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', 'W11023097', 'W11023097', 'UTPEHP2', 'Fillmore Community Medical Center', 'E', 'Bruce', 'Mciff', 'MD', 'Vascular Surgery', 'Radiologist', '', NULL, 'B', '674 S Highway 99', 'Fillmore', 'Millard', 'UT', '84631', '4357435857', NULL, '674 S Highway 99', 'Fillmore', 'Millard', 'UT', '84631', '4357435857', '          ', '', '', '', '0.00', '15.00', '0.00', 8, '2008-07-01', '2011-04-01', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1376596320', 0, 'Y', 0, '2011-11-17', NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W11023098', 'W11023098', 'UTPEHP2', 'Fillmore Community Medical Center', 'Douglas', 'R', 'Newbold', 'MD', 'Family Practice', '', '', NULL, 'B', '674 S Hwy 99', 'Fillmore', NULL, 'UT', '84631', '4357435857', NULL, '674 S Hwy 99', 'Fillmore', '', 'UT', '84631', '4357435857', '', '', NULL, NULL, '0.00', '15.00', '0.00', 8, '2008-07-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1447363239', 0, 'Y', 0, '2013-06-13', NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W11023099', 'W11023099', 'UTPEHP2', 'Fillmore Community Medical Center', 'Ryan', 'B', 'Nielsen', 'MD', 'Vascular Surgery', '', '', NULL, 'B', '674 S Hwy 99', 'Fillmore', 'Millard', 'UT', '84631', '4357435857', NULL, '674 S Highway 99', 'Fillmore', 'Millard', 'UT', '84631', '4357435857', '', '', NULL, NULL, '0.00', '15.00', '0.00', 8, '2008-07-01', NULL, 0, 0, 0, NULL, '', '', '', 'HCFA|UB|', '1821032863', 0, 'Y', 0, '2011-11-18', NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W11023100', 'W11023100', 'UTPEHP2', 'Fillmore Community Medical Center', 'Rodney', 'C', 'Petersen', 'MD', 'Radiologist', NULL, NULL, NULL, 'B', '674 S Hwy 99', 'Fillmore', 'Millard', 'UT', '84631', '4357435857', NULL, NULL, NULL, 'Millard', NULL, NULL, NULL, NULL, '', NULL, NULL, '0.00', '15.00', '0.00', 8, '2008-07-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1548216765', 0, 'Y', 0, '2010-01-12', NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W11023101', 'W11023101', 'UTPEHP2', 'Fillmore Community Medical Center', 'Devon', 'D', 'Peterson', 'CRNA', 'Certified Nurse Anesthetist', NULL, NULL, NULL, 'B', '674 S Hwy 99', 'Fillmore', 'Millard', 'UT', '84631', '4357435857', NULL, NULL, NULL, 'Millard', NULL, NULL, NULL, NULL, '', NULL, NULL, '0.00', '15.00', '0.00', 8, '2008-07-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1245278035', 0, 'Y', 0, '2010-01-12', NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W11023102', 'W11023102', 'UTPEHP2', 'Fillmore Community Medical Center', 'Joseph', 'D', 'Rasband', 'MD', 'Radiology', '', '', NULL, 'B', '674 S Hwy 99', 'Fillmore', 'Millard', 'UT', '84631', '4357435857', NULL, '674 S Hwy 99', 'Fillmore', 'Millard', 'UT', '84631', '4357435857', '', '', NULL, NULL, '0.00', '15.00', '0.00', 8, '2008-07-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1922059542', 0, 'Y', 0, '2014-03-18', NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W11023103', 'W11023103', 'UTPEHP2', 'Fillmore Community Medical Center', 'Lisa', 'M', 'Saturnino', 'MD', 'Family Practice', '', '', NULL, 'B', '674 S Hwy 99', 'Fillmore', 'Millard', 'UT', '84631', '4357435857', NULL, '674 S Hwy 99', 'Fillmore', 'Millard', 'UT', '84631', '4357435857', '', '', NULL, NULL, '0.00', '15.00', '0.00', 8, '2008-07-01', NULL, 0, 0, 0, 'Salt Lake Regional Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1336362490', 0, 'Y', 0, '2013-05-23', NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W11023104', 'W11023104', 'UTPEHP2', 'Fillmore Community Medical Center', 'Alan', 'R', 'Smith', 'MD', 'Family Practice', '', '', NULL, 'B', '674 S Hwy 99', 'Fillmore', NULL, 'UT', '84631', '4357435857', NULL, '674 S Hwy 99', 'Fillmore', '', 'UT', '84631', '4357435857', '', '', NULL, NULL, '0.00', '15.00', '0.00', 8, '2008-07-01', NULL, 0, 0, 0, 'Delta Community Medical Center', '', '', '', 'HCFA|UB|', '1700988201', 0, 'Y', 0, '2014-04-07', NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W11023105', 