NULL, 3, '2006-03-24', '2006-12-31', 1, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '957651', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('528744531', 'W77011776', 'W77011776', 'UT01', 'The Communication Station', 'Linda', 'R', 'White', 'SLP', 'Speech Therapy', NULL, NULL, NULL, 'O', '11934 Cedar Ridge Rd', 'Sandy', 'Salt Lake', 'UT', '84094', '8015769606', NULL, NULL, NULL, '', NULL, NULL, '', '', 'WUDME5', 'UDME', NULL, '0.00', '0.00', NULL, 3, '2006-04-05', '2006-12-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1194798322', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('529212733', 'W77011777', 'W77011777', 'UT02', 'Clark DPM, Gary W', 'Gary', 'W', 'Clark', 'DPM', 'Podiatry', NULL, NULL, NULL, 'B', 'PO Box 1986', 'Cedar City', 'Iron', 'UT', '84721', '4358678521', '4355864073', NULL, NULL, '', NULL, NULL, '', '', 'USTDPOD', NULL, NULL, '0.00', '35.00', NULL, 3, '2006-03-24', '2006-12-31', 0, 0, 0, 'Valley View Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1609861152', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('529212733', 'W77011778', 'W77011778', 'UT02', 'Gary W Clark DPM', 'Gary', 'W', 'Clark', 'DPM', 'Podiatry', NULL, NULL, NULL, 'O', '718 S Main St Ste C', 'Cedar City', 'Iron', 'UT', '84720', '4358678521', '4355864073', NULL, NULL, '', NULL, NULL, '', '', 'USTDPOD', NULL, NULL, '0.00', '35.00', NULL, 3, '2006-03-24', '2006-12-31', 0, 0, 0, 'Valley View Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1609861152', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('611463417', 'W77011779', 'W77011779', 'UT01', 'U Of U Ob Diagnostic Center', 'Karen', 'Y', 'Oh', 'MD', 'Radiologist', NULL, NULL, NULL, 'B', 'PO Box 58859', 'Salt Lake City', 'Salt Lake', 'UT', '84158', NULL, NULL, NULL, NULL, '', NULL, NULL, '', '', 'UUUMG', NULL, NULL, '0.00', '25.00', NULL, 3, '2003-07-01', '2006-07-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '832594', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('611463417', 'W77011780', 'W77011780', 'UT01', 'U Of U Ob Diagnostic Center', 'Karen', 'Y', 'Oh', 'MD', 'Radiologist', NULL, NULL, NULL, 'O', '30 N 1900 E Ste 2B200', 'Salt Lake City', 'Salt Lake', 'UT', '84132', '8015812719', NULL, NULL, NULL, '', NULL, NULL, '', '', 'UUUMG', NULL, NULL, '0.00', '25.00', NULL, 3, '2003-07-01', '2006-07-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '832594', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('621560557', 'W77011781', 'W77011781', 'UT01', 'South Ogden Center For Family Medicine', 'Alan', 'N', 'Bybee', 'PA', 'Family Practice', NULL, NULL, NULL, 'B', '5740 Crestwood Dr', 'Ogden', 'Weber', 'UT', '84405', '8014797792', '8014797795', NULL, NULL, '', NULL, NULL, '', '', 'USTDFAM', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2002-04-01', '2002-04-01', 0, 0, 0, 'Ogden Regional Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1033184940', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('621560557', 'W77011782', 'W77011782', 'UT01', 'Morgan Health Center', 'Alan', 'N', 'Bybee', 'PA', 'Family Practice', NULL, NULL, NULL, 'O', '166 N State St', 'Morgan', 'Morgan', 'UT', '84050', '8018293426', NULL, NULL, NULL, '', NULL, NULL, '', '', 'USTDFAM', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2002-04-01', '2006-06-30', 0, 0, 0, 'Ogden Regional Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1033184940', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('621795211', 'W77011783', 'W77011783', 'UT01', 'Salt Lake Regional Physicians', 'Kelly', 'D', 'Beams', 'MD', 'Internal Medicine', NULL, NULL, NULL, 'B', 'PO Box 95970', 'South Jordan', 'Salt Lake', 'UT', '84095', '8013529500', NULL, NULL, NULL, '', NULL, NULL, '', '', 'USTDINT', NULL, NULL, '0.00', '35.00', NULL, 3, '2002-04-01', '2006-08-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1548234750', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('621795211', 'W77011784', 'W77011784', 'UT01', 'Multispecialty Partners', 'Kelly', 'D', 'Beams', 'MD', 'Internal Medicine', NULL, NULL, NULL, 'O', '1050 E S Temple', 'Salt Lake City', 'Salt Lake', 'UT', '84102', '8013504111', '8013504571', NULL, NULL, '', NULL, NULL, '', '', 'USTDINT', NULL, NULL, '0.00', '35.00', NULL, 3, '2002-04-01', '2006-08-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1548234750', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('621795211', 'W77011785', 'W77011785', 'UT01', 'Salt Lake Regional Physicians', 'Yong', 'Hui', 'Ahn', 'MD', 'Internal Medicine', NULL, NULL, NULL, 'B', 'PO Box 95970', 'South Jordan', 'Salt Lake', 'UT', '84095', '8013529500', NULL, NULL, NULL, '', NULL, NULL, '', '', 'USTDINT', NULL, NULL, '0.00', '35.00', NULL, 3, '2002-04-01', '2006-08-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1427023571', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('621795211', 'W77011786', 'W77011786', 'UT01', 'Multispecialty Partners', 'Yong', 'Hui', 'Ahn', 'MD', 'Internal Medicine', NULL, NULL, NULL, 'O', '1050 E S Temple', 'Salt Lake City', 'Salt Lake', 'UT', '84102', '8013504111', '8013504571', NULL, NULL, '', NULL, NULL, '', '', 'USTDINT', NULL, NULL, '0.00', '35.00', NULL, 3, '2002-04-01', '2006-08-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1427023571', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('621795211', 'W77011787', 'W77011787', 'UT01', 'Salt Lake Regional Physicians', 'Beth', 'Chapman', 'Hanlon', 'MD', 'Internal Medicine', NULL, NULL, NULL, 'B', 'PO Box 95970', 'South Jordan', 'Salt Lake', 'UT', '84095', '8013529500', NULL, NULL, NULL, '', NULL, NULL, '', '', 'USTDINT', NULL, NULL, '0.00', '35.00', NULL, 3, '2002-04-01', '2006-08-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1801860648', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('621795211', 'W77011788', 'W77011788', 'UT01', 'Multispecialty Partners', 'Beth', 'Chapman', 'Hanlon', 'MD', 'Internal Medicine', NULL, NULL, NULL, 'O', '1050 E S Temple', 'Salt Lake City', 'Salt Lake', 'UT', '84102', '8013504111', '8013504571', NULL, NULL, '', NULL, NULL, '', '', 'USTDINT', NULL, NULL, '0.00', '35.00', NULL, 3, '2002-04-01', '2006-08-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1801860648', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('621795211', 'W77011789', 'W77011789', 'UT01', 'Salt Lake Regional Physicians', 'Anna', NULL, 'Hom', 'MD', 'Internal Medicine', 'Hospitalist', NULL, NULL, 'B', 'PO Box 95970', 'South Jordan', 'Salt Lake', 'UT', '84095', '8013529500', NULL, NULL, NULL, '', NULL, NULL, '', '', 'USTDINT', NULL, NULL, '0.00', '35.00', NULL, 3, '2006-03-01', '2006-08-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1063421733', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('621795211', 'W77011790', 'W77011790', 'UT01', 'Multispecialty Partners', 'Anna', NULL, 'Hom', 'MD', 'Internal Medicine', 'Hospitalist', NULL, NULL, 'O', '1050 E S Temple', 'Salt Lake City', 'Salt Lake', 'UT', '84102', '8013504111', '8013504571', NULL, NULL, '', NULL, NULL, '', '', 'USTDINT', NULL, NULL, '0.00', '35.00', NULL, 3, '2006-03-01', '2006-08-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1063421733', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('621795211', 'W77011791', 'W77011791', 'UT01', 'Salt Lake Regional Physicians', 'Arasu', NULL, 'Gopinath', 'MD', 'Internal Medicine', NULL, NULL, NULL, 'B', 'PO Box 95970', 'South Jordan', 'Salt Lake', 'UT', '84095', '8013529500', NULL, NULL, NULL, '', NULL, NULL, '', '', 'USTDCARD', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2004-01-30', '2006-08-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '831896', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('621795211', 'W77011792', 'W77011792', 'UT01', 'Multispecialty Partners', 'Arasu', NULL, 'Gopinath', 'MD', 'Internal Medicine', NULL, NULL, NULL, 'O', '1050 E S Temple', 'Salt Lake City', 'Salt Lake', 'UT', '84102', '8013504111', '8013504571', NULL, NULL, '', NULL, NULL, '', '', 'USTDCARD', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2004-01-30', '2006-08-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '831896', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('621795211', 'W77011793', 'W77011793', 'UT01', 'Salt Lake Regional Physicians', 'Imran', NULL, 'Zubair', 'MD', 'Cardiovascular Disease', NULL, NULL, NULL, 'B', 'PO Box 95970', 'South Jordan', 'Salt Lake', 'UT', '84095', '8013529500', NULL, NULL, NULL, '', NULL, NULL, '', '', 'USTDINT', NULL, NULL, '0.00', '35.00', NULL, 3, '2002-04-01', '2006-08-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '833353', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('621795211', 'W77011794', 'W77011794', 'UT01', 'Multispecialty Partners', 'Imran', NULL, 'Zubair', 'MD', 'Cardiovascular Disease', NULL, NULL, NULL, 'O', '24 S 1100 E Ste 304', 'Salt Lake City', 'Salt Lake', 'UT', '84102', '8017464440', '8017464455', NULL, NULL, '', NULL, NULL, '', '', 'USTDINT', NULL, NULL, '0.00', '35.00', NULL, 3, '2002-04-01', '2006-08-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '833353', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('621795215', 'W77011795', 'W77011795', 'UT01', 'Jordan Valley Surgical Specialists', 'Helen', 'Highsmith', 'Hollingsworth', 'MD', 'Internal Medicine', 'Hospitalist', NULL, NULL, 'O', '3590 W 9000 S Ste 105', 'West Jordan', 'Salt Lake', 'UT', '84088', '8015623150', '8015683149', NULL, NULL, '', NULL, NULL, '', '', 'USTDSURG', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2006-02-01', '2006-09-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '963019', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('621795217', 'W77011796', 'W77011796', 'UT01', 'Davis Hospital Holdings', 'Brannick', 'B', 'Riggs', 'MD', 'Family Practice', NULL, NULL, NULL, 'B', 'PO Box 95970', 'South Jordan', 'Salt Lake', 'UT', '84095', '8013529500', NULL, NULL, NULL, '', NULL, NULL, '', '', 'USTDFAM', NULL, NULL, '0.00', '35.00', NULL, 3, '2003-11-07', '2003-11-07', 0, 0, 0, 'Ogden Regional Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1255324984', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('621795217', 'W77011797', 'W77011797', 'UT01', 'Rock Run Medical', 'Brannick', 'B', 'Riggs', 'MD', 'Family Practice', NULL, NULL, NULL, 'O', '5991 S 3500 W Ste 400', 'Roy', 'Weber', 'UT', '84067', '8017732838', '8017733025', NULL, NULL, '', NULL, NULL, '', '', 'USTDFAM', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2003-11-07', '2006-12-31', 0, 0, 0, 'Ogden Regional Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1255324984', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('621801973', 'W77011798', 'W77011798', 'UT01', 'Pioneer Valley Hospital Physicians', 'Bireen', 'L', 'Whitten', 'MD', 'Internal Medicine', NULL, NULL, NULL, 'B', 'PO Box 95970', 'South Jordan', 'Salt Lake', 'UT', '84095', '8013529500', '8019699028', NULL, NULL, '', NULL, NULL, '', '', 'USTDINT', NULL, NULL, '0.00', '35.00', NULL, 3, '2006-04-12', '2006-09-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1831162882', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('621801973', 'W77011799', 'W77011799', 'UT01', 'Internal Medicine Specialists', 'Bireen', 'L', 'Whitten', 'MD', 'Internal Medicine', NULL, NULL, NULL, 'O', '2530 W 4700 S Ste B8', 'Salt Lake City', 'Salt Lake', 'UT', '84118', '8019675866', '8019699028', NULL, NULL, '', NULL, NULL, '', '', 'USTDINT', NULL, NULL, '0.00', '35.00', NULL, 3, '2006-04-12', '2006-09-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1831162882', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('742412898', 'W77011800', 'W77011800', 'UT01', 'Community Health Centers', 'David', 'J', 'Keahey', 'PA', NULL, NULL, NULL, NULL, 'B', '1798 S W Temple Ste A-100', 'South Salt Lake', 'Salt Lake', 'UT', '84115', '8014126939', '8014126950', NULL, NULL, '', NULL, NULL, '', '', 'USTDFAM', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 6, '2006-04-05', '2006-05-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1003892837', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('742412898', 'W77011801', 'W77011801', 'UT01', 'Community Health Centers', 'David', 'J', 'Keahey', 'PA', NULL, NULL, NULL, NULL, 'O', '461 S 400 E', 'Salt Lake City', 'Salt Lake', 'UT', '84111', '8015398634', '8015377238', NULL, NULL, '', NULL, NULL, '', '', 'USTDFAM', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 6, '2006-04-05', '2006-05-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1003892837', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('742412898', 'W77011802', 'W77011802', 'UT01', 'Community Health Centers', 'Martha', 'P', 'Mandujano', 'PA', NULL, NULL, NULL, NULL, 'B', '1798 S W Temple Ste A-100', 'South Salt Lake', 'Salt Lake', 'UT', '84115', '8014126939', '8014126950', NULL, NULL, '', NULL, NULL, '', '', 'USTDFAM', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 6, '2006-04-05', '2006-05-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1356446215', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('742412898', 'W77011804', 'W77011804', 'UT01', 'Community Health Centers', 'Martha', 'P', 'Mandujano', 'PA', NULL, NULL, NULL, NULL, 'O', '4745 S 3200 W', 'Salt Lake City', 'Salt Lake', 'UT', '84118', '8019646214', '8019829232', NULL, NULL, '', NULL, NULL, '', '', 'USTDFAM', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 6, '2006-04-05', '2006-05-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1356446215', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
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('870395551', 'W77011853', 'W77011853', 'UT01', 'Guthrie Chiropractic', 'Daniel', 'R', 'Guthrie', 'DC', 'Chiropractic', NULL, NULL, NULL, 'O', '3856 W 5400 S Ste 120', 'Salt Lake City', 'Salt Lake', 'UT', '84118', '8019579696', '8019579694', NULL, NULL, '', NULL, NULL, '', '', 'USTDMULT', NULL, '2303', '0.00', '35.00', NULL, 3, '2006-03-01', '2006-03-31', 1, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1972722916', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870395551', 'W77011854', 'W77011854', 'UT01', 'Chiropractic Health Plan', 'Tricia', 'A', 'Chepanoske', 'DC', 'Chiropractic', NULL, NULL, NULL, 'B', '9135 S Monroe St Ste B', 'Sandy', 'Salt Lake', 'UT', '84070', '8013527270', '8013527024', NULL, NULL, '', NULL, NULL, '', '', 'USTDMULT', NULL, '2303', '0.00', '35.00', NULL, 3, '2006-03-29', '2006-03-31', 1, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1457338279', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870395551', 'W77011855', 'W77011855', 'UT01', 'Chiropractic Health Plan', 'Tricia', 'A', 'Chepanoske', 'DC', 'Chiropractic', NULL, NULL, NULL, 'O', '715 E 3900 S Ste 201', 'Salt Lake City', 'Salt Lake', 'UT', '84107', '8016850588', NULL, NULL, NULL, '', NULL, NULL, '', '', 'USTDMULT', NULL, '2303', '0.00', '35.00', NULL, 3, '2006-03-29', '2006-03-31', 1, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1457338279', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870395551', 'W77011856', 'W77011856', 'UT01', 'Chiropractic Health Plan', 'Mark', 'V', 'Vosti', 'DC', 'Chiropractic', NULL, NULL, NULL, 'B', '9135 S Monroe St Ste B', 'Sandy', 'Salt Lake', 'UT', '84070', '8013527270', '8013527024', NULL, NULL, '', NULL, NULL, '', '', 'USTDMULT', NULL, '2303', '0.00', '35.00', NULL, 3, '2006-03-29', '2006-03-31', 1, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1669444303', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870395551', 'W77011857', 'W77011857', 'UT01', 'South Mountain Chiropractic', 'Mark', 'V', 'Vosti', 'DC', 'Chiropractic', NULL, NULL, NULL, 'O', '1101 Draper Pkwy', 'Draper', 'Salt Lake', 'UT', '84020', '8016196090', '8015536323', NULL, NULL, '', NULL, NULL, '', '', 'USTDMULT', NULL, '2303', '0.00', '35.00', NULL, 3, '2006-03-29', '2006-03-31', 1, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1669444303', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870395551', 'W77011858', 'W77011858', 'UT01', 'Chiropractic Health Plan', 'Jeremiah', NULL, 'Hoopes', 'DC', 'Chiropractic', NULL, NULL, NULL, 'B', '9135 S Monroe St Ste B', 'Sandy', 'Salt Lake', 'UT', '84070', '8013527270', '8013527024', NULL, NULL, '', NULL, NULL, '', '', 'USTDMULT', NULL, '2303', '0.00', '35.00', NULL, 3, '2006-03-29', '2006-03-31', 1, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1881652535', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870395551', 'W77011859', 'W77011859', 'UT01', 'Body Needs', 'Jeremiah', NULL, 'Hoopes', 'DC', 'Chiropractic', NULL, NULL, NULL, 'O', '770 S 200 E Ste 102', 'Brigham City', 'Box Elder', 'UT', '84302', '4357230517', '4357230587', NULL, NULL, '', NULL, NULL, '', '', 'USTDMULT', NULL, '2303', '0.00', '35.00', NULL, 3, '2006-03-29', '2006-03-31', 1, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1881652535', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870395551', 'W77011860', 'W77011860', 'UT02', 'Chiropractic Health Plan', 'Joshua', 'A', 'Carr', 'DC', 'Chiropractic', NULL, NULL, NULL, 'B', '9135 S Monroe St Ste B', 'Sandy', 'Salt Lake', 'UT', '84070', '8013527270', '8013527024', NULL, NULL, '', NULL, NULL, '', '', 'USTDMULT', NULL, '2303', '0.00', '35.00', NULL, 3, '2006-04-05', '2006-04-05', 1, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1538235221', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
