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
('529765053', 'W77000438', 'W77000438', 'UT01', NULL, 'Jane', NULL, 'Ricks', 'MD', 'Family Practice', NULL, NULL, NULL, 'B', 'PO Box 1557', 'Draper', 'Salt Lake', 'UT', '84020', '8018914875', NULL, NULL, NULL, '', NULL, NULL, '', '', 'USTDFAM', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2003-04-01', '2006-12-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1295745651', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('542158195', 'W77000439', 'W77000439', 'UT01', NULL, 'Carrie', 'L', 'Sloan', 'MD', 'Obstetrics and Gynecology', 'Obstetrics and Gynecology', NULL, NULL, 'B', '1151 E 3900 S Ste B-299', 'Salt Lake City', 'Salt Lake', 'UT', '84124', '8012686811', NULL, NULL, NULL, '', NULL, NULL, '', '', 'USTDOBG', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2004-09-24', '2006-08-31', 0, 0, 0, 'St Marks Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1124034012', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('571174725', 'W77000440', 'W77000440', 'UT01', NULL, 'Willard', 'Z', 'Maughan', 'MD', 'Dermatology', NULL, NULL, NULL, 'O', '6028 S Ridgeline Dr Ste 200', 'South Ogden', 'Weber', 'UT', '84405', '8014755210', NULL, NULL, NULL, '', NULL, NULL, '', '', 'USTDDERM', '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|', '1235125063', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('571188761', 'W77000441', 'W77000441', 'UT01', 'Westview Womens Center', 'Sean', 'D', 'Biggs', 'MD', 'Family Practice', NULL, NULL, NULL, 'B', 'PO Box 1569', 'Bountiful', 'Davis', 'UT', '84011', '8019631880', '8019631886', NULL, NULL, '', NULL, NULL, '', '', 'USTDOBG', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2003-08-01', '2005-12-01', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1841233558', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('571188761', 'W77000442', 'W77000442', 'UT01', 'Westview Womens Center', 'Larry', 'D', 'Smith', 'MD', 'Obstetrics and Gynecology', NULL, NULL, NULL, 'B', 'PO Box 1569', 'Bountiful', 'Davis', 'UT', '84011', '8019631880', '8019631886', NULL, NULL, '', NULL, NULL, '', '', 'USTDOBG', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2004-01-30', '2006-08-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '831621', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('571188761', 'W77000443', 'W77000443', 'UT01', 'Westview Womens Center', 'Larry', 'D', 'Smith', 'MD', 'Obstetrics and Gynecology', NULL, NULL, NULL, 'O', '3451 S 5600 W Ste E', 'West Valley', 'Salt Lake', 'UT', '84120', '8019631880', '8019631886', NULL, NULL, '', NULL, NULL, '', '', 'USTDOBG', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2004-01-30', '2006-08-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '831621', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('571190130', 'W77000444', 'W77000444', 'UT01', 'Utah Valley Optometric Physicians', 'Rick', 'W', 'Winward', 'OD', 'Optometry', NULL, NULL, NULL, 'B', '1355 N University Ave Ste 100', 'Provo', 'Utah', 'UT', '84604', '8013774333', '8013703951', NULL, NULL, '', NULL, NULL, '', '', 'UTALBERT', NULL, NULL, '0.00', '25.00', NULL, 3, '2002-01-01', '2006-08-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1750373411', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('593765972', 'W77000445', 'W77000445', 'UT01', 'Scott R Mckell, DPM', 'Scott', NULL, 'McKell', 'DPM', 'Podiatry', NULL, NULL, NULL, 'B', '157 N 400 W Ste B-7', 'Orem', 'Utah', 'UT', '84057', '8017651718', NULL, NULL, NULL, '', NULL, NULL, '', '', 'UUVPN', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '1999-11-16', '1999-11-16', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1497820054', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('611463417', 'W77000446', 'W77000446', 'UT01', 'U Of U Ob Diagnostic Center', 'Robert', NULL, 'Andres', 'MD', 'Obstetrics and Gynecology', 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, '2001-09-14', '2006-07-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '831703', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('611463417', 'W77000447', 'W77000447', 'UT01', 'U Of U Ob Diagnostic Center', 'Janice', 'L B', 'Byrne', 'MD', 'Maternal Fetal Medicine', 'Obstetrics and Gynecology', 'Neonatology', 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, '2001-05-31', '2006-07-31', 0, 0, 0, 'University Health Care University Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1629158530', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('611463417', 'W77000448', 'W77000448', 'UT01', 'U Of U Ob Diagnostic Center', 'Michael', 'S', 'Esplin', 'MD', 'Maternal Fetal Medicine', 'Obstetrics and Gynecology', 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, '1999-09-01', '2006-07-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1205916111', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('611463417', 'W77000449', 'W77000449', 'UT01', 'U Of U Ob Diagnostic Center', 'Michael', 'S', 'Esplin', 'MD', 'Maternal Fetal Medicine', 'Obstetrics and Gynecology', 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, '1999-09-01', '2006-07-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1205916111', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('611463417', 'W77000450', 'W77000450', 'UT01', 'U Of U Ob Diagnostic Center', 'Harry', 'H', 'Hatasaka', 'MD', 'Obstetrics and Gynecology', 'Reproductive Endocrinology', 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, '1999-09-01', '2006-07-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1740360650', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('611463417', 'W77000451', 'W77000451', 'UT01', 'U Of U Ob Diagnostic Center', 'Calla', 'Michelle', 'Holmgren', 'MD', 'Obstetrics and Gynecology', 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, '2004-07-01', '2006-07-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '902976', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('611463417', 'W77000452', 'W77000452', 'UT01', 'U Of U Ob Diagnostic Center', 'Ivan', NULL, 'Huang', 'MD', 'Reproductive Endocrinology', 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, '2003-07-03', '2005-10-04', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '832653', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('611463417', 'W77000453', 'W77000453', 'UT01', 'U Of U Ob Diagnostic Center', 'Bryan', 'T', 'Oshiro', 'MD', 'Obstetrics and Gynecology', NULL, NULL, NULL, 'O', '30 N 1900 E Ste 2B200', 'Salt Lake City', 'Salt Lake', 'UT', '84132', '8015812719', NULL, NULL, NULL, '', NULL, NULL, '', '', 'USTDOBG', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '1999-09-01', '2006-07-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1780608489', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('528151384', 'W77000455', 'W77000455', 'UT01', 'Clark, Scott A', 'Scott', 'A', 'Clark', 'DPM', 'Podiatry', NULL, NULL, NULL, 'O', '2178 S 900 E Ste 1', 'Salt Lake City', 'Salt Lake', 'UT', '84106', '8014668206', '8014666601', NULL, NULL, '', NULL, NULL, '', '', 'USTDPOD', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2002-04-01', '2006-08-31', 0, 0, 0, 'St Marks Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1700865748', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('528154740', 'W77000456', 'W77000456', 'UT01', NULL, 'Polly', 'W', 'Sheffield', 'MD', 'General Surgery', 'Pediatrics', NULL, NULL, 'O', '1159 E 200 N Ste 350', 'American Fork', 'Utah', 'UT', '84003', '8017564781', NULL, NULL, NULL, '', NULL, NULL, '', '', 'UUVPN', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '1999-12-01', '2006-05-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1215980974', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('528270680', 'W77000457', 'W77000457', 'UT01', 'Ashby, Clark', 'Clark', NULL, 'Ashby', 'MD', 'Anesthesiology', NULL, NULL, NULL, 'O', '585 N 500 W', 'Provo', 'Utah', 'UT', '84601', '8013750983', NULL, NULL, NULL, '', NULL, NULL, '', '', '110', NULL, '1000', '28.35', NULL, NULL, 3, '2001-01-01', '2004-12-31', 1, 12, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '832251', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('528609270', 'W77000458', 'W77000458', 'UT01', 'Groneman, Michael L', 'Michael', 'L', 'Groneman', 'PT', 'Physical Therapy', NULL, NULL, NULL, 'O', '1055 N 300 W Ste 211', 'Provo', 'Utah', 'UT', '84604', '8013577900', '8013577552', NULL, NULL, '', NULL, NULL, '', '', NULL, NULL, NULL, '0.00', '0.00', '57.75', 3, '2000-11-20', '2006-12-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '834485', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('528609270', 'W77000460', 'W77000460', 'UT01', 'Spanish Fork Physical Therapy', 'Michael', 'L', 'Groneman', 'PT', 'Physical Therapy', NULL, NULL, NULL, 'O', '757 E 800 N', 'Spanish Fork', 'Utah', 'UT', '84660', '8017940333', '8017949553', NULL, NULL, '', NULL, NULL, '', '', NULL, NULL, NULL, '0.00', '0.00', '57.75', 3, '2000-11-20', '2006-12-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '834485', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('528647654', 'W77000461', 'W77000461', 'UT01', 'Herold, Richard J', 'Richard', NULL, 'Herold', 'MD', 'Internal Medicine', NULL, NULL, NULL, 'O', '6028 S Ridgeline Dr Ste 204', 'Ogden', 'Weber', 'UT', '84405', '8014758100', NULL, NULL, NULL, '', NULL, NULL, '', '', 'USTDINT', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2002-04-01', '2006-09-30', 0, 0, 0, 'Ogden Regional Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1891799318', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('528681578', 'W77000462', 'W77000462', 'UT01', 'Christiansen, Robert M', 'Robert', 'M', 'Christiansen', 'MD', 'Ophthalmology', NULL, NULL, NULL, 'O', '324 10th Ave Ste 155', 'Salt Lake City', 'Salt Lake', 'UT', '84103', '8014083937', NULL, NULL, NULL, '', NULL, NULL, '', '', 'USTDOPHT', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2002-04-01', '2006-10-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1114991841', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('528723936', 'W77000463', 'W77000463', 'UT01', 'Nance, Steven G', 'Steven', 'G', 'Nance', 'MD', 'Obstetrics and Gynecology', NULL, NULL, NULL, 'O', '285 E 400 S', 'Springville', 'Utah', 'UT', '84663', '8014890111', NULL, NULL, NULL, '', NULL, NULL, '', '', 'UUVPN', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2001-07-01', '2005-12-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1376645887', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('528728838', 'W77000464', 'W77000464', 'UT01', 'Terashima, Robert', 'Robert', 'S', 'Terashima', 'MD', 'Pediatrics', NULL, NULL, NULL, 'O', '8925 S 2700 W', 'West Jordan', 'Salt Lake', 'UT', '84088', '8015666200', '8015667993', NULL, NULL, '', NULL, NULL, '', '', 'USTDPEDE', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2002-04-01', '2006-02-28', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1922163534', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('529069313', 'W77000465', 'W77000465', 'UT01', 'Moab Family Medicine', 'Katherine', 'K', 'Williams', 'MD', 'Family Practice', NULL, NULL, NULL, 'O', '38 W 300 S', 'Moab', 'Grand', 'UT', '84532', '4352597121', '4352593112', NULL, NULL, '', NULL, NULL, '', '', 'URSTDFAM', NULL, NULL, '0.00', '35.00', NULL, 3, '2005-12-16', '2006-09-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1669455580', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('529216292', 'W77000466', 'W77000466', 'UT01', 'Udy AUD, Mitchell R', 'itchell R', NULL, 'Udy AUD, M', 'GROUP', 'Audiology', NULL, NULL, NULL, 'B', '274 N Main St', 'Logan', 'Cache', 'UT', '84321', '4357531600', NULL, NULL, NULL, '', NULL, NULL, '', '', 'USTDOTHR', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2005-04-29', '2006-09-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '922188', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('529216292', 'W77000467', 'W77000467', 'UT01', 'Udy AUD, Mitchell R', 'itchell R', NULL, 'Udy AUD, M', 'GROUP', 'Audiology', NULL, NULL, NULL, 'O', '44 S 100 W', 'Brigham City', 'Box Elder', 'UT', '84302', '4357233428', '4357231054', NULL, NULL, '', NULL, NULL, '', '', 'USTDOTHR', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2005-04-29', '2006-09-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '922188', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('529549259', 'W77000468', 'W77000468', 'UT01', NULL, 'E Barry', NULL, 'Topham', 'MD', 'Dermatology', NULL, NULL, NULL, 'O', '1775 E 4500 S', 'Salt Lake City', 'Salt Lake', 'UT', '84117', '8012724408', '8012724441', NULL, NULL, '', NULL, NULL, '', '', 'USTDDERM', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2004-11-19', '2006-08-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1386620367', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('542158195', 'W77000469', 'W77000469', 'UT01', NULL, 'Carrie', 'L', 'Sloan', 'MD', 'Obstetrics and Gynecology', 'Obstetrics and Gynecology', NULL, NULL, 'O', '12176 S 1000 E Ste A', 'Draper', 'Salt Lake', 'UT', '84020', '8015233053', NULL, NULL, NULL, '', NULL, NULL, '', '', 'USTDOBG', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2004-09-24', '2006-08-31', 0, 0, 0, 'St Marks Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1124034012', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('547769846', 'W77000470', 'W77000470', 'UT01', 'Val G Mullinax, DPM', 'Val', 'G', 'Mullinax', 'DPM', 'Podiatry', NULL, NULL, NULL, 'O', '1928 N 1120 W Ste 6', 'Provo', 'Utah', 'UT', '84604', '8013743010', NULL, NULL, NULL, '', NULL, NULL, '', '', 'USTDPOD', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2003-10-03', '2005-12-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1528179256', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('550808373', 'W77000472', 'W77000472', 'UT01', 'Donald R Call, Jr, DPM', 'Donald', 'R', 'Call', 'DPM', 'Podiatry', NULL, NULL, NULL, 'B', '2269 W 12250 S', 'Riverton', 'Salt Lake', 'UT', '84065', '8015239581', NULL, NULL, NULL, '', NULL, NULL, '', '', 'USTDPOD', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2003-01-01', '2003-01-01', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1861594624', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('562302331', 'W77000473', 'W77000473', 'UT01', 'Central Utah Anesthesia', 'sia', NULL, 'Central Utah Anesthe', 'GROUP', 'Anesthesiology', NULL, NULL, NULL, 'O', '1067 N 500 W', 'Provo', 'Utah', 'UT', '84604', '8013740354', NULL, NULL, NULL, '', NULL, NULL, '', '', '135', NULL, '1000', '47.25', NULL, NULL, 3, '2004-05-01', '2006-05-31', 1, 12, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '833036', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('562302331', 'W77000474', 'W77000474', 'UT01', 'Central Utah Anesthesia', 'David', NULL, 'Farnworth', 'CRNA', 'Anesthesiology', NULL, NULL, NULL, 'B', 'PO Box 1727', 'Provo', 'Utah', 'UT', '84603', '8013740354', NULL, NULL, NULL, '', NULL, NULL, '', '', '135', NULL, '1000', '40.43', NULL, NULL, 3, '2002-11-01', '2004-05-08', 1, 12, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1457575789', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('562302331', 'W77000475', 'W77000475', 'UT01', 'Central Utah Anesthesia', 'Jay', 'H', 'Gassman', 'MD', 'Anesthesiology', 'Nurse Anesthetist', NULL, NULL, 'O', '1067 N 500 W', 'Provo', 'Utah', 'UT', '84604', '8013758049', NULL, NULL, NULL, '', NULL, NULL, '', '', '135', NULL, '1000', '40.43', NULL, NULL, 3, '2001-07-01', '2004-05-08', 1, 12, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1720193956', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('562302331', 'W77000476', 'W77000476', 'UT01', 'Central Utah Anesthesia', 'Jay', 'H', 'Gassman', 'MD', 'Anesthesiology', 'Nurse Anesthetist', NULL, NULL, 'B', 'PO Box 1727', 'Provo', 'Utah', 'UT', '84603', '8013740354', NULL, NULL, NULL, '', NULL, NULL, '', '', '135', NULL, '1000', '40.43', NULL, NULL, 3, '2001-07-01', '2004-05-08', 1, 12, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1720193956', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('562302331', 'W77000477', 'W77000477', 'UT01', 'Central Utah Anesthesia', 'C', 'Robert', 'Teames', 'CRNA', 'Anesthesiology', NULL, NULL, NULL, 'O', '1067 N 500 W', 'Provo', 'Utah', 'UT', '84604', '8013758049', NULL, NULL, NULL, '', NULL, NULL, '', '', '135', NULL, '1000', '40.43', NULL, NULL, 3, '2002-11-01', '2004-05-08', 1, 12, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '832475', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('562349471', 'W77000478', 'W77000478', 'UT01', 'New Horizon Womens Care', 'Judith', 'A', 'Berry', 'NP', 'Gynecology', NULL, NULL, NULL, 'B', 'PO Box 95970', 'South Jordan', 'Salt Lake', 'UT', '84095', '8013529500', NULL, NULL, NULL, '', NULL, NULL, '', '', 'USTDOBG', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2003-06-01', '2006-11-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1104884253', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