'W11023105', 'UTPEHP2', 'Fillmore Community Medical Center', 'Kimball', 'Bruce', 'Taylor', 'MD', 'Radiologist', '', '', NULL, 'B', '674 S Hwy 99', 'Fillmore', 'Millard', 'UT', '84631', '4357435857', NULL, '674 S Highway 99', 'Fillmore', 'Millard', 'UT', '84631', '4357435857', '', '', NULL, NULL, '0.00', '15.00', '0.00', 8, '2008-07-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1760420996', 0, 'Y', 0, '2010-12-28', NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W11023106', 'W11023106', 'UTPEHP2', 'Fillmore Community Medical Center', 'Gary', 'M', 'Watts', 'MD', 'Radiologist', NULL, NULL, NULL, 'O', '674 S Hwy 99', 'Fillmore', 'Millard', 'UT', '84631', '4357435857', NULL, NULL, NULL, 'Millard', NULL, NULL, NULL, NULL, '', NULL, NULL, '0.00', '15.00', '0.00', 8, '2008-07-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1528014792', 0, 'N', 0, '2010-01-12', NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W11023107', 'W11023107', 'UTPEHP2', 'Fillmore Community Medical Center', 'Jonathan', 'A', 'Weeks', 'MD', 'Family Practice', '', '', NULL, 'B', '674 S Hwy 99', 'Fillmore', 'Millard', 'UT', '84631', '4357435857', NULL, '674 S Hwy 99', 'Fillmore', 'Millard', 'UT', '84631', '4357435857', '', '', NULL, NULL, '0.00', '15.00', '0.00', 8, '2008-07-01', NULL, 0, 0, 0, 'Ogden Regional Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1649364803', 0, 'Y', 0, '2013-10-30', NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W11023108', 'W11023108', 'UTPEHP2', 'Fillmore Community Medical Center', 'Karl', 'N', 'Weenig', 'MD', 'Family Practice', 'Sports Medicine', '', NULL, 'B', '674 S Hwy 99', 'Fillmore', 'Millard', 'UT', '84631', '4357435857', NULL, '674 S Hwy 99', 'Fillmore', 'Millard', 'UT', '84631', '4357435857', '', '', NULL, NULL, '0.00', '15.00', '0.00', 8, '2008-07-01', NULL, 0, 0, 0, 'Mountain View Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1740242973', 0, 'Y', 0, '2013-08-28', NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W11023109', 'W11023109', 'UTPEHP2', 'Fillmore Community Medical Center', 'Steve', 'Fred', 'Wilstead', 'CRNA', 'Certified Nurse Anesthetist', NULL, NULL, NULL, 'O', '674 S Hwy 99', 'Fillmore', 'Millard', 'UT', '84631', '4357435857', NULL, NULL, NULL, 'Millard', NULL, NULL, NULL, NULL, '', NULL, NULL, '0.00', '15.00', '0.00', 8, '2008-07-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1679521744', 0, 'N', 0, '2010-01-12', NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W11023110', 'W11023110', 'UTPEHP2', 'Fillmore Community Medical Center', 'S', 'Douglas', 'Wing', 'MD', 'Radiologist', NULL, NULL, NULL, 'B', '674 S Hwy 99', 'Fillmore', 'Millard', 'UT', '84631', '4357435857', NULL, NULL, NULL, 'Millard', NULL, NULL, NULL, NULL, '', NULL, NULL, '0.00', '15.00', '0.00', 8, '2008-07-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1679510432', 0, 'Y', 0, '2010-01-12', NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W11023111', 'W11023111', 'UTPEHP2', 'Summit After Hours Clinic', 'Joseph', 'J', 'Albano', 'MD', 'Sports Medicine', '', '', NULL, 'B', '1665 Bonanza Dr', 'Park City', 'Summit', 'UT', '84068', '4356470700', NULL, '1665 Bonanza Dr', 'Park City', 'Summit', 'UT', '84068', '4356470700', '', '', NULL, NULL, '0.00', '15.00', '0.00', 8, '2008-07-01', NULL, 0, 0, 0, 'Salt Lake Regional Medical Center', 'St Marks Hospital', NULL, NULL, 'HCFA|UB|', '1003836636', 0, 'Y', 0, '2013-03-27', NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W11023112', 'W11023112', 'UTPEHP2', 'Summit After Hours Clinic', 'D', 'Wain', 'Allen', 'MD', 'Family Practice', '', '', NULL, 'B', '1665 Bonanza Dr', 'Park City', 'Summit', 'UT', '84068', '4356470700', NULL, '1665 Bonanza Dr', 'Park City', 'Summit', 'UT', '84068', '4356470700', '', '', NULL, '', '0.00', '15.00', '0.00', 8, '2008-07-01', NULL, 0, 0, 0, 'Salt Lake Regional Medical Center', '', '', '', 'HCFA|UB|', '1942224050', 0, 'Y', 