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('870395551', 'W77011862', 'W77011862', 'UT02', 'Chiropractic Health Plan', 'Kelly', 'E', 'Murie', 'DC', 'Chiropractic', NULL, NULL, NULL, 'B', '9135 S Monroe St Ste B', 'Sandy', 'Salt Lake', 'UT', '84070', '8013527270', '8013527024', NULL, NULL, '', NULL, NULL, '', '', 'USTDMULT', NULL, '2303', '0.00', '35.00', NULL, 3, '2006-04-05', '2006-04-05', 1, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1306912969', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870395551', 'W77011863', 'W77011863', 'UT02', 'Coral Canyon Chiropractic', 'Kelly', 'E', 'Murie', 'DC', 'Chiropractic', NULL, NULL, NULL, 'O', '1141 W State St Ste 12', 'Hurricane', 'Washington', 'UT', '84737', '4356357771', '4356357701', NULL, NULL, '', NULL, NULL, '', '', 'USTDMULT', NULL, '2303', '0.00', '35.00', NULL, 3, '2006-04-05', '2006-04-05', 1, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1306912969', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
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('870395551', 'W77011865', 'W77011865', 'UT01', 'Hour Chiropractic Clinic', 'Raymond', NULL, 'Hour', 'DC', 'Chiropractic', NULL, NULL, NULL, 'O', '3534 S Redwood Rd', 'Salt Lake City', 'Salt Lake', 'UT', '84119', '8019722162', NULL, NULL, NULL, '', NULL, NULL, '', '', 'USTDMULT', NULL, '2303', '0.00', '35.00', NULL, 3, '2006-04-12', '2006-04-12', 1, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1871670232', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
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('870395551', 'W77011868', 'W77011868', 'UT01', 'Chiropractic Health Plan', 'Brandon', 'L', 'Neff', 'DC', 'Chiropractic', NULL, NULL, NULL, 'B', '9135 S Monroe St Ste B', 'Sandy', 'Salt Lake', 'UT', '84070', '8013527270', '8013527024', NULL, NULL, '', NULL, NULL, '', '', 'USTDMULT', NULL, '2303', '0.00', '35.00', NULL, 3, '2006-04-12', '2006-04-12', 1, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1609839638', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870395551', 'W77011869', 'W77011869', 'UT01', 'Chiropractic Health Plan', 'Brandon', 'L', 'Neff', 'DC', 'Chiropractic', NULL, NULL, NULL, 'O', '10358 S Redwood Rd', 'South Jordan', 'Salt Lake', 'UT', '84095', '8012546697', '8012545739', NULL, NULL, '', NULL, NULL, '', '', 'USTDMULT', NULL, '2303', '0.00', '35.00', NULL, 3, '2006-04-12', '2006-04-12', 1, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1609839638', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870395551', 'W77011870', 'W77011870', 'UT01', 'Chiropractic Health Plan', 'Walter', 'W', 'Wagner', 'DC', 'Chiropractic', NULL, NULL, NULL, 'B', '9135 S Monroe St Ste B', 'Sandy', 'Salt Lake', 'UT', '84070', '8013527270', '8013527024', NULL, NULL, '', NULL, NULL, '', '', 'USTDMULT', NULL, '2303', '0.00', '35.00', NULL, 3, '2006-04-28', '2006-04-28', 1, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1396894622', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870395551', 'W77011871', 'W77011871', 'UT01', 'Walter Wagner DC', 'Walter', 'W', 'Wagner', 'DC', 'Chiropractic', NULL, NULL, NULL, 'O', '6271 Dixie Dr Ste 12', 'West Jordan', 'Salt Lake', 'UT', '84084', '8019666200', '8019666424', NULL, NULL, '', NULL, NULL, '', '', 'USTDMULT', NULL, '2303', '0.00', '35.00', NULL, 3, '2006-04-28', '2006-04-28', 1, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1396894622', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870395551', 'W77011872', 'W77011872', 'UT01', 'Chiropractic Health Plan', 'Lance', 'M', 'Tilley', 'DC', 'Chiropractic', NULL, NULL, NULL, 'B', '9135 S Monroe St Ste B', 'Sandy', 'Salt Lake', 'UT', '84070', '8013527270', '8013527024', NULL, NULL, '', NULL, NULL, '', '', 'USTDMULT', NULL, '2303', '0.00', '35.00', NULL, 3, '2006-04-28', '2006-04-28', 1, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '973631', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870395551', 'W77011873', 'W77011873', 'UT01', 'Mountain View Chiropractic', 'Lance', 'M', 'Tilley', 'DC', 'Chiropractic', NULL, NULL, NULL, 'O', '1150 S Depot Dr Ste 200', 'Ogden', 'Weber', 'UT', '84404', '8016216155', '8016216158', NULL, NULL, '', NULL, NULL, '', '', 'USTDMULT', NULL, '2303', '0.00', '35.00', NULL, 3, '2006-04-28', '2006-04-28', 1, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '973631', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870413860', 'W77011874', 'W77011874', 'UT01', 'Now Care Clinic', 'Diane', 'EH', 'Wilson', 'MD', 'Family Practice', NULL, NULL, NULL, 'B', 'PO Box 241', 'Roy', 'Weber', 'UT', '84067', '8016213466', '8016218811', NULL, NULL, '', NULL, NULL, '', '', 'USTDFAM', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2000-02-02', '2006-05-31', 0, 0, 0, 'Davis Hospital', 'Ogden Regional Medical Center', NULL, NULL, 'HCFA|UB|', '1013932185', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870413860', 'W77011875', 'W77011875', 'UT01', 'Now Care Clinic', 'Diane', 'EH', 'Wilson', 'MD', 'Family Practice', NULL, NULL, NULL, 'O', '698 12th St', 'Ogden', 'Weber', 'UT', '84404', '8016213466', '8016218811', NULL, NULL, '', NULL, NULL, '', '', 'USTDFAM', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2000-02-02', '2006-05-31', 0, 0, 0, 'Davis Hospital', 'Ogden Regional Medical Center', NULL, NULL, 'HCFA|UB|', '1013932185', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870423799', 'W77011876', 'W77011876', 'UT01', 'Eyecare Associates', 'Kris', 'A', 'Hill', 'OD', 'Optometry', NULL, NULL, NULL, 'O', '7400 Union Park Ave Ste 202', 'Midvale', 'Salt Lake', 'UT', '84047', '8015693698', '8015690578', NULL, NULL, '', NULL, NULL, '', '', 'UTALBERT', NULL, NULL, '0.00', '25.00', NULL, 3, '2006-03-09', '2006-07-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1043228554', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870437878', 'W77011877', 'W77011877', 'UT01', 'Beaver Medical Clinic', 'R Wade', NULL, 'Oakden', 'MD', 'Family Practice', NULL, NULL, NULL, 'B', 'PO Box 1690', 'Beaver', 'Beaver', 'UT', '84713', '4354387280', '4354387210', NULL, NULL, '', NULL, NULL, '', '', 'URURAL', NULL, NULL, '0.00', '35.00', NULL, 3, '2003-07-16', '2003-07-16', 0, 0, 0, 'Beaver Valley Hospital', 'Beaver Valley Hospital Pro Fee', NULL, NULL, 'HCFA|UB|', '1346245438', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870437878', 'W77011878', 'W77011878', 'UT01', 'Beaver/Milford Medical Clinic', 'R Wade', NULL, 'Oakden', 'MD', 'Family Practice', NULL, NULL, NULL, 'O', '451 N Main', 'Milford', 'Beaver', 'UT', '84751', '4353872471', '4354382475', NULL, NULL, '', NULL, NULL, '', '', 'URURAL', NULL, NULL, '0.00', '35.00', NULL, 3, '2003-07-16', '2006-11-30', 0, 0, 0, 'Beaver Valley Hospital', 'Beaver Valley Hospital Pro Fee', NULL, NULL, 'HCFA|UB|', '1346245438', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL);
INSERT INTO `providers_new` (`Provider_Tax_ID`, `Provider_Suffix`, `Provider_Network_ID`, `Provider_Region`, `Provider_Name`, `Provider_Doctor_First_Name`, `Provider_Doctor_Middle_Name`, `Provider_Doctor_Last_Name`, `Provider_Doctor_Degree`, `Provider_Specialty_1`, `Provider_Specialty_2`, `Provider_Specialty_3`, `Provider_Specialty_4`, `Provider_Address_Type`, `Provider_Address`, `Provider_City`, `Provider_County`, `Provider_State`, `Provider_Zip`, `Provider_Phone`, `Provider_Fax`, `Provider_Mailing_Address`, `Provider_Mailing_City`, `Provider_Mailing_County`, `Provider_Mailing_State`, `Provider_Mailing_Zip`, `Provider_Mailing_Phone`, `Provider_Mailing_Fax`, `Provider_Primary_Schedule`, `Provider_Secondary_Schedule`, `Provider_Rate_Sheet`, `Provider_Anes_Rate`, `Provider_Default_Rate`, `Provider_Max_DOS`, `Provider_Min_Match_Value`, `Provider_Effective_Date`, `Provider_Term_Date`, `Provider_Pend`, `Provider_Anes_Minutes`, `Provider_PPO`, `Provider_Hospital_1`, `Provider_Hospital_2`, `Provider_Hospital_3`, `Provider_Hospital_4`, `Provider_Type`, `Provider_NPI`, `Provider_Check_Override`, `Exclude_Dir`, `Audit_Status`, `Last_Change_Date`, `Medicare_ID`, `Provider_Lang`, `Provider_Latitude`, `Provider_Longitude`, `Provider_school`, `Provider_cert`) VALUES
('870443687', 'W77011879', 'W77011879', 'UT01', 'U Of U Cardiology', 'Josef', NULL, 'Stehlik', 'MD', NULL, NULL, NULL, NULL, 'B', 'PO Box 581700', 'Salt Lake City', 'Salt Lake', 'UT', '84158', '8015817715', NULL, NULL, NULL, '', NULL, NULL, '', '', 'UUUMG', NULL, NULL, '0.00', '25.00', NULL, 3, '2006-03-01', '2006-07-31', 0, 0, 0, 'University Health Care University Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1558458992', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870443687', 'W77011880', 'W77011880', 'UT01', 'U Of U Cardiology-Medical Dr', 'Josef', NULL, 'Stehlik', 'MD', NULL, NULL, NULL, NULL, 'O', '50 N Medical Dr', 'Salt Lake City', 'Salt Lake', 'UT', '84132', '8015817715', NULL, NULL, NULL, '', NULL, NULL, '', '', 'UUUMG', NULL, NULL, '0.00', '25.00', NULL, 3, '2006-03-01', '2006-07-31', 0, 0, 0, 'University Health Care University Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1558458992', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870452022', 'W77011881', 'W77011881', 'UT01', 'Mt Timpanogos Womens Healthcare', 'Amy', 'A', 'Holtsclaw', 'CNM', 'Nurse Midwife', NULL, NULL, NULL, 'O', '1886 W 800 N', 'Pleasant Grove', 'Utah', 'UT', '84062', '8017565288', '8017567589', NULL, NULL, '', NULL, NULL, '', '', 'USTDOBG', NULL, NULL, '0.00', '35.00', NULL, 3, '2006-03-29', '2006-05-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1760444335', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870464264', 'W77011882', 'W77011882', 'UT01', 'Fit Stop Physical Therapy', 'Jay', 'P', 'Andersen', 'OT', 'Occupational Therapy', NULL, NULL, NULL, 'O', '380 E 1500 S', 'Heber City', 'Wasatch', 'UT', '84032', '4356545607', '4356542602', NULL, NULL, '', NULL, NULL, '', '', 'UDME', 'USTDHCPC', '2293', '0.00', '35.00', NULL, 3, '2006-04-05', '2006-12-31', 1, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1396751210', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870464264', 'W77011883', 'W77011883', 'UT01', 'Fit Stop Physical Therapy', 'Michelle', NULL, 'Alegre', 'SLP', 'Speech Therapy', NULL, NULL, NULL, 'O', '380 E 1500 S', 'Heber City', 'Wasatch', 'UT', '84032', '4356545607', '4356542602', NULL, NULL, '', NULL, NULL, '', '', 'UDME', 'USTDHCPC', '2293', '0.00', '35.00', NULL, 3, '2006-04-05', '2006-12-31', 1, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '963713', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870467746', 'W77011884', 'W77011884', 'UT01', 'U Of U Human Development Division', 'Randall', 'W', 'Rupper', 'MD', 'Internal Medicine', 'Internal Medicine', NULL, NULL, 'B', 'PO Box 581700', 'Salt Lake City', 'Salt Lake', 'UT', '84158', '8012386815', NULL, NULL, NULL, '', NULL, NULL, '', '', 'UUUMG', NULL, NULL, '0.00', '25.00', NULL, 3, '2005-09-30', '2006-07-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1457398703', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870467746', 'W77011885', 'W77011885', 'UT01', 'U Of U Human Development Division', 'Randall', 'W', 'Rupper', 'MD', 'Internal Medicine', 'Internal Medicine', NULL, NULL, 'O', '50 N Medical Dr', 'Salt Lake City', 'Salt Lake', 'UT', '84132', '8015812628', NULL, NULL, NULL, '', NULL, NULL, '', '', 'UUUMG', NULL, NULL, '0.00', '25.00', NULL, 3, '2005-09-30', '2006-07-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1457398703', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870474993', 'W77011886', 'W77011886', 'UT01', 'Lifetree Medical', 'Cindie', 'G', 'Dodenbier', 'NP', NULL, NULL, NULL, NULL, 'B', 'PO Box 27688', 'Salt Lake City', 'Salt Lake', 'UT', '84127', '8015341360', NULL, NULL, NULL, '', NULL, NULL, '', '', 'USTDPAIN', NULL, NULL, '0.00', '35.00', NULL, 3, '2006-04-12', '2006-10-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1578565263', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
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('870656811', 'W77011980', 'W77011980', 'UT01', 'Pro Rehab Physical Therapy', 'Justin', 'A', 'Pope', 'OT', 'Occupational Therapy', NULL, NULL, NULL, 'O', '590 E 100 N Ste 1', 'Price', 'Carbon', 'UT', '84501', '4356131500', '4356131501', NULL, NULL, '', NULL, NULL, '', '', NULL, NULL, NULL, '0.00', '0.00', '57.75', 3, '2006-03-29', '2006-12-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '956305', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