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('621795214', 'W77000524', 'W77000524', 'UT01', 'Family Health Partners', 'Stacey', NULL, 'Bank', 'MD', 'Family Practice', 'Emergency Medicine', NULL, NULL, 'O', '620 E 2100 S', 'Salt Lake City', 'Salt Lake', 'UT', '84106', '8017464000', NULL, NULL, NULL, '', NULL, NULL, '', '', 'USTDINT', NULL, NULL, '0.00', '35.00', NULL, 3, '2005-09-30', '2005-10-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1790797959', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('621795214', 'W77000525', 'W77000525', 'UT01', 'Family Health Partners', 'Stacey', NULL, 'Bank', 'MD', 'Family Practice', 'Emergency Medicine', NULL, NULL, 'B', 'PO Box 95970', 'South Jordan', 'Salt Lake', 'UT', '84095', '8013529500', '8013529502', NULL, NULL, '', NULL, NULL, '', '', 'USTDINT', NULL, NULL, '0.00', '35.00', NULL, 3, '2005-09-30', '2005-10-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1790797959', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('621795214', 'W77000526', 'W77000526', 'UT01', 'Family Health Partners', 'Jonathan', 'W', 'Blanch', 'MD', 'Internal Medicine', 'Hospitalist', NULL, NULL, 'O', '620 E 2100 S', 'Salt Lake City', 'Salt Lake', 'UT', '84106', '8017464000', NULL, NULL, NULL, '', NULL, NULL, '', '', 'USTDINT', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2003-11-07', '2005-10-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1295757573', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('621795214', 'W77000527', 'W77000527', 'UT01', 'Salt Lake Senior Clinic', 'Jonathan', 'W', 'Blanch', 'MD', 'Internal Medicine', 'Hospitalist', NULL, NULL, 'O', '24 S 1100 E Ste 209', 'Salt Lake City', 'Salt Lake', 'UT', '84102', '8013504602', '8013504753', NULL, NULL, '', NULL, NULL, '', '', 'USTDINT', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2003-11-07', '2005-08-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1295757573', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('621795214', 'W77000528', 'W77000528', 'UT01', 'Salt Lake Senior Clinic', 'Gary', 'W', 'Buck', 'PA', 'Family Practice', NULL, NULL, NULL, 'B', 'PO Box 95970', 'South Jordan', 'Salt Lake', 'UT', '84095', '8013529500', '8013529502', NULL, NULL, '', NULL, NULL, '', '', 'USTDINT', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2004-02-27', '2006-10-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '831120', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('621795214', 'W77000529', 'W77000529', 'UT01', 'Salt Lake Senior Clinic', 'Frederick', NULL, 'Gottlieb', 'MD', 'Internal Medicine', NULL, NULL, NULL, 'O', '24 S 1100 E Ste 209', 'Salt Lake City', 'Salt Lake', 'UT', '84102', '8013504602', '8013504753', NULL, NULL, '', NULL, NULL, '', '', 'USTDINT', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2003-05-23', '2006-10-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '834414', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('621795214', 'W77000530', 'W77000530', 'UT01', 'Salt Lake Senior Clinic', 'Mandi', 'J', 'McKay', 'MD', 'Internal Medicine', NULL, NULL, NULL, 'O', '24 S 1100 E Ste 209', 'Salt Lake City', 'Salt Lake', 'UT', '84102', '8013504602', '8013504753', NULL, NULL, '', NULL, NULL, '', '', 'USTDINT', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2004-11-19', '2005-09-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1699716373', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('621795215', 'W77000531', 'W77000531', 'UT01', 'Center for Orthopedic & Rehabilitation Excellence', 'Charles', 'L', 'Beck', 'MD', 'Orthopedic Surgery', 'knees and  shoulders', NULL, NULL, 'O', '8785 Jordan Valley Way Ste B', 'West Jordan', 'Salt Lake', 'UT', '84088', '8015683480', '8015683482', NULL, NULL, '', NULL, NULL, '', '', 'USTDORTH', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2003-08-01', '2006-09-30', 0, 0, 0, 'Jordan Valley Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1528124815', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('621795215', 'W77000532', 'W77000532', 'UT01', 'Jordan Valley Surgical Specialists', 'Stephanie', NULL, 'Fine', 'MD', 'General Surgery', NULL, 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, '2005-03-01', '2006-09-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1922008622', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('621795215', 'W77000533', 'W77000533', 'UT01', 'Jordan Valley Hospital Holdings', 'Stephanie', NULL, 'Fine', 'MD', 'General Surgery', NULL, NULL, NULL, 'B', 'PO Box 95970', 'South Jordan', 'Salt Lake', 'UT', '84095', '8013529500', '8013527976', NULL, NULL, '', NULL, NULL, '', '', 'USTDSURG', NULL, NULL, '0.00', '35.00', NULL, 3, '2005-03-01', '2005-12-14', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1922008622', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('621795215', 'W77000534', 'W77000534', 'UT01', 'Jordan Landing Clinic', 'Brenten', 'C', 'Pugh', 'MD', 'Family Practice', NULL, NULL, NULL, 'O', '7478 Campus View Dr Ste 100', 'West Jordan', 'Salt Lake', 'UT', '84084', '8012807774', '8017482790', NULL, NULL, '', NULL, NULL, '', '', 'USTDFAM', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2002-05-24', '2006-01-31', 0, 0, 0, 'Jordan Valley Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1235158304', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('621795215', 'W77000535', 'W77000535', 'UT01', 'Center for Orthopedic & Rehabilitation Excellence', 'Gary', 'R', 'Zeluff', 'MD', 'Orthopedic Surgery', NULL, NULL, NULL, 'O', '8785 Jordan Valley Way Ste B', 'West Jordan', 'Salt Lake', 'UT', '84088', '8015683480', '8015683482', NULL, NULL, '', NULL, NULL, '', '', 'USTDORTH', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2005-11-23', '2006-09-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1861557688', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
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('562349471', 'W77000538', 'W77000538', 'UT01', 'New Horizon Healthcare', 'Larry', 'D', 'Smith', 'MD', 'Obstetrics and Gynecology', NULL, NULL, NULL, 'O', '1055 N 300 W Ste 411', 'Provo', 'Utah', 'UT', '84604', '8013578877', NULL, NULL, NULL, '', NULL, NULL, '', '', 'USTDOBG', NULL, NULL, '0.00', '35.00', NULL, 3, '2004-01-30', '2004-11-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '831621', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
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('563689606', 'W77000540', 'W77000540', 'UT01', 'Midvalley Clinic', 'David', 'A', 'Peterson', 'MD', 'Radiologist', NULL, NULL, NULL, 'O', '5204 S Redwood Rd Ste B', 'Murray', 'Salt Lake', 'UT', '84123', '8019671400', '8019671515', NULL, NULL, '', NULL, NULL, '', '', 'USTDRAD', NULL, NULL, '0.00', '35.00', NULL, 3, '2003-04-01', '2005-12-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '834583', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