0, '2014-05-20', NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W11023113', 'W11023113', 'UTPEHP2', 'Summit After Hours Clinic', 'Robert', 'W', 'Barnett', 'MD', 'Family Practice', '', '', NULL, 'B', '1665 Bonanza Dr', 'Park City', 'Summit', 'UT', '84068', '4356470700', NULL, '1665 Bonanza Dr', 'Park City', 'Summit', 'UT', '84068', '4356470700', '          ', '', '', '', '0.00', '15.00', '0.00', 8, '2008-07-01', '2009-09-15', 0, 0, 0, 'Salt Lake Regional Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1831146752', 0, 'Y', 0, '2012-09-06', NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W11023114', 'W11023114', 'UTPEHP2', 'Heber Valley Medical Center', 'Tod', 'L', 'Berg', 'MD', 'Family Practice', '', '', NULL, 'B', '1485 S Hwy 40', 'Heber City', 'Wasatch', 'UT', '84032', '4356542500', NULL, '1485 S Hwy 40', 'Heber City', 'Wasatch', 'UT', '84032', '4356542500', '', '', NULL, NULL, '0.00', '15.00', '0.00', 8, '2008-07-01', NULL, 0, 0, 0, 'Heber Valley Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1497713648', 0, 'Y', 0, '2013-09-19', NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W11023115', 'W11023115', 'UTPEHP2', 'Summit After Hours Clinic', 'Benjamin', 'B', 'Betteridge', 'MD', 'Sports Medicine', 'Emergency Medicine', '', NULL, 'B', '1665 Bonanza Dr', 'Park City', 'Summit', 'UT', '84068', '4356470700', NULL, '1665 Bonanza Dr', 'Park City', 'Summit', 'UT', '84068', '4356470700', '', '', NULL, NULL, '0.00', '15.00', '0.00', 8, '2008-07-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1225007388', 0, 'Y', 0, '2013-10-14', NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W11023116', 'W11023116', 'UTPEHP2', 'Heber Valley Medical Center', 'Barry', 'M', 'Birkin', 'MD', 'Radiologist', '', '', NULL, 'O', '1485 S Hwy 40', 'Heber City', 'Wasatch', 'UT', '84032', '4356542500', NULL, '1485 S Hwy 40', 'Heber', 'Wasatch', 'UT', '84032', '4356542500', '', '', NULL, NULL, '0.00', '15.00', '0.00', 8, '2008-07-01', NULL, 0, 0, 0, 'Evanston Regional Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1144289521', 0, 'N', 0, '2010-12-28', NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W11023117', 'W11023117', 'UTPEHP2', 'Heber Valley Medical Center', 'Alan', 'Wilson', 'Bluth', 'PT', 'Physical Therapy', NULL, NULL, NULL, 'B', '1485 S Hwy 40', 'Heber City', 'Wasatch', 'UT', '84032', '4356542500', NULL, '1485 S Hwy 40', 'Heber City', 'Wasatch', 'UT', '84032', '4356542500', '', '', NULL, NULL, '0.00', '15.00', '0.00', 8, '2008-07-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1568436681', 0, 'Y', 0, '2012-04-18', NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W11023118', 'W11023118', 'UTPEHP2', 'Summit After Hours Clinic', 'Cress', 'R', 'Bohnn', 'MD', 'Family Practice', 'Sports Medicine', '', NULL, 'B', '1665 Bonanza Dr', 'Park City', 'Summit', 'UT', '84068', '4356470700', NULL, '1665 Bonanza Dr', 'Park City', 'Summit', 'UT', '84068', '4356470700', '          ', '', '', '', '0.00', '15.00', '0.00', 8, '2008-07-01', '2009-09-15', 0, 0, 0, 'Salt Lake Regional Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1861423113', 0, 'Y', 0, '2012-09-06', NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W11023119', 'W11023119', 'UTPEHP2', 'Summit After Hours Clinic', 'David', 'W', 'Brinton', 'MD', 'Family Practice', 'Sports Medicine', 'Urgent Care', NULL, 'B', '1665 Bonanza Dr', 'Park City', 'Summit', 'UT', '84068', '4356497640', NULL, '1665 Bonanza Dr', 'Park City', 'Summit', 'UT', '84068', '4356497640', '          ', '', '', '', '0.00', '15.00', '0.00', 8, '2008-07-01', '2009-09-15', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1093820706', 0, 'Y', 0, '2010-01-12', NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W11023120', 'W11023120', 'UTPEHP2', 'Heber Valley Medical Center', 'Neal', 'J', 'Burton', 'MD', 'Family Practice', '', '', NULL, 'B', '1485 S Hwy 40', 'Heber City', 'Wasatch', 'UT', '84032', '4356542500', NULL, '1485 S Hwy 40', 'Heber', 'Wasatch', 