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('870656811', 'W77011982', 'W77011982', 'UT01', 'Pro Rehab Physical Therapy', 'Scott', 'R', 'Labrum', 'PT', 'Physical Therapy', NULL, NULL, NULL, 'B', 'PO Box 307', 'Bountiful', 'Davis', 'UT', '84011', '8887006907', NULL, NULL, NULL, '', NULL, NULL, '', '', NULL, NULL, NULL, '0.00', '0.00', '57.75', 3, '2006-03-24', '2006-12-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '958043', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870656811', 'W77011983', 'W77011983', 'UT01', 'Pro Rehab Physical Therapy', 'Scott', 'R', 'Labrum', 'PT', 'Physical Therapy', NULL, NULL, NULL, 'O', '150 E Main', 'Castle Dale', 'Emery', 'UT', '84513', '4353815100', '4353815099', NULL, NULL, '', NULL, NULL, '', '', NULL, NULL, NULL, '0.00', '0.00', '57.75', 3, '2006-03-24', '2006-12-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '958043', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870666061', 'W77011984', 'W77011984', 'UT01', 'Copperview Medical Center', 'Mary', 'D', 'Tipton', 'MD', 'Internal Medicine', 'Pediatrics', NULL, NULL, 'O', '3556 W 9800 S Ste 101', 'South Jordan', 'Salt Lake', 'UT', '84095', '8015679780', '8015679826', NULL, NULL, '', NULL, NULL, '', '', 'USTDMULT', NULL, NULL, '0.00', '35.00', NULL, 3, '2006-03-08', '2006-05-31', 0, 0, 0, 'Jordan Valley Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1922065598', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870680102', 'W77011985', 'W77011985', 'UT02', 'Red Cliffs Administrative Services', 'Robert', 'W', 'Welker', 'MD', 'Family Practice', NULL, NULL, NULL, 'B', '162 E 300 S', 'St George', 'Washington', 'UT', '84770', '4356733521', '4356733522', NULL, NULL, '', NULL, NULL, '', '', 'USTDFAM', NULL, NULL, '0.00', '35.00', NULL, 3, '2006-03-29', '2006-10-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1740278183', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870680102', 'W77011986', 'W77011986', 'UT02', 'Red Cliffs Administrative Services', 'Robert', 'W', 'Welker', 'MD', 'Family Practice', NULL, NULL, NULL, 'O', '162 E 300 S', 'St George', 'Washington', 'UT', '84770', '4356733521', '4356733522', NULL, NULL, '', NULL, NULL, '', '', 'USTDFAM', NULL, NULL, '0.00', '35.00', NULL, 3, '2006-03-29', '2006-10-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1740278183', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870687383', 'W77011987', 'W77011987', 'UT01', 'Western Neurological Associates', 'Gary', 'A', 'Podolny', 'MD', 'Radiologist', NULL, NULL, NULL, 'O', '1151 E 3900 S Ste B150', 'Salt Lake City', 'Salt Lake', 'UT', '84124', '8012623441', NULL, NULL, NULL, '', NULL, NULL, '', '', 'USTDRAD', NULL, NULL, '0.00', '35.00', NULL, 3, '2003-04-01', '2006-05-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '832134', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('876000616', 'W77011988', 'W77011988', 'UT01', 'Blanding Medical Clinic', 'Kevin', 'M', 'Matteson', 'MD', 'General Surgery', NULL, NULL, NULL, 'O', '804 N 400 W', 'Blanding', 'San Juan', 'UT', '84511', '4356782254', '4356782534', NULL, NULL, '', NULL, NULL, '', '', 'URURAL', NULL, NULL, '0.00', '35.00', NULL, 3, '2002-01-01', '2006-10-31', 0, 0, 0, 'Southwest Memorial Hospital', NULL, NULL, NULL, 'HCFA|', '1407853013', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('876000616', 'W77011989', 'W77011989', 'UT01', 'Blanding Medical Clinic', 'Blen', NULL, 'Freestone', 'PA', NULL, NULL, NULL, NULL, 'O', '804 N 400 W', 'Blanding', 'San Juan', 'UT', '84511', '4356782254', '4356782534', NULL, NULL, '', NULL, NULL, '', '', 'URURAL', NULL, NULL, '0.00', '35.00', NULL, 3, '2002-01-01', '2006-10-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|', '1487646337', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W77011990', 'W77011990', 'UT02', 'Bear River Specialists', 'Kevin', 'A', 'Murphy', 'MD', 'General Surgery', 'Internal Medicine', '', NULL, 'B', 'PO Box 27128', 'Salt Lake City', 'Salt Lake', 'UT', '84127', NULL, NULL, 'PO Box 27128', 'Salt Lake City', 'Salt Lake', 'UT', '84127', '', '', 'USTDMULT', NULL, '', '0.00', '35.00', '0.00', 8, '2003-11-07', NULL, 0, 0, 0, 'Brigham City Community Hospital', '', '', '', 'HCFA|UB|', '1083641385', 0, 'Y', 0, '2014-05-12', NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W77011991', 'W77011991', 'UT02', 'Bear River Specialists', 'Kevin', 'A', 'Murphy', 'MD', 'General Surgery', 'Internal Medicine', '', NULL, 'O', '935 N 1000 W', 'Tremonton', 'Box Elder', 'UT', '84337', '4352074800', NULL, '935 N 1000 W', 'Tremonton', 'Box Elder', 'UT', '84337', '4352074800', '', 'USTDMULT', NULL, '', '0.00', '35.00', '0.00', 8, '2003-11-07', NULL, 0, 0, 0, 'Brigham City Community Hospital', '', '', '', 'HCFA|UB|', '1083641385', 0, 'Y', 0, '2014-05-12', NULL, NULL, 0, 0, NULL, NULL);
INSERT INTO `providers_new` (`Provider_Tax_ID`, `Provider_Suffix`, `Provider_Network_ID`, `Provider_Region`, `Provider_Name`, `Provider_Doctor_First_Name`, `Provider_Doctor_Middle_Name`, `Provider_Doctor_Last_Name`, `Provider_Doctor_Degree`, `Provider_Specialty_1`, `Provider_Specialty_2`, `Provider_Specialty_3`, `Provider_Specialty_4`, `Provider_Address_Type`, `Provider_Address`, `Provider_City`, `Provider_County`, `Provider_State`, `Provider_Zip`, `Provider_Phone`, `Provider_Fax`, `Provider_Mailing_Address`, `Provider_Mailing_City`, `Provider_Mailing_County`, `Provider_Mailing_State`, `Provider_Mailing_Zip`, `Provider_Mailing_Phone`, `Provider_Mailing_Fax`, `Provider_Primary_Schedule`, `Provider_Secondary_Schedule`, `Provider_Rate_Sheet`, `Provider_Anes_Rate`, `Provider_Default_Rate`, `Provider_Max_DOS`, `Provider_Min_Match_Value`, `Provider_Effective_Date`, `Provider_Term_Date`, `Provider_Pend`, `Provider_Anes_Minutes`, `Provider_PPO`, `Provider_Hospital_1`, `Provider_Hospital_2`, `Provider_Hospital_3`, `Provider_Hospital_4`, `Provider_Type`, `Provider_NPI`, `Provider_Check_Override`, `Exclude_Dir`, `Audit_Status`, `Last_Change_Date`, `Medicare_ID`, `Provider_Lang`, `Provider_Latitude`, `Provider_Longitude`, `Provider_school`, `Provider_cert`) VALUES
('942854057', 'W77011993', 'W77011993', 'UT02', 'Dixie Regional Medical Center', 'Mette', 'U', 'Hansen', 'MD', 'Physical Medicine and Rehabilitation', NULL, NULL, NULL, 'O', '544 S 400 E', 'St George', 'Washington', 'UT', '84770', '4356884000', '4356885441', NULL, NULL, '', NULL, NULL, '', '', 'URURAL', NULL, NULL, '0.00', '35.00', '0.00', 8, '2005-09-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '0000947130', 0, 'N', 0, '2006-12-15', NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W77011994', 'W77011994', 'UT01', 'Intermountain Health Care', 'Jamile', 'S', 'Woods', 'MD', 'Pulmonary', NULL, NULL, NULL, 'B', 'PO Box 27128', 'Salt Lake City', 'Salt Lake', 'UT', '84127', NULL, NULL, NULL, NULL, '', NULL, NULL, '', '', 'UUVPN', NULL, NULL, '0.00', '35.00', NULL, 8, '2006-04-28', '2006-05-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1114931540', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W77011995', 'W77011995', 'UT01', 'IHC Pulmonary Clinic', 'Jamile', 'S', 'Woods', 'MD', 'Pulmonary', NULL, NULL, NULL, 'O', '1055 N 300 W Ste 500', 'Provo', 'Utah', 'UT', '84604', '8013577291', NULL, NULL, NULL, '', NULL, NULL, '', '', 'UUVPN', NULL, NULL, '0.00', '35.00', NULL, 8, '2006-04-28', '2006-05-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1114931540', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('010814102', 'W77011996', 'W77011996', 'UT01', 'Reed Eye Care', 'Paul', 'Edward', 'Reed', 'OD', 'Optometry', NULL, NULL, NULL, 'O', '1761 N 2000 W Ste 4', 'Ogden', 'Weber', 'UT', '84404', '8017315558', '8017313143', NULL, NULL, '', NULL, NULL, '', '', 'UTALBERT', NULL, NULL, '0.00', '25.00', NULL, 3, '2006-05-26', '2006-08-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '977364', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('010858024', 'W77011997', 'W77011997', 'UT01', 'Interwest Comprehensive Pain Center', 'Vikas', NULL, 'Garg', 'MD', 'Pain Management', NULL, NULL, NULL, 'B', '274 N Main St', 'Logan', 'Cache', 'UT', '84321', '4357531600', NULL, NULL, NULL, '', NULL, NULL, '', '', 'USTDPAIN', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2006-05-26', '2006-12-31', 0, 0, 0, 'Lakeview Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1104852599', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('010858024', 'W77011998', 'W77011998', 'UT01', 'Interwest Comprehensive Pain Center', 'Vikas', NULL, 'Garg', 'MD', 'Pain Management', NULL, NULL, NULL, 'O', '2380 N 400 E Ste A', 'Logan', 'Cache', 'UT', '84341', '4357139681', NULL, NULL, NULL, '', NULL, NULL, '', '', 'USTDPAIN', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2006-05-26', '2006-12-31', 0, 0, 0, 'Lakeview Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1104852599', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('201113815', 'W77011999', 'W77011999', 'UT01', 'Rocky Mountain Therapy Services at First Med East', 'Kimberly', NULL, 'Schonrock-Mazzella', 'PT', 'Physical Therapy', NULL, NULL, NULL, 'B', 'PO Box 307', 'Bountiful', 'Davis', 'UT', '84011', '8012946907', '8012946917', NULL, NULL, '', NULL, NULL, '', '', 'SELECT', NULL, '7140', '0.00', NULL, NULL, 3, '2005-12-16', '2006-12-31', 1, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '949419', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('201113815', 'W77012000', 'W77012000', 'UT01', 'Rocky Mountain Therapy Services at First Med East', 'Kimberly', NULL, 'Schonrock-Mazzella', 'PT', 'Physical Therapy', NULL, NULL, NULL, 'O', '1950 Fort Union Blvd', 'Salt Lake City', 'Salt Lake', 'UT', '84121', '8019431041', '8019438805', NULL, NULL, '', NULL, NULL, '', '', 'SELECT', NULL, '7140', '0.00', NULL, NULL, 3, '2005-12-16', '2006-12-31', 1, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '949419', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('201730782', 'W77012001', 'W77012001', 'UT01', 'Conti Care', 'Laura', 'Croft', 'Maw', 'FNP', 'Nurse Practitioner ', NULL, NULL, NULL, 'O', '1495 N 200 W', 'Orem', 'Utah', 'UT', '84057', '8013616038', '8014893492', NULL, NULL, '', NULL, NULL, '', '', 'USTDFAM', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2006-05-26', '2006-10-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1982661039', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('202278184', 'W77012002', 'W77012002', 'UT01', 'Worksite Wellness', 'c', NULL, 'Worksite Wellness In', 'GROUP', 'Physical Therapy', NULL, NULL, NULL, 'O', '2520 W 4700 S Ste A2', 'Salt Lake City', 'Salt Lake', 'UT', '84118', '8015996412', '8019642435', NULL, NULL, '', NULL, NULL, '', '', 'UDME', 'USTDHCPC', '2293', '0.00', '35.00', NULL, 3, '2006-04-28', '2006-12-31', 1, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '966454', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('202278184', 'W77012003', 'W77012003', 'UT01', 'Worksite Wellness', 'c', NULL, 'Worksite Wellness In', 'GROUP', 'Physical Therapy', NULL, NULL, NULL, 'B', '249 N Main St', 'North Salt Lake', 'Davis', 'UT', '84054', '8012960192', NULL, NULL, NULL, '', NULL, NULL, '', '', 'UDME', 'USTDHCPC', '2293', '0.00', '35.00', NULL, 3, '2006-04-28', '2006-12-31', 1, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '966454', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('203480337', 'W77012004', 'W77012004', 'UT02', 'Tarbet MD PLLC, Kristin J', 'Kristin', 'J', 'Tarbet', 'MD', 'Ophthalmology', NULL, NULL, NULL, 'B', '201 E 5900 S Ste 101', 'Salt Lake City', 'Salt Lake', 'UT', '84107', '8012686600', '8012686602', NULL, NULL, '', NULL, NULL, '', '', 'URSTDOPH', NULL, NULL, '0.00', '35.00', NULL, 3, '2006-05-26', '2006-12-31', 0, 0, 0, 'Dixie Regional Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1083659262', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('203480337', 'W77012005', 'W77012005', 'UT01', 'Cottonwood Eye and Laser', 'Kristin', 'J', 'Tarbet', 'MD', 'Ophthalmology', NULL, NULL, NULL, 'O', '201 E 5900 S Ste 101', 'Salt Lake City', 'Salt Lake', 'UT', '84107', '8012686600', '8012686602', NULL, NULL, '', NULL, NULL, '', '', 'URSTDOPH', NULL, NULL, '0.00', '35.00', NULL, 3, '2006-05-26', '2006-12-31', 0, 0, 0, 'Dixie Regional Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1083659262', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('203480337', 'W77012006', 'W77012006', 'UT02', NULL, 'Kristin', 'J', 'Tarbet', 'MD', 'Ophthalmology', NULL, NULL, NULL, 'O', '619 S Bluff St', 'St George', 'Washington', 'UT', '84770', '4356524040', '4356524041', NULL, NULL, '', NULL, NULL, '', '', 'URSTDOPH', NULL, NULL, '0.00', '35.00', NULL, 3, '2006-05-26', '2006-12-31', 0, 0, 0, 'Dixie Regional Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1083659262', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('204713480', 'W77012007', 'W77012007', 'UT01', 'Foot and Ankle Podiatry', 'John', 'L', 'Black', 'DPM', 'Podiatry', NULL, NULL, NULL, 'O', '875 E 100 N Ste 7', 'Payson', 'Utah', 'UT', '84651', '8014651345', NULL, NULL, NULL, '', NULL, NULL, '', '', 'USTDPOD', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2005-07-29', '2006-08-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1255389136', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('204780557', 'W77012008', 'W77012008', 'UT01', 'David H Warby DPM', 'David', 'H', 'Warby', 'DPM', 'Podiatry', NULL, NULL, NULL, 'O', '934 S Main St', 'Layton', 'Davis', 'UT', '84041', '8015444227', '8015443724', NULL, NULL, '', NULL, NULL, '', '', 'USTDPOD', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2005-08-20', '2006-07-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1912949421', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('364586972', 'W77012009', 'W77012009', 'UT01', 'Pediatric Rapid Treatment Unit Dept U of U', 'tment Unit Dept', ' U of U', 'Pediatric Rapid Trea', 'GROUP', NULL, NULL, NULL, NULL, 'O', '100 N Medical Dr', 'Salt Lake City', 'Salt Lake', 'UT', '84113', '8012367726', NULL, NULL, NULL, '', NULL, NULL, '', '', 'UUUMG', NULL, NULL, '0.00', '25.00', NULL, 3, '2006-07-01', '2006-07-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '979983', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('364586972', 'W77012010', 'W77012010', 'UT01', 'Pediatric Rapid Treatment Unit Dept U of U', 'tment Unit Dept', ' U of U', 'Pediatric Rapid Trea', 'GROUP', NULL, NULL, NULL, NULL, 'B', 'PO Box 581100', 'Salt Lake City', 'Salt Lake', 'UT', '84158', '8015882233', NULL, NULL, NULL, '', NULL, NULL, '', '', 'UUUMG', NULL, NULL, '0.00', '25.00', NULL, 3, '2006-07-01', '2006-07-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '979983', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('371450599', 'W77012011', 'W77012011', 'UT01', 'Mountain Family Health', 'Brian', 'J', 'Rush', 'MD', 'Family Practice', NULL, NULL, NULL, 'B', '348 E 4500 S Ste 220', 'Salt Lake City', 'Salt Lake', 'UT', '84107', '8017477266', NULL, NULL, NULL, '', NULL, NULL, '', '', 'USTDER', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2003-04-01', '2006-11-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1184672511', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('371450599', 'W77012012', 'W77012012', 'UT01', 'Mountain Family Health at Snow Creek', 'Brian', 'J', 'Rush', 'MD', 'Family Practice', NULL, NULL, NULL, 'O', '1600 Snow Creek Dr', 'Park City', 'Summit', 'UT', '84060', '4356550055', '4356558979', NULL, NULL, '', NULL, NULL, '', '', 'USTDER', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2003-04-01', '2006-11-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1184672511', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('371450599', 'W77012013', 'W77012013', 'UT01', 'Mountain Family Health', 'Julie', 'Ann', 'Dolan', 'MD', 'Family Practice', NULL, NULL, NULL, 'B', '348 E 4500 S Ste 220', 'Salt Lake City', 'Salt Lake', 'UT', '84107', '8017477266', NULL, NULL, NULL, '', NULL, NULL, '', '', 'USTDER', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2003-04-01', '2006-11-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1477501252', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('371450599', 'W77012014', 'W77012014', 'UT01', 'Mountain Family Health at Snow Creek', 'Julie', 'Ann', 'Dolan', 'MD', 'Family Practice', NULL, NULL, NULL, 'O', '1600 Snow Creek Dr', 'Park City', 'Summit', 'UT', '84060', '4356550055', '4356558979', NULL, NULL, '', NULL, NULL, '', '', 'USTDER', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2003-04-01', '2006-11-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1477501252', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