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('611463417', 'W77000545', 'W77000545', 'UT01', 'U Of U Ob Diagnostic Center', 'Kjersti', 'M', 'Aagaard-Tillery', 'MD, PhD', 'Obstetrics and Gynecology', 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, '2004-07-01', '2006-07-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1033299938', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('611463417', 'W77000546', 'W77000546', 'UT01', 'U Of U Ob Diagnostic Center', 'David', 'W', 'Branch', 'MD', 'Maternal Fetal Medicine', 'Obstetrics and Gynecology', 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, '1999-09-01', '2006-07-31', 0, 0, 0, 'University Health Care University Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1922012830', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('611463417', 'W77000547', 'W77000547', 'UT01', 'U Of U Ob Diagnostic Center', 'Donna', 'S', 'Dizon-Townson', 'MD', 'Obstetrics and Gynecology', 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, '1999-09-01', '2006-07-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '831218', 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
('611463417', 'W77000548', 'W77000548', 'UT01', 'U Of U Ob Diagnostic Center', 'Michael', 'L', 'Draper', 'MD', 'Maternal Fetal Medicine', 'Obstetrics and Gynecology', NULL, NULL, 'O', '30 N 1900 E Ste 2B200', 'Salt Lake City', 'Salt Lake', 'UT', '84132', '8015812719', NULL, NULL, NULL, '', NULL, NULL, '', '', 'USTDOBG', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2001-09-14', '2006-07-31', 0, 0, 0, 'University Health Care University Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1992769368', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('611463417', 'W77000549', 'W77000549', 'UT01', 'U Of U Ob Diagnostic Center', 'Michael', 'L', 'Draper', 'MD', 'Maternal Fetal Medicine', 'Obstetrics and Gynecology', NULL, NULL, 'B', 'PO Box 58859', 'Salt Lake City', 'Salt Lake', 'UT', '84158', NULL, NULL, NULL, NULL, '', NULL, NULL, '', '', 'USTDOBG', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2001-09-14', '2006-07-31', 0, 0, 0, 'University Health Care University Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1992769368', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('611463417', 'W77000550', 'W77000550', 'UT01', 'U Of U Ob Diagnostic Center', 'Antonio', 'E', 'Frias', 'MD', 'Obstetrics and Gynecology', NULL, NULL, NULL, 'O', '30 N 1900 E Ste 2B200', 'Salt Lake City', 'Salt Lake', 'UT', '84132', '8015817647', NULL, NULL, NULL, '', NULL, NULL, '', '', 'UUUMG', NULL, NULL, '0.00', '25.00', NULL, 3, '2002-01-01', '2006-07-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1033130299', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('611463417', 'W77000551', 'W77000551', 'UT01', 'U Of U Ob Diagnostic Center', 'Robert', NULL, 'Andres', 'MD', 'Obstetrics and Gynecology', 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, '2001-09-14', '2006-07-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '831703', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('611463417', 'W77000552', 'W77000552', 'UT01', 'U Of U Ob Diagnostic Center', 'David', 'W', 'Branch', 'MD', 'Maternal Fetal Medicine', 'Obstetrics and Gynecology', 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, '1999-09-01', '2006-07-31', 0, 0, 0, 'University Health Care University Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1922012830', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('611463417', 'W77000553', 'W77000553', 'UT01', 'U Of U Ob Diagnostic Center', 'Janice', 'L B', 'Byrne', 'MD', 'Maternal Fetal Medicine', 'Obstetrics and Gynecology', 'Neonatology', 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, '2001-05-31', '2006-07-31', 0, 0, 0, 'University Health Care University Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1629158530', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('611463417', 'W77000554', 'W77000554', 'UT01', 'U Of U Ob Diagnostic Center', 'Donna', 'S', 'Dizon-Townson', 'MD', 'Obstetrics and Gynecology', 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, '1999-09-01', '2006-07-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '831218', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('611463417', 'W77000555', 'W77000555', 'UT01', 'U Of U Ob Diagnostic Center', 'Antonio', 'E', 'Frias', 'MD', 'Obstetrics and Gynecology', 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, '2002-01-01', '2006-07-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1033130299', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('611463417', 'W77000556', 'W77000556', 'UT01', 'U Of U Ob Diagnostic Center', 'Harry', 'H', 'Hatasaka', 'MD', 'Obstetrics and Gynecology', 'Reproductive Endocrinology', 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, '1999-09-01', '2006-07-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1740360650', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('611463417', 'W77000557', 'W77000557', 'UT01', 'U Of U Ob Diagnostic Center', 'Gilbert', 'Marc', 'Jackson', 'MD', 'Maternal Fetal Medicine', 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, '2003-09-10', '2006-07-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '671963', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
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('731714968', 'W77000651', 'W77000651', 'UT01', 'Rocky Mountain Anesthesiology Lc', 'John', NULL, 'Jarocki', 'CRNA', 'Anesthesiology', NULL, NULL, NULL, 'O', '5475 S 500 E', 'Ogden', 'Weber', 'UT', '84405', '8014792535', NULL, NULL, NULL, '', NULL, NULL, '', '', '135', NULL, '1000', '47.78', NULL, NULL, 3, '2002-04-01', '2005-10-01', 1, 12, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '833786', 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
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('731714968', 'W77000653', 'W77000653', 'UT01', 'Rocky Mountain Anesthesiology Lc', 'Nancy', NULL, 'Knape', 'CRNA', 'Anesthesiology', NULL, NULL, NULL, 'O', '5475 S 500 E', 'Ogden', 'Weber', 'UT', '84405', '8014792535', NULL, NULL, NULL, '', NULL, NULL, '', '', '135', NULL, '1000', '43.05', NULL, NULL, 3, '2001-04-01', '2004-05-08', 1, 12, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1427050186', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('731714968', 'W77000654', 'W77000654', 'UT01', 'Rocky Mountain Anesthesiology Lc', 'Jenny', 'L', 'LaRose', 'CRNA', 'Nurse Anesthetist', NULL, NULL, NULL, 'O', '5475 S 500 E', 'Ogden', 'Weber', 'UT', '84405', '8014792535', NULL, NULL, NULL, '', NULL, NULL, '', '', 'SELECT', NULL, '16580', '0.00', NULL, NULL, 3, '2005-02-15', '2006-12-31', 1, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '922051', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('731714968', 'W77000655', 'W77000655', 'UT01', 'Rocky Mountain Anesthesiology Lc', 'Bryan', 'J', 'Peterson', 'MD', 'Pain Management', NULL, NULL, NULL, 'B', '1954 E Fort Union Blvd Ste 106', 'Salt Lake City', 'Salt Lake', 'UT', '84121', '8019939508', NULL, NULL, NULL, '', NULL, NULL, '', '', 'SELECT', NULL, '16580', '0.00', NULL, NULL, 3, '2002-04-01', '2006-12-31', 1, 0, 0, 'Ogden Regional Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1578574489', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('731714968', 'W77000656', 'W77000656', 'UT01', 'Rocky Mountain Anesthesiology Lc', 'Bryan', 'J', 'Peterson', 'MD', 'Pain Management', NULL, NULL, NULL, 'O', '5475 S 500 E', 'Ogden', 'Weber', 'UT', '84405', '8014792535', NULL, NULL, NULL, '', NULL, NULL, '', '', 'SELECT', NULL, '16580', '0.00', NULL, NULL, 3, '2002-04-01', '2006-12-31', 1, 0, 0, 'Ogden Regional Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1578574489', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('731714968', 'W77000657', 'W77000657', 'UT01', 'Rocky Mountain Anesthesiology Lc', 'Ron', NULL, 'Poplyk', 'CRNA', 'Nurse Anesthetist', NULL, NULL, NULL, 'B', '1954 E Fort Union Blvd Ste 106', 'Salt Lake City', 'Salt Lake', 'UT', '84121', '8019939508', NULL, NULL, NULL, '', NULL, NULL, '', '', 'SELECT', NULL, '16580', '0.00', NULL, NULL, 3, '2005-10-01', '2006-12-31', 1, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1467463208', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('731714968', 'W77000658', 'W77000658', 'UT01', 'Rocky Mountain Anesthesiology Lc', 'Matthew', NULL, 'Saylor', 'CRNA', 'Anesthesiology', NULL, NULL, NULL, 