'UT', '84032', '4356542500', '', '', NULL, NULL, '0.00', '15.00', '0.00', 8, '2008-07-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1033141924', 0, 'Y', 0, '2011-10-27', NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W11023121', 'W11023121', 'UTPEHP2', 'Heber Valley Medical Center', 'Michael', 'A', 'Dagley', 'CRNA', 'Certified Nurse Anesthetist', NULL, NULL, NULL, 'O', '1485 S Hwy 40', 'Heber City', 'Wasatch', 'UT', '84032', '4356542500', NULL, NULL, NULL, 'Wasatch', NULL, NULL, NULL, NULL, '', NULL, NULL, '0.00', '15.00', '0.00', 8, '2008-07-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1699790113', 0, 'N', 0, '2010-01-12', NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W11023122', 'W11023122', 'UTPEHP2', 'Summit After Hours Clinic', 'Robert', 'J', 'Evers', 'MD', 'Family Practice', '', '', NULL, 'B', '1665 Bonanza Dr', 'Park City', 'Summit', 'UT', '84068', '4356470700', NULL, '1665 Bonanza Dr', 'Park City', 'Summit', 'UT', '84068', '4356470700', '          ', '', '', '', '0.00', '15.00', '0.00', 8, '2008-07-01', '2009-09-15', 0, 0, 0, 'University Health Care University Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1720033905', 0, 'Y', 0, '2011-04-28', NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W11023123', 'W11023123', 'UTPEHP2', 'Summit After Hours Clinic', 'Jill', 'B', 'Faatz', 'MD', 'Family Practice', 'Urgent Care', '', NULL, 'B', '1665 Bonanza Dr', 'Park City', '', 'UT', '84068', '4356470700', NULL, '1665 Bonanza Dr', 'Park City', '', 'UT', '84068', '4356470700', '          ', '', '', '', '0.00', '15.00', '0.00', 8, '2008-07-01', '2009-09-15', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1417981002', 0, 'Y', 0, '2010-09-23', NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W11023124', 'W11023124', 'UTPEHP2', 'Summit After Hours Clinic', 'Joseph', 'P', 'Ferriter', 'MD', 'Family Practice', 'Urgent Care', '', NULL, 'B', '1665 Bonanza Dr', 'Park City', 'Summit', 'UT', '84068', '4356470700', NULL, '1665 Bonanza Dr', 'Park City', 'Summit', 'UT', '84068', '4356470700', '', '', '', '', '0.00', '15.00', '0.00', 8, '2008-07-01', '2009-09-15', 0, 0, 0, 'Salt Lake Regional Medical Center', '', '', '', 'HCFA|UB|', '1023063575', 0, 'Y', 0, '2014-04-08', NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W11023125', 'W11023125', 'UTPEHP2', 'Summit After Hours Clinic', 'Wayne', 'Richard', 'Graham', 'DO', 'Family Practice', '', '', NULL, 'B', '1665 Bonanza Dr', 'Park City', 'Summit', 'UT', '84068', '4356497640', NULL, '1665 Bonanza Dr', 'Park City', 'Summit', 'UT', '84068', '4356497640', '', '', NULL, NULL, '0.00', '15.00', '0.00', 8, '2008-07-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1699781054', 0, 'Y', 0, '2013-02-06', NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W11023126', 'W11023126', 'UTPEHP2', 'Heber Valley Medical Center', 'Todd', 'M', 'Haderlie', 'MD', 'Family Practice', '', '', NULL, 'B', '1485 S Hwy 40', 'Heber City', 'Wasatch', 'UT', '84032', '4356542500', NULL, '1485 S Hwy 40', 'Heber City', 'Wasatch', 'UT', '84032', '4356542500', '', '', NULL, NULL, '0.00', '15.00', '0.00', 8, '2008-07-01', NULL, 0, 0, 0, 'Heber Valley Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1326059155', 0, 'Y', 0, '2013-09-20', NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W11023127', 'W11023127', 'UTPEHP2', 'Heber Valley Medical Center', 'William', 'B', 'Hale', 'MD', 'Radiologist', '', '', NULL, 'O', '1485 S Hwy 40', 'Heber City', 'Wasatch', 'UT', '84032', '4356542500', NULL, '1485 S Hwy 40', 'Heber City', 'Wasatch', 'UT', '84032', '4356542500', '', '', NULL, NULL, '0.00', '15.00', '0.00', 8, '2008-07-01', NULL, 0, 0, 0, 'Evanston Regional Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1689625097', 0, 'N', 0, '2012-08-21', NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W11023128', 'W11023128', 'UTPEHP2', 'Summit After Hours Clinic', 'Christopher', 'L', 'Hays', 'MD', 'Family Practice', 'Sports Medicine', 'Urgent Care', NULL, 'B', '1665 Bonanza