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('870616107', 'W77012100', 'W77012100', 'UT01', 'UUHC Billing Office', 'Benjamin', 'N', 'Storz', 'MD', 'Family Practice', NULL, NULL, NULL, 'B', 'PO Box 510708', 'Salt Lake City', 'Salt Lake', 'UT', '84151', '8015876303', '8015876396', NULL, NULL, '', NULL, NULL, '', '', 'UUUMG', NULL, NULL, '0.00', '25.00', NULL, 3, '2006-05-16', '2006-07-31', 0, 0, 0, 'Jordan Valley Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1568417160', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870616107', 'W77012102', 'W77012102', 'UT01', 'UUHC Redwood Center', 'Benjamin', 'N', 'Storz', 'MD', 'Family Practice', NULL, NULL, NULL, 'O', '1525 W 2100 S', 'Salt Lake City', 'Salt Lake', 'UT', '84119', '8018872400', NULL, NULL, NULL, '', NULL, NULL, '', '', 'UUUMG', NULL, NULL, '0.00', '25.00', NULL, 3, '2006-05-16', '2006-07-31', 0, 0, 0, 'Jordan Valley Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1568417160', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870616107', 'W77012103', 'W77012103', 'UT01', 'UUHC Redstone Clinic', 'Benjamin', 'N', 'Storz', 'MD', 'Family Practice', NULL, NULL, NULL, 'O', '1743 Redstone Ctr Dr Ste 115', 'Park City', 'Summit', 'UT', '84098', '4356589200', NULL, NULL, NULL, '', NULL, NULL, '', '', 'UUUMG', NULL, NULL, '0.00', '25.00', NULL, 3, '2006-05-16', '2006-07-31', 0, 0, 0, 'Jordan Valley Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1568417160', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL);
INSERT INTO `providers_new` (`Provider_Tax_ID`, `Provider_Suffix`, `Provider_Network_ID`, `Provider_Region`, `Provider_Name`, `Provider_Doctor_First_Name`, `Provider_Doctor_Middle_Name`, `Provider_Doctor_Last_Name`, `Provider_Doctor_Degree`, `Provider_Specialty_1`, `Provider_Specialty_2`, `Provider_Specialty_3`, `Provider_Specialty_4`, `Provider_Address_Type`, `Provider_Address`, `Provider_City`, `Provider_County`, `Provider_State`, `Provider_Zip`, `Provider_Phone`, `Provider_Fax`, `Provider_Mailing_Address`, `Provider_Mailing_City`, `Provider_Mailing_County`, `Provider_Mailing_State`, `Provider_Mailing_Zip`, `Provider_Mailing_Phone`, `Provider_Mailing_Fax`, `Provider_Primary_Schedule`, `Provider_Secondary_Schedule`, `Provider_Rate_Sheet`, `Provider_Anes_Rate`, `Provider_Default_Rate`, `Provider_Max_DOS`, `Provider_Min_Match_Value`, `Provider_Effective_Date`, `Provider_Term_Date`, `Provider_Pend`, `Provider_Anes_Minutes`, `Provider_PPO`, `Provider_Hospital_1`, `Provider_Hospital_2`, `Provider_Hospital_3`, `Provider_Hospital_4`, `Provider_Type`, `Provider_NPI`, `Provider_Check_Override`, `Exclude_Dir`, `Audit_Status`, `Last_Change_Date`, `Medicare_ID`, `Provider_Lang`, `Provider_Latitude`, `Provider_Longitude`, `Provider_school`, `Provider_cert`) VALUES
('870616107', 'W77012104', 'W77012104', 'UT01', 'UUHC Billing Office', 'David', 'Dewile', 'Poor', 'MD', 'Family Practice', NULL, NULL, NULL, 'B', 'PO Box 510708', 'Salt Lake City', 'Salt Lake', 'UT', '84151', '8015876303', '8015876396', NULL, NULL, '', NULL, NULL, '', '', 'UUUHC', NULL, NULL, '0.00', '35.00', NULL, 3, '2006-05-16', '2006-08-01', 0, 0, 0, 'University Health Care University Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1275589699', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870616107', 'W77012106', 'W77012106', 'UT01', 'UUHC Westridge Center', 'David', 'Dewile', 'Poor', 'MD', 'Family Practice', NULL, NULL, NULL, 'O', '3730 W 4700 S', 'Salt Lake City', 'Salt Lake', 'UT', '84118', '8012139200', NULL, NULL, NULL, '', NULL, NULL, '', '', 'UUUHC', NULL, NULL, '0.00', '35.00', NULL, 3, '2006-05-16', '2006-08-01', 0, 0, 0, 'University Health Care University Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1275589699', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870616107', 'W77012107', 'W77012107', 'UT01', 'UUHC Redwood Urgent Care DNP', 'David', 'Dewile', 'Poor', 'MD', 'Family Practice', NULL, NULL, NULL, 'O', '1525 W 2100 S', 'Salt Lake City', 'Salt Lake', 'UT', '84119', '8018872400', NULL, NULL, NULL, '', NULL, NULL, '', '', 'UUUHC', NULL, NULL, '0.00', '35.00', NULL, 3, '2006-05-16', '2006-08-01', 0, 0, 0, 'University Health Care University Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1275589699', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870640775', 'W77012108', 'W77012108', 'UT01', 'Uuhc Central Billing', 'Wayne', 'L', 'Stokes', 'MD', 'Physical Medicine and Rehabilitation', NULL, NULL, NULL, 'B', 'PO Box 510708', 'Salt Lake City', 'Salt Lake', 'UT', '84151', '8015876600', '8015876396', NULL, NULL, '', NULL, NULL, '', '', 'UUUMG', NULL, '1000', '37.71', NULL, NULL, 3, '2005-01-01', '2006-03-01', 1, 12, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1871622985', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870640775', 'W77012109', 'W77012109', 'UT01', 'UUHC Redwood Clinic', 'Wayne', 'L', 'Stokes', 'MD', 'Physical Medicine and Rehabilitation', NULL, NULL, NULL, 'O', '1525 W 2100 S', 'Salt Lake City', 'Salt Lake', 'UT', '84119', '8018872400', NULL, NULL, NULL, '', NULL, NULL, '', '', 'UUUMG', NULL, '1000', '37.71', NULL, NULL, 3, '2005-01-01', '2006-03-01', 1, 12, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1871622985', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870645559', 'W77012110', 'W77012110', 'UT01', 'U Of U General Peds', 'Richard', 'T', 'Jackson', 'MD', 'Pediatrics', 'Pediatric Internal Medicine', NULL, NULL, 'B', 'PO Box 581100', 'Salt Lake City', 'Salt Lake', 'UT', '84158', '8012367726', '8012367733', NULL, NULL, '', NULL, NULL, '', '', 'UUMGPED', NULL, NULL, '0.00', '15.00', NULL, 3, '2002-07-01', '2006-07-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1295780559', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870645559', 'W77012111', 'W77012111', 'UT01', 'U Of U General Peds', 'Richard', 'T', 'Jackson', 'MD', 'Pediatrics', 'Pediatric Internal Medicine', NULL, NULL, 'O', '50 N Medical Dr', 'Salt Lake City', 'Salt Lake', 'UT', '84132', '8015812321', NULL, NULL, NULL, '', NULL, NULL, '', '', 'UUMGPED', NULL, NULL, '0.00', '15.00', NULL, 3, '2002-07-01', '2006-07-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1295780559', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870645559', 'W77012112', 'W77012112', 'UT01', 'U Of U General Peds', 'Paul', 's', 'Carbone', 'MD', 'Mental Health', 'Pediatrics', NULL, NULL, 'B', 'PO Box 581100', 'Salt Lake City', 'Salt Lake', 'UT', '84158', '8012367726', '8012367733', NULL, NULL, '', NULL, NULL, '', '', 'UUMGPED', NULL, NULL, '0.00', '15.00', NULL, 3, '2006-05-02', '2006-07-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1194796201', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870645559', 'W77012113', 'W77012113', 'UT01', 'U Of U General Peds', 'Paul', 's', 'Carbone', 'MD', 'Mental Health', 'Pediatrics', NULL, NULL, 'O', '50 N Medical Dr', 'Salt Lake City', 'Salt Lake', 'UT', '84132', '8015812321', NULL, NULL, NULL, '', NULL, NULL, '', '', 'UUMGPED', NULL, NULL, '0.00', '15.00', NULL, 3, '2006-05-02', '2006-07-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1194796201', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870645559', 'W77012114', 'W77012114', 'UT01', 'U Of U General Peds', 'Richard', 'L', 'Jackson', 'MD', 'Pediatrics', 'Pediatric Internal Medicine', NULL, NULL, 'B', 'PO Box 581100', 'Salt Lake City', 'Salt Lake', 'UT', '84158', '8012367726', '8012367733', NULL, NULL, '', NULL, NULL, '', '', 'UUMGPED', NULL, NULL, '0.00', '15.00', NULL, 3, '2006-05-15', '2006-07-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1295780559', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870645559', 'W77012115', 'W77012115', 'UT01', 'U Of U General Peds', 'Richard', 'L', 'Jackson', 'MD', 'Pediatrics', 'Pediatric Internal Medicine', NULL, NULL, 'O', '50 N Medical Dr', 'Salt Lake City', 'Salt Lake', 'UT', '84132', '8015812321', NULL, NULL, NULL, '', NULL, NULL, '', '', 'UUMGPED', NULL, NULL, '0.00', '15.00', NULL, 3, '2006-05-15', '2006-07-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1295780559', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870649259', 'W77012116', 'W77012116', 'UT01', 'Alpine Orthopedic Specialists', 'Randy', 'L', 'Chadwell', 'FNP, PA-C', NULL, NULL, NULL, NULL, 'B', 'PO Box 6250', 'Logan', 'Cache', 'UT', '84341', '4357872000', NULL, NULL, NULL, '', NULL, NULL, '', '', 'USTDORTH', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2006-05-11', '2006-10-31', 0, 0, 0, 'Brigham City Community Hospital', 'Logan Regional Hospital', NULL, NULL, 'HCFA|UB|', '1295838605', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870649259', 'W77012117', 'W77012117', 'UT01', 'Alpine Orthopedic Specialists', 'Randy', 'L', 'Chadwell', 'FNP, PA-C', NULL, NULL, NULL, NULL, 'O', '2310 N 400 E Ste A', 'North Ogden', 'Cache', 'UT', '84341', '4357872000', NULL, NULL, NULL, '', NULL, NULL, '', '', 'USTDORTH', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2006-05-11', '2006-10-31', 0, 0, 0, 'Brigham City Community Hospital', 'Logan Regional Hospital', NULL, NULL, 'HCFA|UB|', '1295838605', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870653164', 'W77012118', 'W77012118', 'UT01', 'Utah Digestive Health Institute', 'John', 'E', 'Lowe', 'MD', 'Gastroenterology', NULL, NULL, NULL, 'B', '6028 S Ridgeline Dr Ste 201', 'Ogden', 'Weber', 'UT', '84405', '8014755400', '8014758614', NULL, NULL, '', NULL, NULL, '', '', 'USTDGAST', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2002-04-01', '2002-04-01', 0, 0, 0, 'Davis Hospital', 'Ogden Regional Medical Center', NULL, NULL, 'HCFA|UB|', '1851387195', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870653164', 'W77012119', 'W77012119', 'UT01', 'Utah Digestive Health Institute', 'John', 'E', 'Lowe', 'MD', 'Gastroenterology', NULL, NULL, NULL, 'O', '1660 W Antelope Dr Ste 320', 'Layton', 'Davis', 'UT', '84041', '8017732268', NULL, NULL, NULL, '', NULL, NULL, '', '', 'USTDGAST', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2002-04-01', '2006-12-31', 0, 0, 0, 'Davis Hospital', 'Ogden Regional Medical Center', NULL, NULL, 'HCFA|UB|', '1851387195', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870656811', 'W77012120', 'W77012120', 'UT01', 'Pro Rehab Physical Therapy', 'Jeffrey', 'N', 'Ohlwiler', 'PT', 'Physical Therapy', NULL, NULL, NULL, 'B', 'PO Box 307', 'Bountiful', 'Davis', 'UT', '84011', '8887006907', NULL, NULL, NULL, '', NULL, NULL, '', '', NULL, NULL, NULL, '0.00', '0.00', '57.75', 3, '2001-03-02', '2001-03-02', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '834566', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870656811', 'W77012121', 'W77012121', 'UT01', 'Pro Rehab Physical Therapy', 'Jeffrey', 'N', 'Ohlwiler', 'PT', 'Physical Therapy', NULL, NULL, NULL, 'O', '200 Park Place', 'East Carbon City', 'Carbon', 'UT', '84520', '4356131500', '4356131501', NULL, NULL, '', NULL, NULL, '', '', NULL, NULL, NULL, '0.00', '0.00', '57.75', 3, '2001-03-02', '2006-12-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '834566', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870677196', 'W77012122', 'W77012122', 'UT01', 'Hidden Valley Eye Care', 'Dallin', 'W', 'Rice', 'OD', 'Optometry', NULL, NULL, NULL, 'O', '1223 Draper Pkwy', 'Draper', 'Salt Lake', 'UT', '84020', '8016199555', '8014060444', NULL, NULL, '', NULL, NULL, '', '', 'UTALBERT', NULL, NULL, '0.00', '25.00', NULL, 3, '2006-05-19', '2006-09-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1467444273', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870677196', 'W77012123', 'W77012123', 'UT01', 'Hidden Valley Eye Care', 'R Bradley', NULL, 'Rice', 'OD', 'Optometry', NULL, NULL, NULL, 'O', '1223 Draper Pkwy', 'Draper', 'Salt Lake', 'UT', '84020', '8016199555', '8014060444', NULL, NULL, '', NULL, NULL, '', '', 'UTALBERT', NULL, NULL, '0.00', '25.00', NULL, 3, '2006-05-19', '2006-09-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1740272319', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870682564', 'W77012124', 'W77012124', 'UT01', 'Tipton OD PC, Jeffrey', 'Jeffrey', 'P', 'Tipton', 'OD', 'Optometry', NULL, NULL, NULL, 'B', '3162 W 1100 N', 'West Point', 'Davis', 'UT', '84015', '8017284569', '8014447183', NULL, NULL, '', NULL, NULL, '', '', 'UTALBERT', NULL, NULL, '0.00', '25.00', NULL, 3, '2006-05-19', '2006-11-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1366443079', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870682564', 'W77012125', 'W77012125', 'UT01', 'Tipton OD PC, Jeffrey', 'Jeffrey', 'P', 'Tipton', 'OD', 'Optometry', NULL, NULL, NULL, 'O', '3162 W 1100 N', 'Clearfield', 'Davis', 'UT', '84015', '8017284569', '8014447183', NULL, NULL, '', NULL, NULL, '', '', 'UTALBERT', NULL, NULL, '0.00', '25.00', NULL, 3, '2006-05-19', '2006-11-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1366443079', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870682564', 'W77012126', 'W77012126', 'UT01', 'Jeffrey Tipton OD', 'Jeffrey', 'P', 'Tipton', 'OD', 'Optometry', NULL, NULL, NULL, 'O', '1055 W Hill Field Rd', 'Layton', 'Davis', 'UT', '84041', '8014447160', '8014447183', NULL, NULL, '', NULL, NULL, '', '', 'UTALBERT', NULL, NULL, '0.00', '25.00', NULL, 3, '2006-05-19', '2006-11-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1366443079', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('876000545', 'W77012127', 'W77012127', 'UT01', 'Health Clinics Of Utah', 'Judith', 'A', 'Berry', 'NP', 'Gynecology', NULL, NULL, NULL, 'O', '150 E Ctr St Ste 1100', 'Provo', 'Utah', 'UT', '84606', '8013747011', NULL, NULL, NULL, '', NULL, NULL, '', '', 'USTDFAM', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2003-06-01', '2006-07-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1104884253', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('880432423', 'W77012128', 'W77012128', 'UT02', 'Parker MD PC, R Jeffrey', 'R Jeffrey', NULL, 'Parker', 'MD', 'Ophthalmology', NULL, NULL, NULL, 'B', '653 N Town Ctr Dr Ste 518', 'Las Vegas', 'Clark', 'NV', '89144', '7023690200', '7022438383', NULL, NULL, '', NULL, NULL, '', '', 'USTDOPHT', NULL, NULL, '0.00', '35.00', NULL, 3, '2006-05-26', '2006-12-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '966674', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('880432423', 'W77012129', 'W77012129', 'UT02', 'Retina Consultants of Southern Utah', 'R Jeffrey', NULL, 'Parker', 'MD', 'Ophthalmology', NULL, NULL, NULL, 'O', '1791 E 280 N', 'St George', 'Washington', 'UT', '84790', '7023690200', '7022438383', NULL, NULL, '', NULL, NULL, '', '', 'USTDOPHT', NULL, NULL, '0.00', '35.00', NULL, 3, '2006-05-26', '2006-12-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '966674', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('912194953', 'W77012130', 'W77012130', 'UT01', 'Foot & Ankle Specialty Clinic', 'William', 'W', 'Martin', 'DPM', 'Podiatry', NULL, NULL, NULL, 'B', '550 E 1400 N Ste N', 'Logan', 'Cache', 'UT', '84341', '4357533953', NULL, NULL, NULL, '', NULL, NULL, '', '', 'USTDMULT', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2003-04-01', '2003-04-01', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1023013794', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('912194953', 'W77012131', 'W77012131', 'UT01', 'Foot & Ankle Specialty Clinic', 'William', 'W', 'Martin', 'DPM', 'Podiatry', NULL, NULL, NULL, 'O', '255 S 100 E', 'Tooele', 'Tooele', 'UT', '84074', '4358439888', NULL, NULL, NULL, '', NULL, NULL, '', '', 'USTDMULT', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2003-04-01', '2006-12-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1023013794', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W77012132', 'W77012132', 'UT02', 'Intermountain Health Care', 'Dixie', 'Lee', 'Harris', 'MD', 'Pulmonary', '', '', NULL, 'B', 'PO Box 27128', 'Salt Lake City', 'Salt Lake', 'UT', '84127', NULL, NULL, NULL, NULL, '', NULL, NULL, '', '', 'USTDMULT', 'USTDHCPC', NULL, '0.00', '35.00', '0.00', 8, '2006-05-26', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1740296730', 0, 'Y', 