'B', '1954 E Fort Union Blvd', 'Salt Lake City', 'Salt Lake', 'UT', '84121', '8019939508', NULL, NULL, NULL, '', NULL, NULL, '', '', '135', NULL, '1000', '47.78', NULL, NULL, 3, '2002-04-01', '2005-10-01', 1, 12, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '832358', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('621795214', 'W77000659', 'W77000659', 'UT01', 'Salt Lake Senior Clinic', 'Keith', 'J', 'Lane', 'MD', 'Internal Medicine', 'Geriatric Medicine', NULL, NULL, 'O', '24 S 1100 E Ste 209', 'Salt Lake City', 'Salt Lake', 'UT', '84102', '8013504602', '8013504753', NULL, NULL, '', NULL, NULL, '', '', 'USTDINT', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2003-05-23', '2006-10-31', 0, 0, 0, 'Salt Lake Regional Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1558370361', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('621795214', 'W77000660', 'W77000660', 'UT01', 'Family Health Partners', 'Elizabeth', 'L', 'Remillong', 'MD', 'Family Practice', NULL, NULL, NULL, 'O', '620 E 2100 S', 'Salt Lake City', 'Salt Lake', 'UT', '84106', '8017464000', NULL, NULL, NULL, '', NULL, NULL, '', '', 'USTDINT', NULL, NULL, '0.00', '35.00', NULL, 3, '2005-09-30', '2005-10-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '940043', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('621795215', 'W77000661', 'W77000661', 'UT01', 'Jordan Landing Clinic', 'Sean', 'D', 'Biggs', 'MD', 'Family Practice', NULL, NULL, NULL, 'O', '7478 Campus View Dr Ste 100', 'West Jordan', 'Salt Lake', 'UT', '84084', '8012807774', '8017482790', NULL, NULL, '', NULL, NULL, '', '', 'USTDFAM', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2003-08-01', '2005-10-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1841233558', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('621795215', 'W77000662', 'W77000662', 'UT01', 'Jordan Valley Hospital Holdings', 'Brenten', 'C', 'Pugh', 'MD', 'Family Practice', NULL, NULL, NULL, 'B', 'PO Box 95970', 'South Jordan', 'Salt Lake', 'UT', '84095', '8013529500', '8013527976', NULL, NULL, '', NULL, NULL, '', '', 'USTDFAM', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2002-05-24', '2006-01-31', 0, 0, 0, 'Jordan Valley Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1235158304', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('621795216', 'W77000663', 'W77000663', 'UT01', 'Pioneer Valley Hospital', 'Joseph', 'A', 'Conrad', 'MD', 'Internal Medicine', 'Geriatric Medicine ', NULL, NULL, 'B', '3336 Pioneer Pkwy Ste 101', 'Salt Lake City', 'Salt Lake', 'UT', '84120', '8019643946', '8019643635', NULL, NULL, '', NULL, NULL, '', '', 'USTDINT', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2001-01-01', '2007-01-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1164502662', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
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('621795217', 'W77000665', 'W77000665', 'UT01', 'Davis Internal Medicine', 'Marian', 'H', 'Pham', 'MD', 'Internal Medicine', 'Pediatrics', NULL, NULL, 'B', 'PO Box 95970', 'South Jordan', 'Salt Lake', 'UT', '84095', '8013529500', NULL, NULL, NULL, '', NULL, NULL, '', '', 'USTDINT', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2005-04-29', '2006-12-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1285667980', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('621795217', 'W77000666', 'W77000666', 'UT01', 'Davis Internal Medicine', 'John', 'K', 'Reis', 'MD', 'Internal Medicine', NULL, NULL, NULL, 'O', '1492 W Antelope Dr Ste 203', 'Layton', 'Davis', 'UT', '84041', '8017737500', NULL, NULL, NULL, '', NULL, NULL, '', '', 'USTDMULT', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2002-04-01', '2006-12-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1588689095', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('621795217', 'W77000667', 'W77000667', 'UT01', 'Davis Internal Medicine', 'Lovenia', 'M', 'Stam', 'NP', 'Family Practice', NULL, NULL, NULL, 'O', '1492 W Antelope Dr Ste 203', 'Layton', 'Davis', 'UT', '84041', '8017737500', NULL, NULL, NULL, '', NULL, NULL, '', '', 'USTDINT', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2002-04-01', '2006-12-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '831612', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('651189885', 'W77000668', 'W77000668', 'UT01', NULL, 'Jon', 'B', 'Bishop', 'MD', 'Plastic Surgery', NULL, NULL, NULL, 'O', '700 W 800 N Ste 442', 'Orem', 'Utah', 'UT', '84057', '8018020120', NULL, 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|', '1609818616', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('680562507', 'W77000669', 'W77000669', 'UT01', 'Davis Hospital & Medical Center LP', 'l Therapy at Da', 'vis Hospital', 'Wasatch Peak Physica', 'GROUP', 'Physical Therapy', 'Occupational Therapy', 'Speech Therapy', NULL, 'B', 'PO Box 26894', 'Salt Lake City', 'Salt Lake', 'UT', '84126', '8018258091', NULL, NULL, NULL, '', NULL, NULL, '', '', NULL, NULL, NULL, '0.00', '0.00', '42.00', 3, '1999-09-01', '2006-12-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '832879', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
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('680562677', 'W77000671', 'W77000671', 'UT01', 'Intermountain Ear Nose And Throat Specialists', 'Timothy', 'L', 'Pefaur', 'PA', 'Family Practice', 'Ear, Nose and Throat', NULL, NULL, 'O', '22 S 900 E', 'Salt Lake City', 'Salt Lake', 'UT', '84102', '8013282522', NULL, NULL, NULL, '', NULL, NULL, '', '', 'USTDENT', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2005-06-24', '2006-08-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1871628404', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
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INSERT INTO `providers_new` (`Provider_Tax_ID`, `Provider_Suffix`, `Provider_Network_ID`, `Provider_Region`, `Provider_Name`, `Provider_Doctor_First_Name`, `Provider_Doctor_Middle_Name`, `Provider_Doctor_Last_Name`, `Provider_Doctor_Degree`, `Provider_Specialty_1`, `Provider_Specialty_2`, `Provider_Specialty_3`, `Provider_Specialty_4`, `Provider_Address_Type`, `Provider_Address`, `Provider_City`, `Provider_County`, `Provider_State`, `Provider_Zip`, `Provider_Phone`, `Provider_Fax`, `Provider_Mailing_Address`, `Provider_Mailing_City`, `Provider_Mailing_County`, `Provider_Mailing_State`, `Provider_Mailing_Zip`, `Provider_Mailing_Phone`, `Provider_Mailing_Fax`, `Provider_Primary_Schedule`, `Provider_Secondary_Schedule`, `Provider_Rate_Sheet`, `Provider_Anes_Rate`, `Provider_Default_Rate`, `Provider_Max_DOS`, `Provider_Min_Match_Value`, `Provider_Effective_Date`, `Provider_Term_Date`, `Provider_Pend`, `Provider_Anes_Minutes`, `Provider_PPO`, `Provider_Hospital_1`, `Provider_Hospital_2`, `Provider_Hospital_3`, `Provider_Hospital_4`, `Provider_Type`, `Provider_NPI`, `Provider_Check_Override`, `Exclude_Dir`, `Audit_Status`, `Last_Change_Date`, `Medicare_ID`, `Provider_Lang`, `Provider_Latitude`, `Provider_Longitude`, `Provider_school`, `Provider_cert`) VALUES
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('810608733', 'W77000961', 'W77000961', 'UT01', 'Nexus Pain Care', 'Robin', 'R', 'Ockey', 'MD', 'Physical Medicine and Rehabilitation', NULL, NULL, NULL, 'B', 'PO Box 27688', 'Salt Lake City', 'Salt Lake', 'UT', '84127', '8015341360', NULL, NULL, NULL, '', NULL, NULL, '', '', 'USTDPHMR', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2003-05-01', '2006-10-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1326046160', 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