Dr', 'Park City', 'Summit', 'UT', '84068', '4356470700', NULL, '1665 Bonanza Dr', 'Park City', 'Summit', 'UT', '84068', '4356470700', '', '', NULL, NULL, '0.00', '15.00', '0.00', 8, '2008-07-01', NULL, 0, 0, 0, 'Park City Medical Center', 'Salt Lake Regional Medical Center', '', '', 'HCFA|UB|', '1144274499', 0, 'Y', 0, '2014-04-08', NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W11023129', 'W11023129', 'UTPEHP2', 'Summit After Hours Clinic', 'Natascha', 'S', 'Lautenschlaeger', 'MD', 'Family Practice', NULL, NULL, NULL, 'B', '1665 Bonanza Dr', 'Park City', NULL, 'UT', '84068', '4356470700', NULL, NULL, NULL, 'Summit', NULL, NULL, NULL, NULL, '', NULL, NULL, '0.00', '15.00', '0.00', 8, '2008-07-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1952491561', 0, 'Y', 0, '2010-01-12', NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W11023130', 'W11023130', 'UTPEHP2', 'Summit After Hours Clinic', 'R', 'Herbert', 'Lepley', 'APRN', 'Family Practice', 'Advanced Practice Registered Nurse', '', NULL, 'B', '1665 Bonanza Dr', 'Park City', 'Summit', 'UT', '84068', '4356470700', NULL, '1665 Bonanza Dr', 'Park City', 'Summit', 'UT', '84068', '4356470700', '', '', NULL, NULL, '0.00', '15.00', '0.00', 8, '2008-07-01', NULL, 0, 0, 0, 'Salt Lake Regional Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1588611495', 0, 'Y', 0, '2013-05-23', NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W11023131', 'W11023131', 'UTPEHP2', 'Summit After Hours Clinic', 'Debra', 'Sue', 'Martin', 'MD', 'Emergency Medicine', '', '', NULL, 'B', '1665 Bonanza Dr', 'Park City', 'Summit', 'UT', '84068', '4356470700', NULL, '1665 Bonanza Dr', 'Park City', 'Summit', 'UT', '84068', '4356470700', '', '', NULL, NULL, '0.00', '15.00', '0.00', 8, '2008-07-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1972543684', 0, 'Y', 0, '2011-07-19', NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W11023132', 'W11023132', 'UTPEHP2', 'Heber Valley Medical Center', 'Stanton', 'B', 'McDonald', 'MD', 'Family Practice', '', '', NULL, 'B', '1485 S Hwy 40', 'Heber City', 'Wasatch', 'UT', '84032', '4356542500', NULL, '1485 S Hwy 40', 'Heber City', 'Wasatch', 'UT', '84032', '4356542500', '', '', NULL, NULL, '0.00', '15.00', '0.00', 8, '2008-07-01', NULL, 0, 0, 0, 'Heber Valley Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1982636890', 0, 'Y', 0, '2013-01-17', 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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INSERT INTO `providers_new` (`Provider_Tax_ID`, `Provider_Suffix`, `Provider_Network_ID`, `Provider_Region`, `Provider_Name`, `Provider_Doctor_First_Name`, `Provider_Doctor_Middle_Name`, `Provider_Doctor_Last_Name`, `Provider_Doctor_Degree`, `Provider_Specialty_1`, `Provider_Specialty_2`, `Provider_Specialty_3`, `Provider_Specialty_4`, `Provider_Address_Type`, `Provider_Address`, `Provider_City`, `Provider_County`, `Provider_State`, `Provider_Zip`, `Provider_Phone`, `Provider_Fax`, `Provider_Mailing_Address`, `Provider_Mailing_City`, `Provider_Mailing_County`, `Provider_Mailing_State`, `Provider_Mailing_Zip`, `Provider_Mailing_Phone`, `Provider_Mailing_Fax`, `Provider_Primary_Schedule`, `Provider_Secondary_Schedule`, `Provider_Rate_Sheet`, `Provider_Anes_Rate`, `Provider_Default_Rate`, `Provider_Max_DOS`, `Provider_Min_Match_Value`, `Provider_Effective_Date`, `Provider_Term_Date`, `Provider_Pend`, `Provider_Anes_Minutes`, `Provider_PPO`, `Provider_Hospital_1`, `Provider_Hospital_2`, `Provider_Hospital_3`, `Provider_Hospital_4`, `Provider_Type`, `Provider_NPI`, `Provider_Check_Override`, `Exclude_Dir`, `Audit_Status`, `Last_Change_Date`, `Medicare_ID`, `Provider_Lang`, `Provider_Latitude`, `Provider_Longitude`, `Provider_school`, `Provider_cert`) VALUES