0, '2008-07-29', NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W77012133', 'W77012133', 'UT02', 'American Fork Pulmonary Clinic', 'Dixie', 'Lee', 'Harris', 'MD', 'Pulmonary', '', '', NULL, 'O', '170 N 1100 E', 'American Fork', 'Utah', 'UT', '84003', '8018554222', '8013577919', NULL, NULL, '', NULL, NULL, '', '', 'USTDMULT', 'USTDHCPC', NULL, '0.00', '35.00', '0.00', 8, '2006-05-26', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1740296730', 0, 'Y', 0, '2008-07-29', NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W77012134', 'W77012134', 'UT02', 'Intermountain Health Care', 'Blaine', 'J', 'Cashmore', 'MD', 'General Surgery', '', '', NULL, 'B', 'PO Box 27128', 'Salt Lake City', 'Salt Lake', 'UT', '84127', NULL, NULL, NULL, NULL, '', NULL, NULL, '', '', 'USTDSURG', 'USTDHCPC', NULL, '0.00', '35.00', '0.00', 8, '2006-05-26', NULL, 0, 0, 0, 'Mountain West Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1174576144', 0, 'Y', 0, '2006-12-15', NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W77012135', 'W77012135', 'UT01', 'Intermountain Health Care', 'Blaine', 'J', 'Cashmore', 'MD', 'General Surgery', NULL, NULL, NULL, 'B', 'PO Box 27128', 'Salt Lake City', 'Salt Lake', 'UT', '84127', NULL, NULL, NULL, NULL, '', NULL, NULL, '', '', 'USTDSURG', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 8, '2006-05-26', '2006-05-26', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '975655', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W77012136', 'W77012136', 'UT02', 'IHC Heber Clinic', 'Blaine', 'J', 'Cashmore', 'MD', 'General Surgery', '', '', NULL, 'O', '1485 S Hwy 40 Ste E', 'Heber City', 'Wasatch', 'UT', '84032', '4356574400', '4356574460', NULL, NULL, '', NULL, NULL, '', '', 'USTDSURG', 'USTDHCPC', NULL, '0.00', '35.00', '0.00', 8, '2006-05-26', NULL, 0, 0, 0, 'Mountain West Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1174576144', 0, 'Y', 0, '2006-12-15', NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W77012137', 'W77012137', 'UT02', NULL, 'Blaine', 'J', 'Cashmore', 'MD', 'General Surgery', '', '', NULL, 'O', '1820 Sidewinder Dr', 'Park City', 'Summit', 'UT', '84060', '4356574460', '4356574460', NULL, NULL, '', NULL, NULL, '', '', 'USTDSURG', 'USTDHCPC', NULL, '0.00', '35.00', '0.00', 8, '2006-05-26', NULL, 0, 0, 0, 'Mountain West Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1174576144', 0, 'Y', 0, '2006-12-15', NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W77012138', 'W77012138', 'UT02', 'Intermountain Health Care', 'William', 'T', 'Sause', 'MD', 'Radiation Oncology', NULL, NULL, NULL, 'B', 'PO Box 27128', 'Salt Lake City', 'Salt Lake', 'UT', '84127', NULL, NULL, NULL, NULL, '', NULL, NULL, '', '', 'USTDMULT', NULL, NULL, '0.00', '35.00', NULL, 8, '2006-05-19', '2006-12-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1881612927', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W77012139', 'W77012139', 'UT02', 'Dixie Regional Medical Center', 'William', 'T', 'Sause', 'MD', 'Radiation Oncology', '', '', NULL, 'O', '544 S 400 E', 'St George', 'Washington', 'UT', '84770', '4356885447', '4356885441', '544 S 400 E', 'St George', 'Salt Lake', 'UT', '84770', '4356885447', '4356885441', 'USTDMULT', NULL, NULL, '0.00', '35.00', '0.00', 8, '2006-05-19', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1881612927', 0, 'N', 0, '2010-06-07', NULL, NULL, 0, 0, NULL, NULL),
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('204187908', 'W77012208', 'W77012208', 'UT01', 'Belnap and Van der Werf Surgical Assc', 'LeGrand', 'P', 'Belnap', 'MD', 'General Surgery', NULL, NULL, NULL, 'O', '1250 E 3900 S Ste 220', 'Salt Lake City', 'Salt Lake', 'UT', '84124', '8012534103', '8012530942', NULL, NULL, '', NULL, NULL, '', '', 'WCSTLPB5', NULL, NULL, '0.00', '0.00', NULL, 3, '2002-11-01', '2006-10-31', 0, 0, 0, 'Salt Lake Regional Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1225060676', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('204457261', 'W77012209', 'W77012209', 'UT02', 'Summit Foot and Ankle Clinic', 'Brad', 'S', 'Webb', 'MD', 'Podiatry', NULL, NULL, NULL, 'O', '230 N 1680 E Ste I-2', 'St George', 'Washington', 'UT', '84790', '4356529515', NULL, NULL, NULL, '', NULL, NULL, '', '', 'USTDPOD', NULL, NULL, '0.00', '35.00', NULL, 3, '2006-07-27', '2006-10-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '976713', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL);
INSERT INTO `providers_new` (`Provider_Tax_ID`, `Provider_Suffix`, `Provider_Network_ID`, `Provider_Region`, `Provider_Name`, `Provider_Doctor_First_Name`, `Provider_Doctor_Middle_Name`, `Provider_Doctor_Last_Name`, `Provider_Doctor_Degree`, `Provider_Specialty_1`, `Provider_Specialty_2`, `Provider_Specialty_3`, `Provider_Specialty_4`, `Provider_Address_Type`, `Provider_Address`, `Provider_City`, `Provider_County`, `Provider_State`, `Provider_Zip`, `Provider_Phone`, `Provider_Fax`, `Provider_Mailing_Address`, `Provider_Mailing_City`, `Provider_Mailing_County`, `Provider_Mailing_State`, `Provider_Mailing_Zip`, `Provider_Mailing_Phone`, `Provider_Mailing_Fax`, `Provider_Primary_Schedule`, `Provider_Secondary_Schedule`, `Provider_Rate_Sheet`, `Provider_Anes_Rate`, `Provider_Default_Rate`, `Provider_Max_DOS`, `Provider_Min_Match_Value`, `Provider_Effective_Date`, `Provider_Term_Date`, `Provider_Pend`, `Provider_Anes_Minutes`, `Provider_PPO`, `Provider_Hospital_1`, `Provider_Hospital_2`, `Provider_Hospital_3`, `Provider_Hospital_4`, `Provider_Type`, `Provider_NPI`, `Provider_Check_Override`, `Exclude_Dir`, `Audit_Status`, `Last_Change_Date`, `Medicare_ID`, `Provider_Lang`, `Provider_Latitude`, `Provider_Longitude`, `Provider_school`, `Provider_cert`) VALUES
('204574521', 'W77012210', 'W77012210', 'UT01', 'Health for Life', 'Douglas', 'K', 'Endo', 'PT', 'Physical Therapy', NULL, NULL, NULL, 'O', '5974 Fashion Point Dr Ste 110', 'Ogden', 'Weber', 'UT', '84403', '8014756800', '8014756802', NULL, NULL, '', NULL, NULL, '', '', NULL, NULL, NULL, '0.00', '0.00', '57.75', 3, '2005-05-20', '2006-12-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '925104', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('204673147', 'W77012211', 'W77012211', 'UT01', 'The Foot and Ankle Health Center', 'John', 'T', 'Cloninger', 'DPM', 'Podiatry', NULL, NULL, NULL, 'O', '6028 S Ridgeline Dr Ste 205', 'Ogden', 'Weber', 'UT', '84405', '8014092100', '8014758614', NULL, NULL, '', NULL, NULL, '', '', 'USTDPOD', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2006-07-27', '2006-12-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1457304180', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('204872226', 'W77012212', 'W77012212', 'UT01', NULL, 'Richard', 'T', 'Stevens', 'MD', 'Family Practice', NULL, NULL, NULL, 'O', '169 Springcreek Pkwy PO Box 609', 'Providence', 'Cache', 'UT', '84332', '4357520330', '4357550922', NULL, NULL, '', NULL, NULL, '', '', 'USTDFAM', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2006-07-13', '2006-10-31', 0, 0, 0, 'Logan Regional Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1790739449', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('205297628', 'W77012213', 'W77012213', 'UT01', NULL, 'Stacey', NULL, 'Bank', 'MD', 'Family Practice', 'Emergency Medicine', NULL, NULL, 'O', '1151 E 3900 S Ste B299', 'Salt Lake City', 'Salt Lake', 'UT', '84124', '8018920135', '8012662362', NULL, NULL, '', NULL, NULL, '', '', 'USTDINT', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2005-09-30', '2006-11-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1790797959', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('223887117', 'W77012214', 'W77012214', 'UT01', 'Mountain Valley Eye Institute', 'Sandra', 'J', 'Lehman', 'OD', 'Optometry', NULL, NULL, NULL, 'B', 'PO Box 27688', 'Salt Lake City', 'Salt Lake', 'UT', '84127', '8015341360', '8013669883', NULL, NULL, '', NULL, NULL, '', '', 'USTDOPHT', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2005-12-20', '2006-10-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1598708182', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('223887117', 'W77012215', 'W77012215', 'UT01', 'Mountain Valley Eye Institute', 'Sandra', 'J', 'Lehman', 'OD', 'Optometry', NULL, NULL, NULL, 'O', '2700 Homestead Rd Ste 30', 'Park City', 'Summit', 'UT', '84098', '4356583090', NULL, NULL, NULL, '', NULL, NULL, '', '', 'USTDOPHT', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2005-12-20', '2006-10-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1598708182', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('237268471', 'W77012216', 'W77012216', 'UT01', 'U Of U Radiology Associates', 'Sheldon', 'L', 'Litwin', 'MD', 'Cardiovascular Disease', 'Radiologist', NULL, NULL, 'B', 'PO Box 581200', 'Salt Lake City', 'Salt Lake', 'UT', '84158', '8012367725', NULL, NULL, NULL, '', NULL, NULL, '', '', 'UUUMG', NULL, '1000', '37.71', NULL, NULL, 3, '1999-09-01', '2006-07-31', 1, 12, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1861447989', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('237268471', 'W77012217', 'W77012217', 'UT01', 'U Of U Radiology Associates', 'Sheldon', 'L', 'Litwin', 'MD', 'Cardiovascular Disease', 'Radiologist', NULL, NULL, 'O', '50 N Medical Dr', 'Salt Lake City', 'Salt Lake', 'UT', '84132', '8012367725', NULL, NULL, NULL, '', NULL, NULL, '', '', 'UUUMG', NULL, '1000', '37.71', NULL, NULL, 3, '1999-09-01', '2006-07-31', 1, 12, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1861447989', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('237268471', 'W77012218', 'W77012218', 'UT01', 'U Of U Radiology Associates', 'Shannon', 'E', 'Bownds', 'MD', 'Radiologist', NULL, NULL, NULL, 'B', 'PO Box 581200', 'Salt Lake City', 'Salt Lake', 'UT', '84158', '8012367725', NULL, NULL, NULL, '', NULL, NULL, '', '', 'UUUMG', NULL, '1000', '37.71', NULL, NULL, 3, '2006-07-01', '2006-07-31', 1, 12, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '991489', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
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('870305037', 'W77012302', 'W77012302', 'UT01', 'Nelson, John C', 'Roger', 'F', 'Young', 'OD', 'Optometry', NULL, NULL, NULL, 'B', '3465 Pioneer Pkwy Ste 4', 'West Valley', 'Salt Lake', 'UT', '84120', '8019660081', '8019660218', NULL, NULL, '', NULL, NULL, '', '', 'USTDOPHT', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2006-07-13', '2006-09-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1366554461', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870305037', 'W77012303', 'W77012303', 'UT01', 'Nelson, John C', 'Roger', 'F', 'Young', 'OD', 'Optometry', NULL, NULL, NULL, 'O', '3465 Pioneer Pkwy Ste 4', 'West Valley', 'Salt Lake', 'UT', '84120', '8019660081', '8019660218', NULL, NULL, '', NULL, NULL, '', '', 'USTDOPHT', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2006-07-13', '2006-09-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1366554461', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870373083', 'W77012305', 'W77012305', 'UT01', 'Heart And Lung Institute', 'Bruce', 'R', 'Kenwood', 'DO', NULL, NULL, NULL, NULL, 'O', '5979 S Fashion Blvd', 'Murray', 'Salt Lake', 'UT', '84107', '8012632370', '8012651200', NULL, NULL, '', NULL, NULL, '', '', 'USTDCARD', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2006-07-05', '2006-09-30', 0, 0, 0, 'Jordan Valley Medical Center', 'Salt Lake Regional Medical Center', NULL, NULL, 'HCFA|UB|', '1144279019', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870373083', 'W77012306', 'W77012306', 'UT01', 'Heart And Lung Institute', 'Bruce', 'R', 'Kenwood', 'DO', NULL, NULL, NULL, NULL, 'O', '3570 W 9000 S Ste 110', 'West Jordan', 'Salt Lake', 'UT', '84088', '8012330140', '8012330148', NULL, NULL, '', NULL, NULL, '', '', 'USTDCARD', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2006-07-05', '2006-09-30', 0, 0, 0, 'Jordan Valley Medical Center', 'Salt Lake Regional Medical Center', NULL, NULL, 'HCFA|UB|', '1144279019', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870380540', 'W77012307', 'W77012307', 'UT01', 'Western Urological Clinic', 'Peter', 'C', 'Fisher', 'MD', 'Urology', NULL, NULL, NULL, 'O', '4252 Highland Dr Ste 200', 'Salt Lake City', 'Salt Lake', 'UT', '84124', '8019931800', NULL, NULL, NULL, '', NULL, NULL, '', '', 'USTDURO', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2006-07-27', '2006-11-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1902847940', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870383107', 'W77012308', 'W77012308', 'UT01', NULL, 'Curtis', 'M', 'Campbell', 'MD', 'Urology', NULL, NULL, NULL, 'O', '4403 Harrison Blvd Ste 4400', 'Ogden', 'Weber', 'UT', '84403', '8013574550', '8013874565', NULL, NULL, '', NULL, NULL, '', '', 'USTDSURG', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2006-07-20', '2006-12-31', 0, 0, 0, 'Ogden Regional Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1023059557', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870393111', 'W77012309', 'W77012309', 'UT01', 'Ogden Audiology Services', 'Stephen', NULL, 'Harward', 'AUD', 'Audiology', NULL, NULL, NULL, 'B', '425 E 5350 S Ste 120', 'Ogden', 'Weber', 'UT', '84405', '8014793346', NULL, NULL, NULL, '', NULL, NULL, '', '', 'USTDOTHR', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '1998-01-01', '2006-07-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1609899459', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870393111', 'W77012310', 'W77012310', 'UT01', 'Ogden Audiology Services', 'Stephen', NULL, 'Harward', 'AUD', 'Audiology', NULL, NULL, NULL, 'O', '3903 Harrison Blvd Ste 201', 'Ogden', 'Weber', 'UT', '84403', '8014793346', NULL, NULL, NULL, '', NULL, NULL, '', '', 'USTDOTHR', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '1998-01-01', '2006-07-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1609899459', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870395551', 'W77012311', 'W77012311', 'UT02', 'Chiropractic Health Plan', 'Neil', 'C', 'Logan', 'DC', 'Chiropractic', NULL, NULL, NULL, 'B', '9135 S Monroe St Ste B', 'Sandy', 'Salt Lake', 'UT', '84070', '8013527270', '8013527024', NULL, NULL, '', NULL, NULL, '', '', 'SELECT', NULL, '2303', '0.00', NULL, NULL, 3, '2006-07-05', '2006-07-05', 1, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1538234653', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870395551', 'W77012312', 'W77012312', 'UT02', 'Chiropractic Health Plan', 'Neil', 'C', 'Logan', 'DC', 'Chiropractic', NULL, NULL, NULL, 'O', '943 S Main St Ste 2', 'Cedar City', 'Iron', 'UT', '84720', '4355900797', NULL, NULL, NULL, '', NULL, NULL, '', '', 'SELECT', NULL, '2303', '0.00', NULL, NULL, 3, '2006-07-05', '2006-07-05', 1, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1538234653', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870395551', 'W77012313', 'W77012313', 'UT01', 'Chiropractic Health Plan', 'Lew', 'A', 'Wheelwright', 'DC', 'Chiropractic', NULL, NULL, NULL, 'B', '9135 S Monroe St Ste B', 'Sandy', 'Salt Lake', 'UT', '84070', '8013527270', '8013527024', NULL, NULL, '', NULL, NULL, '', '', 'SELECT', NULL, '2303', '0.00', NULL, NULL, 3, '2006-07-05', '2006-07-05', 1, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1194732933', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870395551', 'W77012314', 'W77012314', 'UT01', 'Chiropractic Health Center', 'Lew', 'A', 'Wheelwright', 'DC', 'Chiropractic', NULL, NULL, NULL, 'O', '3500 Harrison Blvd Ste 200', 'Ogden', 'Weber', 'UT', '84403', '8016272225', '8016272228', NULL, NULL, '', NULL, NULL, '', '', 'SELECT', NULL, '2303', '0.00', NULL, NULL, 3, '2006-07-05', '2006-07-05', 1, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1194732933', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870395551', 'W77012315', 'W77012315', 'UT01', 'Chiropractic Health Plan', 'Lori', 'L', 'Bosley', 'DC', 'Chiropractic', NULL, NULL, NULL, 'B', '9135 S Monroe St Ste B', 'Sandy', 'Salt Lake', 'UT', '84070', '8013527270', '8013527024', NULL, NULL, '', NULL, NULL, '', '', 'SELECT', NULL, '2303', '0.00', NULL, NULL, 3, '2006-07-05', '2006-07-05', 1, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1164638300', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870395551', 'W77012316', 'W77012316', 'UT01', 'Chiropractic Health Center', 'Lori', 'L', 'Bosley', 'DC', 'Chiropractic', NULL, NULL, NULL, 'O', '3500 Harrison Blvd Ste 200', 'Ogden', 'Weber', 'UT', '84403', '8016272225', '8016272228', NULL, NULL, '', NULL, NULL, '', '', 'SELECT', NULL, '2303', '0.00', NULL, NULL, 3, '2006-07-05', '2006-07-05', 1, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1164638300', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL);