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('810608733', 'W77000963', 'W77000963', 'UT01', 'Nexus Pain Care', 'Brian', 'K', 'Olenslager', 'MD', 'Physical Medicine and Rehabilitation', NULL, NULL, NULL, 'B', 'PO Box 27688', 'Salt Lake City', 'Salt Lake', 'UT', '84127', '8015341360', NULL, NULL, NULL, '', NULL, NULL, '', '', 'USTDPAIN', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2004-08-06', '2006-10-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1225036064', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('810608733', 'W77000965', 'W77000965', 'UT01', 'Nexus Pain Care', 'Richard', NULL, 'Rosenthal', 'MD', 'Pain Management', NULL, NULL, NULL, 'O', '3585 N University Ave Ste 150', 'Provo', 'Utah', 'UT', '84604', '8013566100', NULL, NULL, NULL, '', NULL, NULL, '', '', 'USTDPAIN', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2003-04-01', '2006-10-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1073512745', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('810608733', 'W77000966', 'W77000966', 'UT01', 'Nexus Pain Care', 'Cynthia', 'C', 'Sullivan', 'PA', 'Pain Management', NULL, NULL, NULL, 'O', '3585 N University Ave Ste 150', 'Provo', 'Utah', 'UT', '84604', '8013566100', NULL, NULL, NULL, '', NULL, NULL, '', '', 'USTDPAIN', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2004-10-29', '2006-10-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '911510', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
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('743134262', 'W77000970', 'W77000970', 'UT01', 'Pediatric Neurology Dept University of Utah', 'Francis', 'M', 'Filloux', 'MD', 'Pediatric Neurology', 'Neurology', NULL, NULL, 'O', '100 N Medical Dr', 'Salt Lake City', 'Salt Lake', 'UT', '84132', '8015882000', NULL, NULL, NULL, '', NULL, NULL, '', '', 'UUMGPED', NULL, NULL, '0.00', '15.00', NULL, 3, '2000-01-01', '2006-07-31', 0, 0, 0, 'Primary Childrens Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1942389515', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
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('841401924', 'W77001056', 'W77001056', 'UT01', 'Alpine Medical Group', 'Shaun', 'S', 'Evans', 'CRNA', 'Certified Nurse Anesthetist', 'Anesthesiology', NULL, NULL, 'B', '1954 E Fort Union Blvd Ste 101', 'Salt Lake City', 'Salt Lake', 'UT', '84121', '8019939500', '8017335618', '1954 E Fort Union Blvd', 'Salt Lake City', '', 'UT', '84121', '', '', NULL, NULL, '1000', '47.25', NULL, NULL, 3, '2003-09-01', '2007-04-01', 1, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1649292897', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('841401924', 'W77001057', 'W77001057', 'UT01', 'Alpine Medical Group Ob/Gyn & Pediatrics', 'Rita', NULL, 'Gambrel', 'CNM', 'Obstetrics and Gynecology', NULL, NULL, NULL, 'O', '1060 E 100 S Ste 400', 'Salt Lake City', 'Salt Lake', 'UT', '84102', '8015212640', '8013636407', NULL, NULL, '', NULL, NULL, '', '', 'USTDMULT', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2000-01-01', '2006-02-22', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '831392', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
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('841401924', 'W77001059', 'W77001059', 'UT01', 'Alpine Internal Medicine', 'Beth', 'Chapman', 'Hanlon', 'MD', 'Internal Medicine', NULL, NULL, NULL, 'O', '1060 E 100 S Ste L10', 'Salt Lake City', 'Salt Lake', 'UT', '84102', '8013281260', '8013284361', NULL, NULL, '', NULL, NULL, '', '', 'USTDMULT', NULL, NULL, '0.00', '35.00', NULL, 3, '2002-04-01', '2006-11-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1801860648', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
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('841367175', 'W77001064', 'W77001064', 'UT01', 'Canyon View Medical Group', 'Jared', 'L', 'Bingham', 'MD', 'Family Practice', NULL, NULL, NULL, 'O', '57 W Main St', 'Santaquin', 'Utah', 'UT', '84655', '8017543122', NULL, NULL, NULL, '', NULL, NULL, '', '', 'UUVPN', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2000-06-23', '2006-05-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1932154200', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('841367175', 'W77001065', 'W77001065', 'UT01', 'Canyon View Medical Group', 'Tracy', 'M', 'Frandsen', 'MD', 'Family Practice', NULL, NULL, NULL, 'O', '325 W Ctr St', 'Spanish Fork', 'Utah', 'UT', '84660', '8017987301', 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|', '1003854324', 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
('841367175', 'W77001066', 'W77001066', 'UT01', 'Canyon View Medical Group', 'Bret', 'N', 'LeSueur', 'DO', 'Family Practice', NULL, NULL, NULL, 'O', '5 E 400 N', 'Springville', 'Utah', 'UT', '84663', '8014898464', '8014896378', NULL, NULL, '', NULL, NULL, '', '', 'UUVPN', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2000-02-25', '2005-12-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1871548248', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('841367175', 'W77001067', 'W77001067', 'UT01', 'Canyon View Medical Group', 'Stuart', 'B', 'Porter', 'DO', 'Family Practice', NULL, NULL, NULL, 'O', '325 W Ctr St', 'Spanish Fork', 'Utah', 'UT', '84660', '8017987301', NULL, NULL, NULL, '', NULL, NULL, '', '', 'UUVPN', NULL, NULL, '0.00', '35.00', NULL, 3, '1999-09-01', '2005-06-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1689612996', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('841367175', 'W77001068', 'W77001068', 'UT01', 'Canyon View Medical Group', 'Roman', 'Y', 'Takasaki', 'MD', 'Family Practice', NULL, NULL, NULL, 'O', '325 W Ctr St', 'Spanish Fork', 'Utah', 'UT', '84660', '8017987301', 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|', '1669428611', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('841367175', 'W77001069', 'W77001069', 'UT01', 'Canyon View Medical Group', 'John', 'S', 'Taylor', 'MD', 'Family Practice', NULL, NULL, NULL, 'B', '325 W Ctr St', 'Spanish Fork', 'Utah', 'UT', '84660', '8014898464', NULL, NULL, NULL, '', NULL, NULL, '', '', 'UUVPN', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2000-04-01', '2006-05-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1740228055', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('841367175', 'W77001070', 'W77001070', 'UT01', 'Canyon View Medical Group', 'John', 'S', 'Taylor', 'MD', 'Family Practice', NULL, NULL, NULL, 'O', '5 E 400 N', 'Springville', 'Utah', 'UT', '84663', '8014898464', '8014896378', NULL, NULL, '', NULL, NULL, '', '', 'UUVPN', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2000-04-01', '2005-12-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1740228055', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('841372856', 'W77001071', 'W77001071', 'UT01', 'Ramsey, Keith P', 'Keith', 'P', 'Ramsey', 'DO', 'Pediatrics', NULL, NULL, NULL, 'O', '8822 Redwood Rd Ste S103', 'West Jordan', 'Salt Lake', 'UT', '84088', '8012532273', NULL, NULL, NULL, '', NULL, NULL, '', '', 'USTDPEDE', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2002-04-01', '2006-10-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1245294586', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('841388333', 'W77001072', 'W77001072', 'UT01', 'Rocky Mountain Ophthalmology', 'Neil', 'J', 'Atodaria', 'MD', 'Ophthalmology', NULL, NULL, NULL, 'B', '4400 S 700 E Ste 240', 'Murray', 'Salt Lake', 'UT', '84107', '8012644464', '8012882521', NULL, NULL, '', NULL, NULL, '', '', 'UUUMG', NULL, NULL, '0.00', '25.00', NULL, 3, '2004-07-12', '2006-07-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '903018', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('841388333', 'W77001073', 'W77001073', 'UT01', 'Rocky Mountain Ophthalmology', 'Dustin', 'J', 'Coupal', 'MD', 'Ophthalmology', NULL, NULL, NULL, 'B', '4400 S 700 E Ste 240', 'Murray', 'Salt Lake', 'UT', '84107', '8012644464', '8012882521', NULL, NULL, '', NULL, NULL, '', '', 'UUUMG', NULL, NULL, '0.00', '25.00', NULL, 3, '2005-07-08', '2006-07-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '936586', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