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('942854057', 'W11023395', 'W11023395', 'UTPEHP2', 'Sevier Valley Medical Center', 'Brent', 'J', 'Allen', 'MD', 'General Surgery', '', '', NULL, 'O', '1000 N Main', 'Richfield', 'Sevier', 'UT', '84701', '4358968271', NULL, '1000 N Main', 'Richfield', 'Sevier', 'UT', '84701', '4358968271', '          ', '', '', '', '0.00', '15.00', '0.00', 8, '2008-07-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1477660389', 0, 'N', 0, '2012-10-23', NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W11023396', 'W11023396', 'UTPEHP2', 'Sevier Valley Medical Center', 'Rex', 'K', 'Belnap', 'CRNA', 'Certified Nurse Anesthetist', NULL, NULL, NULL, 'B', '1000 N Main', 'Richfield', 'Sevier', 'UT', '84701', '4358930332', NULL, NULL, NULL, 'Sevier', NULL, NULL, NULL, NULL, '', NULL, NULL, '0.00', '15.00', '0.00', 8, '2008-07-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1659476950', 0, 'Y', 0, '2010-01-12', NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W11023397', 'W11023397', 'UTPEHP2', 'Sevier Valley Medical Center', 'Kerry', 'A', 'Blackham', 'MD', 'Family Practice', '', '', NULL, 'B', '1000 N Main', 'Richfield', 'Sevier', 'UT', '84701', '4358968271', NULL, '1000 N Main', 'Richfield', 'Sevier', 'UT', '84701', '4358968271', '', '', NULL, NULL, '0.00', '15.00', '0.00', 8, '2008-07-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1922014273', 0, 'Y', 0, '2013-10-14', NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W11023398', 'W11023398', 'UTPEHP2', 'Sevier Valley Medical Center', 'Roger', 'D', 'Blomquist', 'MD', 'Radiologist', NULL, NULL, NULL, 'O', '1000 N Main', 'Richfield', 'Sevier', 'UT', '84701', '4358968271', NULL, NULL, NULL, 'Sevier', NULL, NULL, NULL, NULL, '', NULL, NULL, '0.00', '15.00', '0.00', 8, '2008-07-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1437264223', 0, 'N', 0, '2010-01-12', NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W11023399', 'W11023399', 'UTPEHP2', 'Sevier Valley Medical Center', 'Jeffrey', 'J', 'Brown', 'DO', 'Family Practice', '', '', NULL, 'B', '1000 N Main', 'Richfield', 'Sevier', 'UT', '84701', '4358968271', NULL, '1000 N Main', 'Richfield', 'Sevier', 'UT', '84701', '4358968271', '', '', NULL, NULL, '0.00', '15.00', '0.00', 8, '2008-07-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1205840642', 0, 'Y', 0, '2013-12-18', NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W11023400', 'W11023400', 'UTPEHP2', 'Sevier Valley Medical Center', 'Leland', 'J', 'Chappell', 'MD', 'Family Practice', '', '', NULL, 'B', '1000 N Main', 'Richfield', 'Sevier', 'UT', '84701', '4358968271', NULL, '1000 N Main', 'Richfield', 'Sevier', 'UT', '84701', '4358968271', '', '', NULL, NULL, '0.00', '15.00', '0.00', 8, '2008-07-01', NULL, 0, 0, 0, 'Sevier Valley Hospital', '', '', '', 'HCFA|UB|', '1447351424', 0, 'Y', 0, '2010-09-03', NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W11023401', 'W11023401', 'UTPEHP2', 'Sevier Valley Medical Center', 'David', 'Ray', 'Crimin', 'DO', 'Family Practice', '', '', NULL, 'B', '1000 N Main', 'Richfield', 'Sevier', 'UT', '84701', '4358968271', NULL, '1000 N Main', 'Richfield', 'Sevier', 'UT', '84701', '4358968271', '', '', NULL, NULL, '0.00', '15.00', '0.00', 8, '2008-07-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1225044431', 0, 'Y', 0, '2013-12-18', NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W11023402', 'W11023402', 'UTPEHP2', 'Sevier Valley Medical Center', 'Ronald', 'T', 'Draper', 'CRNA', 'Certified Nurse Anesthetist', NULL, NULL, NULL, 'B', '1000 N Main', 'Richfield', 'Sevier', 'UT', '84701', '4358968271', NULL, NULL, NULL, 'Sevier', NULL, NULL, NULL, NULL, '', NULL, NULL, '0.00', '15.00', '0.00', 8, '2008-07-01', NULL, 0, 0, 0, 'Delta Community Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1013004498', 0, 'Y', 0, '2010-01-12', NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W11023403', 'W11023403', 'UTPEHP2', 'Sevier Valley Medical Center', 'C', 'B', 'Fox', 'CCCA', 'Audiology', '', '', NULL, 'O', '1000 N Main', 'Richfield', 'Sevier', 'UT', '84701', '4358930332', NULL, '1000 N Main', 'Richfield', 'Sevier', 