INSERT INTO `providers_new` (`Provider_Tax_ID`, `Provider_Suffix`, `Provider_Network_ID`, `Provider_Region`, `Provider_Name`, `Provider_Doctor_First_Name`, `Provider_Doctor_Middle_Name`, `Provider_Doctor_Last_Name`, `Provider_Doctor_Degree`, `Provider_Specialty_1`, `Provider_Specialty_2`, `Provider_Specialty_3`, `Provider_Specialty_4`, `Provider_Address_Type`, `Provider_Address`, `Provider_City`, `Provider_County`, `Provider_State`, `Provider_Zip`, `Provider_Phone`, `Provider_Fax`, `Provider_Mailing_Address`, `Provider_Mailing_City`, `Provider_Mailing_County`, `Provider_Mailing_State`, `Provider_Mailing_Zip`, `Provider_Mailing_Phone`, `Provider_Mailing_Fax`, `Provider_Primary_Schedule`, `Provider_Secondary_Schedule`, `Provider_Rate_Sheet`, `Provider_Anes_Rate`, `Provider_Default_Rate`, `Provider_Max_DOS`, `Provider_Min_Match_Value`, `Provider_Effective_Date`, `Provider_Term_Date`, `Provider_Pend`, `Provider_Anes_Minutes`, `Provider_PPO`, `Provider_Hospital_1`, `Provider_Hospital_2`, `Provider_Hospital_3`, `Provider_Hospital_4`, `Provider_Type`, `Provider_NPI`, `Provider_Check_Override`, `Exclude_Dir`, `Audit_Status`, `Last_Change_Date`, `Medicare_ID`, `Provider_Lang`, `Provider_Latitude`, `Provider_Longitude`, `Provider_school`, `Provider_cert`) VALUES
('870395551', 'W77012317', 'W77012317', 'UT01', 'Chiropractic Health Plan', 'Ryan', 'B', 'Bosley', 'DC', 'Chiropractic', NULL, NULL, NULL, 'B', '9135 S Monroe St Ste B', 'Sandy', 'Salt Lake', 'UT', '84070', '8013527270', '8013527024', NULL, NULL, '', NULL, NULL, '', '', 'SELECT', NULL, '2303', '0.00', NULL, NULL, 3, '2006-07-05', '2006-07-05', 1, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1013020213', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870395551', 'W77012318', 'W77012318', 'UT01', 'Chiropractic Health Center', 'Ryan', 'B', 'Bosley', 'DC', 'Chiropractic', NULL, NULL, NULL, 'O', '3500 Harrison Blvd Ste 200', 'Ogden', 'Weber', 'UT', '84403', '8016272225', '8016272228', NULL, NULL, '', NULL, NULL, '', '', 'SELECT', NULL, '2303', '0.00', NULL, NULL, 3, '2006-07-05', '2006-07-05', 1, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1013020213', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870395551', 'W77012319', 'W77012319', 'UT01', 'Chiropractic Health Plan', 'Richard', 'P', 'Amon', 'DC', 'Chiropractic', NULL, NULL, NULL, 'B', '9135 S Monroe St Ste B', 'Sandy', 'Salt Lake', 'UT', '84070', '8013527270', '8013527024', NULL, NULL, '', NULL, NULL, '', '', 'SELECT', NULL, '2303', '0.00', NULL, NULL, 3, '2006-06-26', '2006-06-26', 1, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1265407282', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870395551', 'W77012320', 'W77012320', 'UT01', 'Amon Chiropractic Center', 'Richard', 'P', 'Amon', 'DC', 'Chiropractic', NULL, NULL, NULL, 'O', '3996 S 1900 W', 'Roy', 'Weber', 'UT', '84067', '8017312200', '8017312228', NULL, NULL, '', NULL, NULL, '', '', 'SELECT', NULL, '2303', '0.00', NULL, NULL, 3, '2006-06-26', '2006-06-26', 1, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1265407282', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870395551', 'W77012321', 'W77012321', 'UT01', 'Chiropractic Health Plan', 'Gailen', 'E', 'Lundell', 'DC', 'Chiropractic', NULL, NULL, NULL, 'B', '9135 S Monroe St Ste B', 'Sandy', 'Salt Lake', 'UT', '84070', '8013527270', '8013527024', NULL, NULL, '', NULL, NULL, '', '', 'SELECT', NULL, '2303', '0.00', NULL, NULL, 3, '2006-07-20', '2006-07-20', 1, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1093765364', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870395551', 'W77012322', 'W77012322', 'UT01', 'Chiropractic Health Center', 'Gailen', 'E', 'Lundell', 'DC', 'Chiropractic', NULL, NULL, NULL, 'O', '3500 Harrison Blvd Ste 200', 'Ogden', 'Weber', 'UT', '84403', '8016272225', '8016272228', NULL, NULL, '', NULL, NULL, '', '', 'SELECT', NULL, '2303', '0.00', NULL, NULL, 3, '2006-07-20', '2006-07-20', 1, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1093765364', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870395551', 'W77012323', 'W77012323', 'UT01', 'Chiropractic Health Plan', 'Brian', 'J', 'Lundell', 'DC', 'Chiropractic', NULL, NULL, NULL, 'B', '9135 S Monroe St Ste B', 'Sandy', 'Salt Lake', 'UT', '84070', '8013527270', '8013527024', NULL, NULL, '', NULL, NULL, '', '', 'SELECT', NULL, '2303', '0.00', NULL, NULL, 3, '2006-07-20', '2006-07-20', 1, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1992756365', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870395551', 'W77012324', 'W77012324', 'UT01', 'Chiropractic Health Center', 'Brian', 'J', 'Lundell', 'DC', 'Chiropractic', NULL, NULL, NULL, 'O', '3500 Harrison Blvd Ste 200', 'Ogden', 'Weber', 'UT', '84403', '8016272225', '8016272228', NULL, NULL, '', NULL, NULL, '', '', 'SELECT', NULL, '2303', '0.00', NULL, NULL, 3, '2006-07-20', '2006-07-20', 1, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1992756365', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870395551', 'W77012325', 'W77012325', 'UT01', 'Chiropractic Health Plan', 'J Dean', NULL, 'Fitzgerald', 'DC', 'Chiropractic', NULL, NULL, NULL, 'B', '9135 S Monroe St Ste B', 'Sandy', 'Salt Lake', 'UT', '84070', '8013527270', '8013527024', NULL, NULL, '', NULL, NULL, '', '', 'SELECT', NULL, '2303', '0.00', NULL, NULL, 3, '2006-07-20', '2006-07-20', 1, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1427129105', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870395551', 'W77012326', 'W77012326', 'UT01', 'Leading Edge Chiropractic', 'J Dean', NULL, 'Fitzgerald', 'DC', 'Chiropractic', NULL, NULL, NULL, 'O', '375 E Lagoon St', 'Roosevelt', 'Duchesne', 'UT', '84066', '4357221461', '4357221444', NULL, NULL, '', NULL, NULL, '', '', 'SELECT', NULL, '2303', '0.00', NULL, NULL, 3, '2006-07-20', '2006-07-20', 1, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1427129105', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870410144', 'W77012327', 'W77012327', 'UT01', 'U Of U Dept Of Ob/Gyn', 'Katherine', NULL, 'Morgan', 'APRN', 'Obstetrics and Gynecology', NULL, NULL, NULL, 'B', 'PO Box 58859', 'Salt Lake City', 'Salt Lake', 'UT', '84158', '8015855172', '8015855164', NULL, NULL, '', NULL, NULL, '', '', 'UUUMG', NULL, '1000', '37.71', NULL, NULL, 3, '2003-10-29', '2006-07-31', 1, 12, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1629021647', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870410144', 'W77012328', 'W77012328', 'UT01', 'U Of U Dept Of Ob/Gyn', 'Katherine', NULL, 'Morgan', 'APRN', 'Obstetrics and Gynecology', NULL, NULL, NULL, 'O', '50 N Medical Dr', 'Salt Lake City', 'Salt Lake', 'UT', '84132', '8015812719', NULL, NULL, NULL, '', NULL, NULL, '', '', 'UUUMG', NULL, '1000', '37.71', NULL, NULL, 3, '2003-10-29', '2006-07-31', 1, 12, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1629021647', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870410144', 'W77012329', 'W77012329', 'UT01', 'U Of U Dept Of Ob/Gyn', 'Erin', 'AS', 'Clark', 'MD', 'Obstetrics and Gynecology', 'Maternal Fetal Medicine', NULL, NULL, 'B', 'PO Box 58859', 'Salt Lake City', 'Salt Lake', 'UT', '84158', '8015855172', '8015855164', NULL, NULL, '', NULL, NULL, '', '', 'UUUMG', NULL, NULL, '0.00', '25.00', NULL, 3, '2006-07-01', '2006-07-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1457305757', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870410144', 'W77012330', 'W77012330', 'UT01', 'U Of U Dept Of Ob/Gyn', 'Erin', 'AS', 'Clark', 'MD', 'Obstetrics and Gynecology', 'Maternal Fetal Medicine', NULL, NULL, 'O', '50 N Medical Dr', 'Salt Lake City', 'Salt Lake', 'UT', '84132', '8015812719', NULL, NULL, NULL, '', NULL, NULL, '', '', 'UUUMG', NULL, NULL, '0.00', '25.00', NULL, 3, '2006-07-01', '2006-07-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1457305757', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870410144', 'W77012331', 'W77012331', 'UT01', 'U Of U Dept Of Ob/Gyn', 'Jennifer', 'E', 'Warren', 'MD', 'Obstetrics and Gynecology', NULL, NULL, NULL, 'B', 'PO Box 58859', 'Salt Lake City', 'Salt Lake', 'UT', '84158', '8015855172', '8015855164', NULL, NULL, '', NULL, NULL, '', '', 'UUUMG', NULL, NULL, '0.00', '25.00', NULL, 3, '2006-07-01', '2006-07-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1558315853', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870410144', 'W77012332', 'W77012332', 'UT01', 'U Of U Dept Of Ob/Gyn', 'Jennifer', 'E', 'Warren', 'MD', 'Obstetrics and Gynecology', NULL, NULL, NULL, 'O', '50 N Medical Dr', 'Salt Lake City', 'Salt Lake', 'UT', '84132', '8015812719', NULL, NULL, NULL, '', NULL, NULL, '', '', 'UUUMG', NULL, NULL, '0.00', '25.00', NULL, 3, '2006-07-01', '2006-07-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1558315853', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870414618', 'W77012333', 'W77012333', 'UT02', 'Foot And Ankle Institute', 'Leon', 'K', 'Reber', 'DPM', 'Podiatry', NULL, NULL, NULL, 'B', '754 S Main St Ste 3', 'St George', 'Washington', 'UT', '84770', '4356282671', NULL, NULL, NULL, '', NULL, NULL, '', '', 'USTDPOD', NULL, NULL, '0.00', '35.00', NULL, 3, '2006-07-27', '2006-12-31', 0, 0, 0, 'Dixie Regional Medical Center', 'Valley View Medical Center', NULL, NULL, 'HCFA|UB|', '1336179886', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870414618', 'W77012334', 'W77012334', 'UT02', 'Foot And Ankle Institute', 'Leon', 'K', 'Reber', 'DPM', 'Podiatry', NULL, NULL, NULL, 'O', '754 S Main St Ste 3', 'St George', 'Washington', 'UT', '84770', '4356282671', NULL, NULL, NULL, '', NULL, NULL, '', '', 'USTDPOD', NULL, NULL, '0.00', '35.00', NULL, 3, '2006-07-27', '2006-12-31', 0, 0, 0, 'Dixie Regional Medical Center', 'Valley View Medical Center', NULL, NULL, 'HCFA|UB|', '1336179886', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870442845', 'W77012335', 'W77012335', 'UT01', 'U Of U Hematology/Oncology Division', 'Michael', NULL, 'Boyer', 'MD', 'Pediatric Hematology and Oncolocy', 'Hematology and Oncology', NULL, NULL, 'B', 'PO Box 581700', 'Salt Lake City', 'Salt Lake', 'UT', '84158', '8015850124', NULL, NULL, NULL, '', NULL, NULL, '', '', 'UUUMG', NULL, NULL, '0.00', '25.00', NULL, 3, '2006-07-01', '2006-07-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1598763112', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870442845', 'W77012336', 'W77012336', 'UT01', 'U Of U Hematology/Oncology Division', 'Michael', NULL, 'Boyer', 'MD', 'Pediatric Hematology and Oncolocy', 'Hematology and Oncology', NULL, NULL, 'O', '50 N Medical Dr', 'Salt Lake City', 'Salt Lake', 'UT', '84132', '8015853229', NULL, NULL, NULL, '', NULL, NULL, '', '', 'UUUMG', NULL, NULL, '0.00', '25.00', NULL, 3, '2006-07-01', '2006-07-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1598763112', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870443152', 'W77012337', 'W77012337', 'UT01', 'U Of U Endocrinology Division', 'Paige', 'M', 'Gault', 'MD', NULL, NULL, NULL, NULL, 'B', 'PO Box 581700', 'Salt Lake City', 'Salt Lake', 'UT', '84158', NULL, NULL, NULL, NULL, '', NULL, NULL, '', '', 'UUUMG', NULL, NULL, '0.00', '25.00', NULL, 3, '2006-07-01', '2006-07-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '991517', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870443152', 'W77012338', 'W77012338', 'UT01', 'U Of U Endocrinology Division', 'Paige', 'M', 'Gault', 'MD', NULL, NULL, NULL, NULL, 'O', '50 N Medical Dr', 'Salt Lake City', 'Salt Lake', 'UT', '84132', '8015817761', NULL, NULL, NULL, '', NULL, NULL, '', '', 'UUUMG', NULL, NULL, '0.00', '25.00', NULL, 3, '2006-07-01', '2006-07-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '991517', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
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('870682547', 'W77012424', 'W77012424', 'UT01', 'Dr Roy Gibson and Associates', 'Roy', 'R', 'Gibson', 'OD', 'Optometry', NULL, NULL, NULL, 'O', '1055 W Hill Field Rd', 'Layton', 'Davis', 'UT', '84041', '8014447167', '8014447183', NULL, NULL, '', NULL, NULL, '', '', 'USTDOPHT', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2006-07-05', '2006-11-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1104816743', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL);
INSERT INTO `providers_new` (`Provider_Tax_ID`, `Provider_Suffix`, `Provider_Network_ID`, `Provider_Region`, `Provider_Name`, `Provider_Doctor_First_Name`, `Provider_Doctor_Middle_Name`, `Provider_Doctor_Last_Name`, `Provider_Doctor_Degree`, `Provider_Specialty_1`, `Provider_Specialty_2`, `Provider_Specialty_3`, `Provider_Specialty_4`, `Provider_Address_Type`, `Provider_Address`, `Provider_City`, `Provider_County`, `Provider_State`, `Provider_Zip`, `Provider_Phone`, `Provider_Fax`, `Provider_Mailing_Address`, `Provider_Mailing_City`, `Provider_Mailing_County`, `Provider_Mailing_State`, `Provider_Mailing_Zip`, `Provider_Mailing_Phone`, `Provider_Mailing_Fax`, `Provider_Primary_Schedule`, `Provider_Secondary_Schedule`, `Provider_Rate_Sheet`, `Provider_Anes_Rate`, `Provider_Default_Rate`, `Provider_Max_DOS`, `Provider_Min_Match_Value`, `Provider_Effective_Date`, `Provider_Term_Date`, `Provider_Pend`, `Provider_Anes_Minutes`, `Provider_PPO`, `Provider_Hospital_1`, `Provider_Hospital_2`, `Provider_Hospital_3`, `Provider_Hospital_4`, `Provider_Type`, `Provider_NPI`, `Provider_Check_Override`, `Exclude_Dir`, `Audit_Status`, `Last_Change_Date`, `Medicare_ID`, `Provider_Lang`, `Provider_Latitude`, `Provider_Longitude`, `Provider_school`, `Provider_cert`) VALUES