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('841431764', 'W77001156', 'W77001156', 'UT01', 'Eastern Utah Eye Physicians', 'Timothy', 'L', 'Byers', 'MD', 'Ophthalmology', NULL, NULL, NULL, 'O', '200 N Fairgrounds Rd Ste 2', 'Price', 'Carbon', 'UT', '84501', '4356378689', '4356371123', NULL, NULL, '', NULL, NULL, '', '', 'UEASTUT', 'USTDHCPC', NULL, '0.00', '20.00', NULL, 3, '2002-10-01', '2006-10-31', 0, 0, 0, 'Castleview Hospital', 'Castleview Hospital-Pro Fees', NULL, NULL, 'HCFA|UB|', '1073620324', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('860750222', 'W77001157', 'W77001157', 'UT01', 'Concentra Medical Centers', 'nters', NULL, 'Concentra Medical Ce', 'GROUP', 'Physical Therapy', NULL, NULL, NULL, 'O', '385 W 9000 S', 'Sandy', 'Salt Lake', 'UT', '84070', '8889972669', '8884488916', NULL, NULL, '', NULL, NULL, '', '', NULL, NULL, NULL, '0.00', '0.00', '57.75', 3, '2005-08-22', '2006-12-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '939391', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('860750222', 'W77001158', 'W77001158', 'UT01', 'Concentra Medical Centers', 'nters', NULL, 'Concentra Medical Ce', 'GROUP', 'Physical Therapy', NULL, NULL, NULL, 'B', 'PO Box 11050', 'Denver', 'Denver', 'CO', '80211', '8008588599', NULL, NULL, NULL, '', NULL, NULL, '', '', NULL, NULL, NULL, '0.00', '0.00', '57.75', 3, '2005-08-22', '2006-12-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '939391', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870212456', 'W77001159', 'W77001159', 'UT01', 'Jackson Family Clinic', 'John', 'W', 'Jackson', 'MD', 'Family Practice', NULL, NULL, NULL, 'B', 'PO Box 669', 'Gunnison', 'Sanpete', 'UT', '84634', NULL, NULL, NULL, NULL, '', NULL, NULL, '', '', 'URURAL', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2005-10-28', '2006-11-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1548321862', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870217443', 'W77001160', 'W77001160', 'UT01', 'East Carbon Medical Service', 'Russell', NULL, 'Hunt', 'PA', 'Family Practice', NULL, NULL, NULL, 'O', '305 Ctr St', 'East Carbon City', 'Carbon', 'UT', '84520', '4358884411', '4358882270', NULL, NULL, '', NULL, NULL, '', '', 'URURAL', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2003-04-01', '2006-10-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1740242866', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870217443', 'W77001161', 'W77001161', 'UT01', 'East Carbon Medical Service', 'Kurt', 'V', 'King', 'MD', 'Urgent Care', 'Internal Medicine', 'Emergency Medicine', NULL, 'O', '305 Ctr St', 'East Carbon City', 'Carbon', 'UT', '84520', '4358884411', '4358882270', NULL, NULL, '', NULL, NULL, '', '', 'URURAL', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2001-01-01', '2006-10-31', 0, 0, 0, 'Logan Regional Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1649267949', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870217443', 'W77001162', 'W77001162', 'UT01', 'East Carbon Medical Service', 'Virginia', NULL, 'Wheeler', 'NP', 'Family Practice', NULL, NULL, NULL, 'O', '305 Ctr St', 'East Carbon City', 'Carbon', 'UT', '84520', '4358884411', '4358882270', NULL, NULL, '', NULL, NULL, '', '', 'URURAL', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2002-09-01', '2006-10-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1699737510', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870218917', 'W77001163', 'W77001163', 'UT01', 'Tanner Clinic-Audiology', 'ogy', NULL, 'Tanner Clinic-Audiol', 'GROUP', 'Audiology', NULL, NULL, NULL, 'O', '2121 Robins Dr', 'Layton', 'Davis', 'UT', '84041', '8017734840', '8017749219', NULL, NULL, '', NULL, NULL, '', '', 'USTDMULT', NULL, NULL, '0.00', '35.00', NULL, 3, '2001-01-01', '2005-03-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '831053', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870218917', 'W77001164', 'W77001164', 'UT01', 'Tanner Memorial Clinic', 'Gary', 'J', 'Alexander', 'MD', 'Internal Medicine', 'Pulmonary', 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, '2001-01-01', '2006-06-30', 0, 0, 0, 'Davis Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1265418024', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870218917', 'W77001165', 'W77001165', 'UT01', 'Tanner Memorial Clinic', 'Layne', 'T', 'Barker', 'MD', 'Family Practice', 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, '2001-01-01', '2006-06-30', 0, 0, 0, 'Davis Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1992781918', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('841411398', 'W77001166', 'W77001166', 'UT01', 'Foothill Family Clinic', 'Alfred', 'H', 'Namba', 'MD', 'Internal Medicine', NULL, NULL, NULL, 'O', '6360 S 3000 E Ste 100', 'Salt Lake City', 'Salt Lake', 'UT', '84121', '8013651032', '8013651033', NULL, NULL, '', NULL, NULL, '', '', 'UFOOTHIL', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2002-11-01', '2006-12-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1588791834', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('841411398', 'W77001168', 'W77001168', 'UT01', 'Foothill Family Clinic', 'Mark', 'A', 'Rosen', 'MD', 'Orthopedic Surgery', NULL, NULL, NULL, 'O', '6360 S 3000 E Ste 100', 'Salt Lake City', 'Salt Lake', 'UT', '84121', '8013651032', '8013651033', NULL, NULL, '', NULL, NULL, '', '', 'UFOOTHIL', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2002-04-01', '2006-12-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1609823426', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('841411398', 'W77001170', 'W77001170', 'UT01', 'Foothill Family Clinic', 'E Douglas', NULL, 'Slawson', 'MD', 'General Surgery', NULL, NULL, NULL, 'O', '6360 S 3000 E Ste 100', 'Salt Lake City', 'Salt Lake', 'UT', '84121', '8013651032', '8013651033', NULL, NULL, '', NULL, NULL, '', '', 'UFOOTHIL', NULL, NULL, '0.00', '35.00', NULL, 3, '2002-11-01', '2005-10-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '834002', 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
('841411398', 'W77001171', 'W77001171', 'UT01', 'Foothill Family Clinic', 'Jack', NULL, 'Taylor', 'MD', 'Family Practice', NULL, NULL, NULL, 'O', '2295 Foothill Dr', 'Salt Lake City', 'Salt Lake', 'UT', '84109', '8014863021', '8014856339', NULL, NULL, '', NULL, NULL, '', '', 'UFOOTHIL', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2002-11-01', '2006-12-31', 0, 0, 0, 'St Marks Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1467477505', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('841411398', 'W77001172', 'W77001172', 'UT01', 'Foothill Family Clinic', 'Jack', NULL, 'Taylor', 'MD', 'Family Practice', NULL, NULL, NULL, 'B', '6360 S 3000 E Ste 100', 'Salt Lake City', 'Salt Lake', 'UT', '84121', '8013651032', '8013651033', NULL, NULL, '', NULL, NULL, '', '', 'UFOOTHIL', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2002-11-01', '2006-12-31', 0, 0, 0, 'St Marks Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1467477505', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('841411398', 'W77001173', 'W77001173', 'UT01', 'Foothill Family Clinic', 'Carl', 'T', 'Woolsey', 'MD', 'Obstetrics and Gynecology', NULL, NULL, NULL, 'O', '6360 S 3000 E Ste 100', 'Salt Lake City', 'Salt Lake', 'UT', '84121', '8013651032', '8013651033', NULL, NULL, '', NULL, NULL, '', '', 'UFOOTHIL', NULL, NULL, '0.00', '35.00', NULL, 3, '2002-04-01', '2004-11-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '831241', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('841424470', 'W77001174', 'W77001174', 'UT01', 'Pham, Kieuanh Jacqueline', 'Jacqueline', 'K', 'Pham', 'MD', 'Internal Medicine', NULL, NULL, NULL, 'B', 'PO Box 17905', 'Salt Lake City', 'Salt Lake', 'UT', '84117', '8012772323', NULL, NULL, NULL, '', NULL, NULL, '', '', 'USTDINT', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2002-04-01', '2006-10-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '831105', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('841401924', 'W77001175', 'W77001175', 'UT01', 'Alpine Internal Medicine', 'Alex', 'H', 'Tessnow', 'MD', 'Internal Medicine', NULL, NULL, NULL, 'O', '1060 E 100 S Ste L10', 'Salt Lake City', 'Salt Lake', 'UT', '84102', '8013281260', '8013284361', NULL, NULL, '', NULL, NULL, '', '', 'USTDMULT', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2002-04-01', '2006-11-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1740255801', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('841401924', 