'UT', '84701', '4358930332', '', '', '', '', '0.00', '15.00', '0.00', 8, '2008-07-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1811938939', 0, 'N', 0, '2014-04-14', NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W11023404', 'W11023404', 'UTPEHP2', 'Sevier Valley Medical Center', 'Mark', 'Robert', 'Greenwood', 'MD', 'Family Practice', 'Urgent Care', '', NULL, 'B', '1000 N Main', 'Richfield', 'Sevier', 'UT', '84701', '4358968271', NULL, '1000 N Main', 'Richfield', 'Sevier', 'UT', '84701', '4358968271', '', '', NULL, NULL, '0.00', '15.00', '0.00', 8, '2008-07-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1083620298', 0, 'Y', 0, '2014-04-08', NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W11023405', 'W11023405', 'UTPEHP2', 'Sevier Valley Medical Center', 'Mark', 'William', 'Greenwood', 'MD', 'Family Practice', NULL, NULL, NULL, 'B', '1000 N Main', 'Richfield', 'Sevier', 'UT', '84701', '4358968271', NULL, NULL, NULL, 'Sevier', NULL, NULL, NULL, NULL, '', NULL, NULL, '0.00', '15.00', '0.00', 8, '2008-07-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1164437067', 0, 'Y', 0, '2010-01-12', NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W11023406', 'W11023406', 'UTPEHP2', 'Sevier Valley Medical Center', 'N', 'Rod', 'Hinck', 'SLP', 'Speech Therapy', '', '', NULL, 'O', '1000 N Main', 'Richfield', 'Sevier', 'UT', '84701', '4358968271', NULL, '1000 N Main', 'Richfield', 'Sevier', 'UT', '84701', '4358968271', '          ', '', '', '', '0.00', '15.00', '0.00', 8, '2008-07-01', '2010-09-07', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1114029394', 0, 'N', 0, '2010-01-12', NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W11023407', 'W11023407', 'UTPEHP2', 'Sevier Valley Medical Center', 'Devon', 'D', 'Peterson', 'CRNA', 'Certified Nurse Anesthetist', NULL, NULL, NULL, 'B', '1000 N Main', 'Richfield', 'Sevier', 'UT', '84701', '4358968271', NULL, NULL, NULL, 'Sevier', NULL, NULL, NULL, NULL, '', NULL, NULL, '0.00', '15.00', '0.00', 8, '2008-07-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1245278035', 0, 'Y', 0, '2010-01-12', NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W11023408', 'W11023408', 'UTPEHP2', 'Sevier Valley Medical Center', 'David', 'M', 'Pope', 'MD', 'Family Practice', '', '', NULL, 'B', '1000 N Main', 'Richfield', 'Sevier', 'UT', '84701', '4358968271', NULL, '1000 N Main', 'Richfield', 'Sevier', 'UT', '84701', '4358968271', '', '', NULL, NULL, '0.00', '15.00', '0.00', 8, '2008-07-01', NULL, 0, 0, 0, 'Sevier Valley Hospital', '', '', '', 'HCFA|UB|', '1467554451', 0, 'Y', 0, '2013-11-04', NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W11023409', 'W11023409', 'UTPEHP2', 'Sevier Valley Medical Center', 'Spencer', 'Lee', 'Scoville', 'DO', 'Family Practice', '', '', NULL, 'B', '1000 N Main', 'Richfield', 'Sevier', 'UT', '84701', '4358930327', NULL, '1000 N Main', 'Richfield', 'Sevier', 'UT', '84701', '4358930327', '', '', NULL, NULL, '0.00', '15.00', '0.00', 8, '2008-07-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1821192436', 0, 'Y', 0, '2012-05-04', NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W11023410', 'W11023410', 'UTPEHP2', 'Sevier Valley Medical Center', 'Thomas', 'J', 'Tavenner', 'CRNA', 'Certified Nurse Anesthetist', NULL, NULL, NULL, 'B', '1000 N Main', 'Richfield', 'Sevier', 'UT', '84701', '4358968271', NULL, NULL, NULL, 'Sevier', NULL, NULL, NULL, NULL, '', NULL, NULL, '0.00', '15.00', '0.00', 8, '2008-07-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1912002536', 0, 'Y', 0, '2010-01-12', NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W11023411', 'W11023411', 'UTPEHP2', 'Sevier Valley Medical Center', 'Steve', 'Fred', 'Wilstead', 'CRNA', 'Certified Nurse Anesthetist', NULL, NULL, NULL, 'O', '1000 N Main', 'Richfield', 'Sevier', 'UT', '84701', '4358968271', NULL, NULL, NULL, 'Sevier', NULL, NULL, NULL, NULL, '', NULL, NULL, '0.00', '15.00', '0.00', 8, '2008-07-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1679521744', 