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('870687383', 'W77012426', 'W77012426', 'UT01', 'Western Neurological Associates', 'Brian', 'R', 'Mumford', 'MD', 'Radiologist', NULL, NULL, NULL, 'O', '1151 E 3900 S Ste B150', 'Salt Lake City', 'Salt Lake', 'UT', '84124', '8012623441', NULL, NULL, NULL, '', NULL, NULL, '', '', 'USTDRAD', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2006-07-05', '2006-07-05', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1801812854', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870766965', 'W77012427', 'W77012427', 'UT01', 'Lone Peak Primary Care', 'Theresa', 'D', 'Gourde', 'MD', 'Family Practice', 'Internal Medicine', NULL, NULL, 'O', '10011 So Centennial Pky Ste 150', 'Sandy', 'Salt Lake', 'UT', '84094', '8015458480', '8015458411', NULL, NULL, '', NULL, NULL, '', '', 'USTDMULT', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2002-09-01', '2006-10-31', 0, 0, 0, 'Jordan Valley Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1487688685', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870766965', 'W77012428', 'W77012428', 'UT01', 'Lone Peak Primary Care', 'Anne', 'M', 'Dubosky', 'MD', 'Family Practice', NULL, NULL, NULL, 'O', '10011 So Centennial Pky Ste 150', 'Sandy', 'Salt Lake', 'UT', '84094', '8015458480', '8015458411', NULL, NULL, '', NULL, NULL, '', '', 'USTDFAM', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2004-12-17', '2006-10-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1295769446', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('876151902', 'W77012429', 'W77012429', 'UT01', 'U of U Ophthalmology', 'John', 'T', 'DellaCroce', 'MD', 'Ophthalmology', NULL, NULL, NULL, 'B', '50 N Medical Dr', 'Salt Lake City', 'Salt Lake', 'UT', '84132', '8015813195', '8015851295', NULL, NULL, '', NULL, NULL, '', '', 'UUUMG', NULL, '1000', '37.71', NULL, NULL, 3, '2006-07-01', '2006-07-31', 1, 12, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '991635', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('876151902', 'W77012430', 'W77012430', 'UT01', 'U of U Ophthalmology', 'John', 'T', 'DellaCroce', 'MD', 'Ophthalmology', NULL, NULL, NULL, 'O', '50 N Medical Dr', 'Salt Lake City', 'Salt Lake', 'UT', '84132', '8015812352', NULL, NULL, NULL, '', NULL, NULL, '', '', 'UUUMG', NULL, '1000', '37.71', NULL, NULL, 3, '2006-07-01', '2006-07-31', 1, 12, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '991635', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
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('876151902', 'W77012432', 'W77012432', 'UT01', 'U of U Ophthalmology', 'Huck', 'A', 'Holz', 'MD', 'Ophthalmology', NULL, NULL, NULL, 'O', '50 N Medical Dr', 'Salt Lake City', 'Salt Lake', 'UT', '84132', '8015812352', NULL, NULL, NULL, '', NULL, NULL, '', '', 'UUUMG', NULL, NULL, '0.00', '25.00', NULL, 3, '2006-07-05', '2006-07-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '991809', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
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('876151902', 'W77012434', 'W77012434', 'UT01', 'U of U Ophthalmology', 'Darcy', 'H', 'Wolsey', 'MD', 'Ophthalmology', NULL, NULL, NULL, 'O', '50 N Medical Dr', 'Salt Lake City', 'Salt Lake', 'UT', '84132', '8015812352', NULL, NULL, NULL, '', NULL, NULL, '', '', 'UUUMG', NULL, NULL, '0.00', '25.00', NULL, 3, '2006-07-01', '2006-07-31', 0, 0, 0, 'St Marks Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1174575153', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
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('876157946', 'W77012438', 'W77012438', 'UT01', 'U of U ENT', 'Frank', 'M', 'Warren', 'MD', 'Ear, Nose and Throat', 'Pediatric Ear, Nose and Throat', NULL, NULL, 'O', '50 N Medical Dr', 'Salt Lake City', 'Salt Lake', 'UT', '84132', '8015818915', NULL, NULL, NULL, '', NULL, NULL, '', '', 'UUUMG', NULL, NULL, '0.00', '25.00', NULL, 3, '2006-07-01', '2006-07-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1780637363', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('900259079', 'W77012439', 'W77012439', 'UT01', NULL, 'Louis', NULL, 'Borgenicht', 'MD', 'Pediatrics', NULL, NULL, NULL, 'O', '850 E 300 S Ste 5', 'Salt Lake City', 'Salt Lake', 'UT', '84102', '8015318689', '8015311277', NULL, NULL, '', NULL, NULL, '', '', 'USTDPEDE', 'USTDPEDE', NULL, '0.00', '35.00', NULL, 3, '2002-04-01', '2006-12-31', 0, 0, 0, 'Salt Lake Regional Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1588748859', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W77012440', 'W77012440', 'UT02', 'Intermountain Health Care', 'Kevin', 'J', 'Colver', 'MD', 'Internal Medicine', 'Hospitalist', NULL, NULL, 'B', 'PO Box 27128', 'Salt Lake City', 'Salt Lake', 'UT', '84127', NULL, NULL, NULL, NULL, '', NULL, NULL, '', '', 'USTDINT', 'USTDHCPC', NULL, '0.00', '35.00', '0.00', 8, '1999-09-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1013922533', 0, 'Y', 0, '2008-07-29', NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W77012441', 'W77012441', 'UT02', 'IHC Utah Valley Hospitalists', 'Kevin', 'J', 'Colver', 'MD', 'Internal Medicine', 'Hospitalist', NULL, NULL, 'O', '1055 N 300 W Ste 500', 'Provo', 'Utah', 'UT', '84604', '8013578310', '8013573814', NULL, NULL, '', NULL, NULL, '', '', 'USTDINT', 'USTDHCPC', NULL, '0.00', '35.00', '0.00', 8, '1999-09-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1013922533', 0, 'Y', 0, '2008-07-29', NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W77012442', 'W77012442', 'UT02', 'Intermountain Health Care', 'Julie', 'A', 'Gainer', 'DO', 'Maternal Fetal Medicine', 'Hospitalist', '', NULL, 'B', 'PO Box 27128', 'Salt Lake City', 'Salt Lake', 'UT', '84127', NULL, NULL, 'PO Box 27128', 'Salt Lake City', 'Salt Lake', 'UT', '84127', '', '', 'USTDOBG', 'USTDHCPC', NULL, '0.00', '35.00', '0.00', 8, '2006-07-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1538106414', 0, 'Y', 0, '2011-07-26', NULL, NULL, 0, 0, NULL, NULL),
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('942854057', 'W77012444', 'W77012444', 'UT02', 'Intermountain Health Care', 'Michael', 'R', 'Kline', 'MD', 'Pulmonary', 'Family Practice', NULL, NULL, 'B', 'PO Box 27128', 'Salt Lake City', 'Salt Lake', 'UT', '84127', NULL, NULL, NULL, NULL, '', NULL, NULL, '', '', 'USTDINT', NULL, NULL, '0.00', '35.00', NULL, 8, '2006-07-05', '2006-12-31', 0, 0, 0, 'Dixie Regional Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1073531331', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W77012445', 'W77012445', 'UT02', 'IHC Zion Orthopaedics & Sports Medicine', 'Michael', 'R', 'Kline', 'MD', 'Pulmonary', 'Family Practice', 'Internal Medicine', NULL, 'O', '1380 E Medical Ctr Dr', 'St George', 'Washington', 'UT', '84790', '4352512650', '4352512668', '1380 E Medical Ctr Dr', 'St George', 'Washington', 'UT', '84790', '4352512650', '4352512668', 'USTDINT', NULL, '', '0.00', '35.00', '0.00', 8, '2006-07-05', NULL, 0, 0, 0, 'Dixie Regional Medical Center', '', '', '', 'HCFA|UB|', '1073531331', 0, 'N', 0, '2014-06-17', NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W77012446', 'W77012446', 'UT02', 'Intermountain Health Care', 'Jan', 'Bernhisel', 'Broadbent', 'MD', 'Allergy and Immunology', NULL, NULL, NULL, 'B', 'PO Box 27128', 'Salt Lake City', 'Salt Lake', 'UT', '84127', NULL, NULL, NULL, NULL, '', NULL, NULL, '', '', 'USTDMULT', 'USTDHCPC', NULL, '0.00', '35.00', '0.00', 8, '2006-07-20', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1265487300', 0, 'Y', 0, '2008-07-29', NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W77012447', 'W77012447', 'UT02', 'IHC Memorial Health Center', 'Jan', 'Bernhisel', 'Broadbent', 'MD', 'Allergy and Immunology', NULL, NULL, NULL, 'O', '2000 S 900 E', 'Salt Lake City', 'Salt Lake', 'UT', '84105', '8014647510', NULL, NULL, NULL, '', NULL, NULL, '', '', 'USTDMULT', 'USTDHCPC', NULL, '0.00', '35.00', '0.00', 8, '2006-07-20', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1265487300', 0, 'Y', 0, '2008-07-29', NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W77012448', 'W77012448', 'UT02', 'Intermountain Health Care', 'Russell', 'W', 'Rhoades', 'DO', 'Internal Medicine', 'Hospitalist', NULL, NULL, 'B', 'PO Box 27128', 'Salt Lake City', 'Salt Lake', 'UT', '84127', NULL, NULL, NULL, NULL, '', NULL, NULL, '', '', 'USTDINT', 'USTDHCPC', NULL, '0.00', '35.00', '0.00', 8, '2006-07-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1164436507', 0, 'Y', 0, '2008-07-29', NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W77012449', 'W77012449', 'UT02', 'IHC Utah Valley Hospitalists', 'Russell', 'W', 'Rhoades', 'DO', 'Internal Medicine', 'Hospitalist', NULL, NULL, 'O', '1055 N 300 W Ste 500', 'Provo', 'Utah', 'UT', '84604', '8013578310', '8013573814', NULL, NULL, '', NULL, NULL, '', '', 'USTDINT', 'USTDHCPC', NULL, '0.00', '35.00', '0.00', 8, '2006-07-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1164436507', 0, 'Y', 0, '2008-07-29', NULL, NULL, 0, 0, NULL, NULL),
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('870218917', 'W77012501', 'W77012501', 'UT01', 'Tanner Memorial Clinic', 'Duane', 'E', 'Farley', 'MD', 'Obstetrics and Gynecology', NULL, NULL, NULL, 'B', 'PO Box 337', 'Layton', 'Davis', 'UT', '84041', '8017734840', '8015258151', NULL, NULL, '', NULL, NULL, '', '', 'UTANNER', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '1999-09-01', '2006-06-30', 0, 0, 0, 'Davis Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1538145586', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870218917', 'W77012502', 'W77012502', 'UT01', 'Tanner Memorial Clinic', 'Duane', 'E', 'Farley', 'MD', 'Obstetrics and Gynecology', NULL, NULL, NULL, 'O', '380 N 400 W', 'Kaysville', 'Davis', 'UT', '84037', '8017734840', NULL, NULL, NULL, '', NULL, NULL, '', '', 'UTANNER', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '1999-09-01', '2006-06-30', 0, 0, 0, 'Davis Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1538145586', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870218917', 'W77012503', 'W77012503', 'UT01', 'Tanner Memorial Clinic', 'Nathan', NULL, 'Forbush', 'MD', 'Pediatrics', NULL, NULL, NULL, 'B', 'PO Box 337', 'Layton', 'Davis', 'UT', '84041', '8017734840', '8015258151', NULL, NULL, '', NULL, NULL, '', '', 'UTANNER', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2006-07-01', '2006-07-01', 0, 0, 0, 'Davis Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1962439851', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870218917', 'W77012504', 'W77012504', 'UT01', 'Tanner Memorial Clinic', 'Nathan', NULL, 'Forbush', 'MD', 'Pediatrics', NULL, NULL, NULL, 'O', '2121 Robins Dr', 'Layton', 'Davis', 'UT', '84041', '8017734840', '8015258151', NULL, NULL, '', NULL, NULL, '', '', 'UTANNER', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2006-07-01', '2006-07-01', 0, 0, 0, 'Davis Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1962439851', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870218917', 'W77012505', 'W77012505', 'UT01', 'Tanner Memorial Clinic', 'Chadd', 'D', 'Nelson', 'DO', 'Internal Medicine', NULL, NULL, NULL, 'B', 'PO Box 337', 'Layton', 'Davis', 'UT', '84041', '8017734840', '8015258151', NULL, NULL, '', NULL, NULL, '', '', 'UTANNER', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2006-08-01', '2006-08-01', 0, 0, 0, 'Davis Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1619904679', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870218917', 'W77012506', 'W77012506', 'UT01', 'Tanner Memorial Clinic', 'Chadd', 'D', 'Nelson', 'DO', 'Internal Medicine', NULL, NULL, NULL, 'O', '2121 Robins Dr', 'Layton', 'Davis', 'UT', '84041', '8017734840', '8015258151', NULL, NULL, '', NULL, NULL, '', '', 'UTANNER', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2006-08-01', '2006-08-01', 0, 0, 0, 'Davis Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1619904679', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870281028', 'W77012507', 'W77012507', 'UT01', 'Central Utah Clinic', 'Terry', 'A', 'Hammond', 'MD', 'Nephrology', NULL, NULL, NULL, 'B', '1055 N 500 W', 'Provo', 'Utah', 'UT', '84604', '8013742362', '8013742615', NULL, NULL, '', NULL, NULL, '', '', 'UUVPN', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '1999-09-01', '2005-12-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1124064845', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870281028', 'W77012508', 'W77012508', 'UT01', 'Central Utah Clinic', 'Terry', 'A', 'Hammond', 'MD', 'Nephrology', NULL, NULL, NULL, 'O', '48 N 1100 E Ste B', 'American Fork', 'Utah', 'UT', '84003', '8014922815', '8018155500', NULL, NULL, '', NULL, NULL, '', '', 'UUVPN', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '1999-09-01', '2006-05-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1124064845', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870281028', 'W77012509', 'W77012509', 'UT01', 'Central Utah Clinic', 'Ronald', 'W', 'Asay', 'MD', 'Cardiovascular Disease', NULL, NULL, NULL, 'B', '1055 N 500 W', 'Provo', 'Utah', 'UT', '84604', '8013742362', '8013742615', NULL, NULL, '', NULL, NULL, '', '', 'UUVPN', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '1999-09-01', '2006-05-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1578521308', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870281028', 'W77012510', 'W77012510', 'UT01', 'Wasatch Otolaryngology Group', 'Ronald', 'W', 'Asay', 'MD', 'Cardiovascular Disease', NULL, NULL, NULL, 'O', '700 W 800 N Ste 230', 'Orem', 'Utah', 'UT', '84057', '8014290620', NULL, NULL, NULL, '', NULL, NULL, '', '', 'UUVPN', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '1999-09-01', '2006-05-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1578521308', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870281028', 'W77012511', 'W77012511', 'UT01', 'Central Utah Clinic', 'Alan', 'L', 'Colledge', 'MD', 'Physical Medicine and Rehabilitation', NULL, NULL, NULL, 'O', '1055 N 500 W', 'Provo', 'Utah', 'UT', '84604', '8013742362', '8014298191', NULL, NULL, '', NULL, NULL, '', '', 'UUVPN', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2002-07-01', '2005-12-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1629169370', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870281028', 'W77012512', 'W77012512', 'UT01', 'Central Utah Clinic', 'M Eric', NULL, 'Carter', 'MD', 'Cardiovascular Disease', NULL, NULL, NULL, 'B', '1055 N 500 W', 'Provo', 'Utah', 'UT', '84604', '8013742362', '8013742615', NULL, NULL, '', NULL, NULL, '', '', 'UUVPN', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2006-08-14', '2006-08-14', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '913281', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870281028', 'W77012513', 'W77012513', 'UT01', 'Central Utah Clinic', 'M Eric', NULL, 'Carter', 'MD', 'Cardiovascular Disease', NULL, NULL, NULL, 'B', '1055 N 500 W', 'Provo', 'Utah', 'UT', '84604', '8013742362', '8013742615', NULL, NULL, '', NULL, NULL, '', '', 'UUVPN', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2006-08-14', '2006-08-14', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '913281', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870281028', 'W77012514', 'W77012514', 'UT01', 'Central Utah Clinic', 'M Eric', NULL, 'Carter', 'MD', 'Cardiovascular Disease', NULL, NULL, NULL, 'O', '48 N 1100 E Ste B', 'American Fork', 'Utah', 'UT', '84003', '8014922815', '8018155500', NULL, NULL, '', NULL, NULL, '', '', 'UUVPN', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2006-08-14', '2006-08-14', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '913281', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870281028', 'W77012515', 'W77012515', 'UT01', 'Central Utah Clinic', 'M Eric', NULL, 'Carter', 'MD', 'Cardiovascular Disease', NULL, NULL, NULL, 'O', '1055 N 500 W Bldg C Ste 101', 'Provo', 'Utah', 'UT', '84604', '8013734366', '8014298191', NULL, NULL, '', NULL, NULL, '', '', 'UUVPN', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2006-08-14', '2006-08-14', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '913281', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870281028', 'W77012516', 'W77012516', 'UT01', 'Central Utah Clinic', 'Bruce', 'C', 'McAllister', 'MD', 'Radiation Oncology', NULL, NULL, NULL, 'B', '1055 N 500 W', 'Provo', 'Utah', 'UT', '84604', '8013742362', '8013742615', NULL, NULL, '', NULL, NULL, '', '', 'UUVPN', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2006-06-30', '2006-06-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1144223835', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870281028', 