'W77001176', 'W77001176', 'UT01', 'Alpine Internal Medicine', 'Wanda', NULL, 'Updike', 'MD', 'Infectious Disease', NULL, NULL, NULL, 'O', '1060 E 100 S Ste L10', 'Salt Lake City', 'Salt Lake', 'UT', '84102', '8013281260', '8013284361', NULL, NULL, '', NULL, NULL, '', '', 'USTDMULT', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2002-04-01', '2006-11-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1518932664', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('841401924', 'W77001177', 'W77001177', 'UT01', 'Alpine Medical Anesthesia & Pain Management', 'Mary', 'Jean', 'Walker', 'NP', 'Pain Management', NULL, NULL, NULL, 'O', '1050 E S Temple', 'Salt Lake City', 'Salt Lake', 'UT', '84102', '8019931566', '8017335618', NULL, NULL, '', NULL, NULL, '', '', 'USTDPAIN', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2004-01-30', '2007-03-01', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1508851890', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('841401924', 'W77001178', 'W77001178', 'UT01', 'Alpine Medical Group', 'Mary', 'Jean', 'Walker', 'NP', 'Pain Management', NULL, NULL, NULL, 'B', '1954 E Fort Union Blvd Ste 101', 'Salt Lake City', 'Salt Lake', 'UT', '84121', '8019931556', NULL, NULL, NULL, '', NULL, NULL, '', '', 'USTDPAIN', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2004-01-30', '2007-03-01', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1508851890', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('841401924', 'W77001179', 'W77001179', 'UT01', 'Alpine Medical Anesthesia & Pain Management', 'David', 'C', 'Wallace', 'MD', 'Anesthesiology', NULL, NULL, NULL, 'O', '1050 E S Temple', 'Salt Lake City', 'Salt Lake', 'UT', '84102', '8019931566', '8017335618', '1954 E Fort Union Blvd', 'Salt Lake City', '', 'UT', '84121', '', '', NULL, NULL, '1000', '47.25', NULL, NULL, 3, '2002-12-01', '2007-04-01', 1, 12, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '832036', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('841401924', 'W77001180', 'W77001180', 'UT01', 'Alpine Medical Group', 'David', 'C', 'Wallace', 'MD', 'Anesthesiology', NULL, NULL, NULL, 'B', '1954 E Fort Union Blvd Ste 101', 'Salt Lake City', 'Salt Lake', 'UT', '84121', '8019939500', '8017335618', '1954 E Fort Union Blvd', 'Salt Lake City', '', 'UT', '84121', '', '', NULL, NULL, '1000', '47.25', NULL, NULL, 3, '2002-12-01', '2007-04-01', 1, 12, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '832036', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('841401924', 'W77001181', 'W77001181', 'UT01', 'Alpine Medical Group', 'Kathryn', NULL, 'Young', 'CRNA', 'Anesthesiology', NULL, NULL, NULL, 'B', '1954 E Fort Union Blvd Ste 101', 'Salt Lake City', 'Salt Lake', 'UT', '84121', '8019939500', '8017335618', NULL, NULL, '', NULL, NULL, '', '', '135', NULL, '1000', '44.10', NULL, NULL, 3, '1999-09-01', '2005-08-01', 1, 12, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '834315', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('841407804', 'W77001182', 'W77001182', 'UT01', NULL, 'Christine', 'A', 'Cheng', 'MD', 'Plastic Surgery', NULL, NULL, NULL, 'O', '415 Medical Dr Ste D102', 'Bountiful', 'Davis', 'UT', '84010', '8012989774', NULL, NULL, NULL, '', NULL, NULL, '', '', 'USTDPLAS', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '1999-09-01', '2006-12-31', 0, 0, 0, 'Lakeview Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1306848338', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('841411398', 'W77001183', 'W77001183', 'UT01', 'Foothill Family Clinic', 'Ross', NULL, 'Brunetti', 'MD', 'Family Practice', NULL, NULL, NULL, 'B', '6360 S 3000 E Ste 100', 'Salt Lake City', 'Salt Lake', 'UT', '84121', '8013651032', '8013651033', NULL, NULL, '', NULL, NULL, '', '', 'UFOOTHIL', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2002-11-01', '2006-12-31', 0, 0, 0, 'St Marks Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1700811023', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('841411398', 'W77001184', 'W77001184', 'UT01', 'Foothill Family Clinic', 'Richard', 'W', 'Chapa', 'MD', 'Obstetrics and Gynecology', NULL, NULL, NULL, 'O', '2295 Foothill Dr', 'Salt Lake City', 'Salt Lake', 'UT', '84109', '8014863021', '8014856339', NULL, NULL, '', NULL, NULL, '', '', 'UFOOTHIL', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2002-04-01', '2006-12-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1568556298', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('841411398', 'W77001185', 'W77001185', 'UT01', 'Foothill Family Clinic', 'Shane', NULL, 'Christensen', 'MD', 'Family Practice', NULL, NULL, NULL, 'O', '6360 S 3000 E Ste 100', 'Salt Lake City', 'Salt Lake', 'UT', '84121', '8013651032', '8013651033', NULL, NULL, '', NULL, NULL, '', '', 'UFOOTHIL', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2002-11-01', '2006-12-31', 0, 0, 0, 'St Marks Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1861427189', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('841411398', 'W77001186', 'W77001186', 'UT01', 'Foothill Family Clinic', 'Tyler', 'L', 'Collins', 'DPM', 'Podiatry', NULL, NULL, NULL, 'B', '6360 S 3000 E Ste 100', 'Salt Lake City', 'Salt Lake', 'UT', '84121', '8013651032', '8013651033', NULL, NULL, '', NULL, NULL, '', '', 'UFOOTHIL', NULL, NULL, '0.00', '35.00', NULL, 3, '2002-04-01', '2002-04-01', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1376617563', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('841411398', 'W77001187', 'W77001187', 'UT01', 'Foothill Family Clinic', 'Anne', NULL, 'Donohue', 'MD', 'Family Practice', NULL, NULL, NULL, 'B', '6360 S 3000 E Ste 100', 'Salt Lake City', 'Salt Lake', 'UT', '84121', '8013651032', '8013651033', NULL, NULL, '', NULL, NULL, '', '', 'UFOOTHIL', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2002-11-01', '2006-12-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '832068', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870218917', 'W77001188', 'W77001188', 'UT01', 'Tanner Memorial Clinic', 'Mark', 'E', 'Baxter', 'MD', 'Family Practice', 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, '2000-12-02', '2006-06-30', 0, 0, 0, 'Davis Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1437135290', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870218917', 'W77001189', 'W77001189', 'UT01', 'Tanner Memorial Clinic', 'Michael', 'L', 'Beus', 'MD', 'Family Practice', 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, '2001-01-01', '2006-06-30', 0, 0, 0, 'Davis Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1770569543', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870218917', 'W77001190', 'W77001190', 'UT01', 'Tanner Memorial Clinic', 'Mark', 'R', 'Bitner', 'MD', 'Obstetrics and Gynecology', 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, '2001-01-01', '2006-06-30', 0, 0, 0, 'Davis Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1447236203', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870218917', 'W77001191', 'W77001191', 'UT01', 'Tanner Memorial Clinic', 'Scott', 'R', 'Checketts', 'MD', 'Dermatology', 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, '2001-01-01', '2006-06-30', 0, 0, 0, 'Davis Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1790762961', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870218917', 'W77001192', 'W77001192', 'UT01', 'Tanner Memorial Clinic', 'Jason', 'R', 'Fife', 'DO', 'Family Practice', 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, '2004-04-02', '2006-06-30', 0, 0, 0, 'Davis Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1790761740', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870218917', 'W77001193', 'W77001193', 'UT01', 'Tanner Memorial Clinic', 'Stephen', 'M', 'Foote', 'DO', 'Family Practice', 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, '2002-07-01', '2006-06-30', 0, 0, 0, 'Davis Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1689650632', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
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