'W77012517', 'W77012517', 'UT01', 'Central Utah Clinic', 'Bruce', 'C', 'McAllister', 'MD', 'Radiation Oncology', NULL, NULL, NULL, 'O', '1034 N 500 W', 'Provo', 'Utah', 'UT', '84604', '8013742367', '8014290600', NULL, NULL, '', NULL, NULL, '', '', 'UUVPN', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2006-06-30', '2006-06-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1144223835', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870281028', 'W77012518', 'W77012518', 'UT01', 'Central Utah Clinic', 'Tala''at', '', 'Al-Shuquirat', 'MD', 'Pulmonary', 'Emergency Medicine', NULL, NULL, 'B', '1055 N 500 W', 'Provo', 'Utah', 'UT', '84604', '8013742362', '8013742615', NULL, NULL, '', NULL, NULL, '', '', 'UUVPN', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2006-07-01', '2006-07-01', 0, 0, 0, 'Mountain View Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1104875574', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870281028', 'W77012519', 'W77012519', 'UT01', 'Central Utah Clinic', 'Tala''at', '', 'Al-Shuquirat', 'MD', 'Pulmonary', 'Emergency Medicine', NULL, NULL, 'O', '1120 E 100 N', 'Payson', 'Utah', 'UT', '84651', '8014654813', NULL, NULL, NULL, '', NULL, NULL, '', '', 'UUVPN', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2006-07-01', '2006-07-01', 0, 0, 0, 'Mountain View Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1104875574', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870281028', 'W77012520', 'W77012520', 'UT01', 'Central Utah Clinic', 'Karl', 'N', 'Weenig', 'MD', 'Family Practice', 'Sports Medicine', NULL, NULL, 'B', '1055 N 500 W', 'Provo', 'Utah', 'UT', '84604', '8013742362', '8013742615', NULL, NULL, '', NULL, NULL, '', '', 'UUVPN', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2006-07-10', '2006-07-10', 0, 0, 0, 'Mountain View Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1740242973', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870281028', 'W77012521', 'W77012521', 'UT01', 'Central Utah Clinic', 'Karl', 'N', 'Weenig', 'MD', 'Family Practice', 'Sports Medicine', NULL, NULL, 'O', '1055 N 500 W Ste 121', 'Provo', 'Utah', 'UT', '84604', '8013577350', NULL, NULL, NULL, '', NULL, NULL, '', '', 'UUVPN', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2006-07-10', '2006-07-10', 0, 0, 0, 'Mountain View Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1740242973', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870281028', 'W77012522', 'W77012522', 'UT01', 'Central Utah Clinic', 'Scott', 'D', 'Valadez', 'MD', 'Radiologist', NULL, NULL, NULL, 'O', '1055 N 500 W', 'Provo', 'Utah', 'UT', '84604', '8013742362', '8014298191', NULL, NULL, '', NULL, NULL, '', '', 'UUVPN', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2006-08-21', '2006-08-21', 0, 0, 0, 'Mountain View Hospital', 'Timpanogos Regional Hospital', NULL, NULL, 'HCFA|UB|', '1114900206', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870284475', 'W77012523', 'W77012523', 'UT01', 'Granger Medical Clinic', 'David', 'M', 'Witter', 'MD', 'Physical Medicine and Rehabilitation', NULL, NULL, NULL, 'B', 'PO Box 70658', 'West Valley', 'Salt Lake', 'UT', '84170', '8019653720', '8019653740', NULL, NULL, '', NULL, NULL, '', '', 'UGRANGER', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2006-09-01', '2006-09-01', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1518992510', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870284475', 'W77012524', 'W77012524', 'UT01', 'Granger Medical Clinic', 'David', 'M', 'Witter', 'MD', 'Physical Medicine and Rehabilitation', NULL, NULL, NULL, 'O', '3725 W 4100 S', 'West Valley', 'Salt Lake', 'UT', '84120', '8019653600', '8019683605', NULL, NULL, '', NULL, NULL, '', '', 'UGRANGER', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2006-09-01', '2006-09-01', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1518992510', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870286381', 'W77012525', 'W77012525', 'UT01', 'Ogden Clinic', 'Richard', 'C', 'Hammond', 'DO', 'Neurology', NULL, NULL, NULL, 'O', '4650 Harrison Blvd', 'Ogden', 'Weber', 'UT', '84403', '8014794621', '8014762670', NULL, NULL, '', NULL, NULL, '', '', 'UOGDCLIN', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2006-08-01', '2006-08-01', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '988014', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870342259', 'W77012526', 'W77012526', 'UT01', 'Wayne Community Health Centers', 'Bret', 'D', 'Hilton', 'PA', NULL, NULL, NULL, NULL, 'B', 'PO Box 303', 'Bicknell', 'Wayne', 'UT', '84715', '4354253744', '4354253785', NULL, NULL, '', NULL, NULL, '', '', 'USTDURGE', NULL, NULL, '0.00', '35.00', NULL, 3, '2005-04-01', '2006-09-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1467451609', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870342259', 'W77012527', 'W77012527', 'UT01', 'Wayne Community Health Centers', 'Bret', 'D', 'Hilton', 'PA', NULL, NULL, NULL, NULL, 'O', '128 S 300 W', 'Bicknell', 'Wayne', 'UT', '84715', '4354253744', '4354253785', NULL, NULL, '', NULL, NULL, '', '', 'USTDURGE', NULL, NULL, '0.00', '35.00', NULL, 3, '2005-04-01', '2006-09-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1467451609', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870358327', 'W77012528', 'W77012528', 'UT01', 'Olympus Clinic', 'Maisa', 'N', 'Morris', 'MD', 'Family Practice', NULL, NULL, NULL, 'B', '4624 Holladay Blvd', 'Salt Lake City', 'Salt Lake', 'UT', '84117', '8012772682', '8012772980', NULL, NULL, '', NULL, NULL, '', '', 'USTDFAM', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2006-08-18', '2006-08-18', 0, 0, 0, 'Health South Rehabilitation Hospital of Utah (inpatient services only)', NULL, NULL, NULL, 'HCFA|UB|', '1497794655', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870358327', 'W77012529', 'W77012529', 'UT01', 'Olympus Clinic', 'Maisa', 'N', 'Morris', 'MD', 'Family Practice', NULL, NULL, NULL, 'O', '4624 Holladay Blvd', 'Salt Lake City', 'Salt Lake', 'UT', '84117', '8012772682', '8012772980', NULL, NULL, '', NULL, NULL, '', '', 'USTDFAM', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2006-08-18', '2006-08-18', 0, 0, 0, 'Health South Rehabilitation Hospital of Utah (inpatient services only)', NULL, NULL, NULL, 'HCFA|UB|', '1497794655', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL);
INSERT INTO `providers_new` (`Provider_Tax_ID`, `Provider_Suffix`, `Provider_Network_ID`, `Provider_Region`, `Provider_Name`, `Provider_Doctor_First_Name`, `Provider_Doctor_Middle_Name`, `Provider_Doctor_Last_Name`, `Provider_Doctor_Degree`, `Provider_Specialty_1`, `Provider_Specialty_2`, `Provider_Specialty_3`, `Provider_Specialty_4`, `Provider_Address_Type`, `Provider_Address`, `Provider_City`, `Provider_County`, `Provider_State`, `Provider_Zip`, `Provider_Phone`, `Provider_Fax`, `Provider_Mailing_Address`, `Provider_Mailing_City`, `Provider_Mailing_County`, `Provider_Mailing_State`, `Provider_Mailing_Zip`, `Provider_Mailing_Phone`, `Provider_Mailing_Fax`, `Provider_Primary_Schedule`, `Provider_Secondary_Schedule`, `Provider_Rate_Sheet`, `Provider_Anes_Rate`, `Provider_Default_Rate`, `Provider_Max_DOS`, `Provider_Min_Match_Value`, `Provider_Effective_Date`, `Provider_Term_Date`, `Provider_Pend`, `Provider_Anes_Minutes`, `Provider_PPO`, `Provider_Hospital_1`, `Provider_Hospital_2`, `Provider_Hospital_3`, `Provider_Hospital_4`, `Provider_Type`, `Provider_NPI`, `Provider_Check_Override`, `Exclude_Dir`, `Audit_Status`, `Last_Change_Date`, `Medicare_ID`, `Provider_Lang`, `Provider_Latitude`, `Provider_Longitude`, `Provider_school`, `Provider_cert`) VALUES
('870382132', 'W77012530', 'W77012530', 'UT01', 'Katzman, Howard A', 'Howard', 'A', 'Katzman', 'MD', 'Ophthalmology', NULL, NULL, NULL, 'B', '1485 E 3900 S', 'Salt Lake City', 'Salt Lake', 'UT', '84124', '8019719066', NULL, NULL, NULL, '', NULL, NULL, '', '', 'USTDOPHT', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2003-11-07', '2006-10-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1760492912', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870395551', 'W77012531', 'W77012531', 'UT01', 'Chiropractic Health Plan', 'Jeffrey', 'T', 'Owens', 'DC', 'Chiropractic', NULL, NULL, NULL, 'B', '9135 S Monroe St Ste B', 'Sandy', 'Salt Lake', 'UT', '84070', '8013527270', '8013527024', NULL, NULL, '', NULL, NULL, '', '', 'SELECT', NULL, '2303', '0.00', NULL, NULL, 3, '2006-08-09', '2006-08-09', 1, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1033277025', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870395551', 'W77012532', 'W77012532', 'UT01', 'Chiropractic Health Plan', 'Jeffrey', 'T', 'Owens', 'DC', 'Chiropractic', NULL, NULL, NULL, 'O', '9035 S 1300 E Ste 1', 'Sandy', 'Salt Lake', 'UT', '84094', '8015698787', NULL, NULL, NULL, '', NULL, NULL, '', '', 'SELECT', NULL, '2303', '0.00', NULL, NULL, 3, '2006-08-09', '2006-08-09', 1, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1033277025', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870395551', 'W77012533', 'W77012533', 'UT01', 'Chiropractic Health Plan', 'Sean', 'T', 'Smith', 'DC', 'Chiropractic', NULL, NULL, NULL, 'B', '9135 S Monroe St Ste B', 'Sandy', 'Salt Lake', 'UT', '84070', '8013527270', '8013527024', NULL, NULL, '', NULL, NULL, '', '', 'SELECT', NULL, '2303', '0.00', NULL, NULL, 3, '2006-08-18', '2006-08-18', 1, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1821048208', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870395551', 'W77012534', 'W77012534', 'UT01', 'Art City Chiropractic', 'Sean', 'T', 'Smith', 'DC', 'Chiropractic', NULL, NULL, NULL, 'O', '1220 N Main St Ste 12', 'Springville', 'Utah', 'UT', '84663', '8014899230', NULL, NULL, NULL, '', NULL, NULL, '', '', 'SELECT', NULL, '2303', '0.00', NULL, NULL, 3, '2006-08-18', '2006-08-18', 1, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1821048208', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870395551', 'W77012535', 'W77012535', 'UT01', 'Chiropractic Health Plan', 'David', 'M', 'Hammond', 'DC', 'Chiropractic', NULL, NULL, NULL, 'B', '9135 S Monroe St Ste B', 'Sandy', 'Salt Lake', 'UT', '84070', '8013527270', '8013527024', NULL, NULL, '', NULL, NULL, '', '', 'SELECT', NULL, '2303', '0.00', NULL, NULL, 3, '2006-08-30', '2006-08-30', 1, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1457372005', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870395551', 'W77012536', 'W77012536', 'UT01', 'Alpine Health and Rehabilitation Center', 'David', 'M', 'Hammond', 'DC', 'Chiropractic', NULL, NULL, NULL, 'O', '1745 W 7800 S', 'West Jordan', 'Salt Lake', 'UT', '84088', '8015651155', '8015651157', NULL, NULL, '', NULL, NULL, '', '', 'SELECT', NULL, '2303', '0.00', NULL, NULL, 3, '2006-08-30', '2006-08-30', 1, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1457372005', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870406457', 'W77012537', 'W77012537', 'UT01', 'Tooele Foot Clinic', 'Kim', 'A', 'Halladay', 'DPM', 'Podiatry', NULL, NULL, NULL, 'B', '300 S Main St Ste 2', 'Tooele', 'Tooele', 'UT', '84074', '4358820711', '4358821778', NULL, NULL, '', NULL, NULL, '', '', 'USTDPOD', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2003-04-01', '2006-12-31', 0, 0, 0, 'Mountain West Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1902809528', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870410144', 'W77012538', 'W77012538', 'UT01', 'U Of U Dept Of Ob/Gyn', 'Shawn', 'E', 'Gurtcheff', 'MD', 'Reproductive Endocrinology', 'Obstetrics and Gynecology', NULL, NULL, 'B', 'PO Box 58859', 'Salt Lake City', 'Salt Lake', 'UT', '84158', '8015855172', '8015855164', NULL, NULL, '', NULL, NULL, '', '', 'UUUMG', NULL, '1000', '37.71', NULL, NULL, 3, '2006-07-12', '2006-07-31', 1, 12, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '994754', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
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('870516264', 'W77012575', 'W77012575', 'UT01', 'Utah County Surgical Associates', 'Jennifer', 'J', 'Tittensor', 'MD', 'General Surgery', NULL, NULL, NULL, 'O', '3550 N University Ave Ste 250', 'Provo', 'Utah', 'UT', '84604', '8013749625', NULL, NULL, NULL, '', NULL, NULL, '', '', 'UUVPN', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2006-08-01', '2006-08-01', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1568497634', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870516264', 'W77012576', 'W77012576', 'UT01', 'Utah County Surgical Associates', 'Jory', 'Q', 'Sorensen', 'FNP', 'Nurse Practitioner ', NULL, NULL, NULL, 'O', '3550 N University Ave Ste 250', 'Provo', 'Utah', 'UT', '84604', '8013749625', NULL, NULL, NULL, '', NULL, NULL, '', '', 'UUVPN', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2006-08-09', '2006-08-09', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1376689877', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
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('870567427', 'W77012594', 'W77012594', 'UT01', 'University Of Utah Emergency Physicians', 'Kelly', 'A', 'Larrabee', 'PA', NULL, NULL, NULL, NULL, 'B', 'PO Box 510726', 'Salt Lake City', 'Salt Lake', 'UT', '84151', '8015876600', '8015876396', NULL, NULL, '', NULL, NULL, '', '', 'UUUMG', NULL, '1000', '37.71', NULL, NULL, 3, '2006-08-06', '2006-08-06', 1, 12, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '994917', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
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('870642019', 'W77012606', 'W77012606', 'UT01', 'Pediatric Urology Associates', 'Michael', 'C', 'Wallis', 'MD', 'Urology', NULL, NULL, NULL, 'B', 'PO Box 581075', 'Salt Lake City', 'Salt Lake', 'UT', '84158', '8015883300', NULL, NULL, NULL, '', NULL, NULL, '', '', 'UUMGPED', NULL, NULL, '0.00', '15.00', NULL, 3, '2006-08-01', '2006-08-01', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1558384388', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
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('870643070', 'W77012617', 'W77012617', 'UT01', 'Circle Of Life Womens Center', 'Karen', 'E', 'McBride', 'CNM', 'Obstetrics and Gynecology', NULL, NULL, NULL, 'B', 'PO Box 6971', 'Licoln', 'Lancaster', 'NE', '68506', '4024867000', NULL, NULL, NULL, '', NULL, NULL, '', '', 'USTDOBG', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2002-04-01', '2006-10-31', 0, 0, 0, 'Ogden Regional Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1568485001', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870645895', 'W77012618', 'W77012618', 'UT01', 'U Of U Pediatric Orthopedics', 'David', 'M', 'Cearley', 'MD', 'Orthopedic Surgery', NULL, NULL, NULL, 'B', 'PO Box 58886', 'Salt Lake City', 'Salt Lake', 'UT', '84158', '8015883900', NULL, NULL, NULL, '', NULL, NULL, '', '', 'UUMGPED', NULL, NULL, '0.00', '15.00', NULL, 3, '2006-08-01', '2006-08-01', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '994777', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
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('870650775', 'W77012620', 'W77012620', 'UT01', 'Specialized Optical', 'Greg', 'M', 'Wenom', 'OD', 'Optometry', NULL, NULL, NULL, 'O', '5735 Harrison Blvd', 'Ogden', 'Weber', 'UT', '84403', '8013939440', '8013926229', NULL, NULL, '', NULL, NULL, '', '', 'UTALBERT', NULL, NULL, '0.00', '25.00', NULL, 3, '2006-08-09', '2006-12-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1356420590', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
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