0, 'N', 0, '2010-01-12', NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W11023412', 'W11023412', 'UTPEHP2', 'Sevier Valley Medical Center', 'Blake', 'O', 'Zobell', 'DPM', 'Podiatry', '', '', NULL, 'O', '1000 N Main', 'Richfield', 'Sevier', 'UT', '84701', '4358968271', NULL, '1000 N Main', 'Richfield', 'Sevier', 'UT', '84701', '4358968271', '          ', '', '', '', '0.00', '15.00', '0.00', 8, '2008-07-01', '2013-11-22', 0, 0, 0, 'Sanpete Valley Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1720026560', 0, 'N', 0, '2014-03-03', NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W11023413', 'W11023413', 'UTPEHP2', 'SW Emergency Physicians', 'David', 'Lee', 'Barnett', 'MD', 'Emergency Medicine', NULL, NULL, NULL, 'O', '1303 N Main', 'Cedar City', NULL, 'UT', '84720', '4358685251', NULL, NULL, NULL, 'Iron', NULL, NULL, NULL, NULL, '', NULL, NULL, '0.00', '15.00', '0.00', 8, '2008-07-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1902893332', 0, 'N', 0, '2010-01-12', NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W11023414', 'W11023414', 'UTPEHP2', 'SW Emergency Physicians', 'Stanford', 'James', 'Benson', 'MD', 'Emergency Medicine', NULL, NULL, NULL, 'O', '1303 N Main', 'Cedar City', NULL, 'UT', '84720', '4358685251', NULL, NULL, NULL, 'Iron', NULL, NULL, NULL, NULL, '', NULL, NULL, '0.00', '15.00', '0.00', 8, '2008-07-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1588655856', 0, 'N', 0, '2010-01-12', NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W11023415', 'W11023415', 'UTPEHP2', 'Valley View Medical Center', 'Grant', NULL, 'Blatter', 'PT', 'Physical Therapy', NULL, NULL, NULL, 'B', '1303 N Main', 'Cedar City', NULL, 'UT', '84720', '4358685000', NULL, NULL, NULL, 'Iron', NULL, NULL, NULL, NULL, '', NULL, NULL, '0.00', '15.00', '0.00', 8, '2008-07-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1558377309', 0, 'Y', 0, '2010-01-12', NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W11023416', 'W11023416', 'UTPEHP2', 'SW Emergency Physicians', 'Jeffery', 'L', 'Bleazard', 'MD', 'Emergency Medicine', NULL, NULL, NULL, 'O', '1303 N Main', 'Cedar City', NULL, 'UT', '84720', '4358685251', NULL, NULL, NULL, 'Iron', NULL, NULL, NULL, NULL, '', NULL, NULL, '0.00', '15.00', '0.00', 8, '2008-07-01', NULL, 0, 0, 0, 'Valley View Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1003836024', 0, 'N', 0, '2010-01-12', NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W11023417', 'W11023417', 'UTPEHP2', 'SW Emergency Physicians', 'Brett', 'D', 'Christiansen', 'MD', 'Emergency Medicine', NULL, NULL, NULL, 'O', '1303 N Main', 'Cedar City', NULL, 'UT', '84720', '4358685251', NULL, NULL, NULL, 'Iron', NULL, NULL, NULL, NULL, '', NULL, NULL, '0.00', '15.00', '0.00', 8, '2008-07-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1073500492', 0, 'N', 0, '2010-01-12', NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W11023418', 'W11023418', 'UTPEHP2', 'SW Emergency Physicians', 'Richard', 'C', 'Cox', 'MD', 'Emergency Medicine', NULL, NULL, NULL, 'O', '1303 N Main', 'Cedar City', NULL, 'UT', '84720', '4358685251', NULL, NULL, NULL, 'Iron', NULL, NULL, NULL, NULL, '', NULL, NULL, '0.00', '15.00', '0.00', 8, '2008-07-01', NULL, 0, 0, 0, 'Valley View Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1831119056', 0, 'N', 0, '2010-01-12', NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W11023419', 'W11023419', 'UTPEHP2', 'Emergency Room', 'Jeffery', 'G', 'Gardner', 'MD', 'Emergency Medicine', NULL, NULL, NULL, 'O', '1303 N Main', 'Cedar City', NULL, 'UT', '84720', '4358685000', NULL, NULL, NULL, 'Iron', NULL, NULL, NULL, NULL, '', NULL, NULL, '0.00', '15.00', '0.00', 8, '2008-07-01', NULL, 0, 0, 0, 'Valley View Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1588656946', 0, 'N', 0, '2010-01-12', NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W11023420', 'W11023420', 'UTPEHP2', 'Valley View Medical Center', 'Jim', 'R', 'Keate', 'PT', 'Physical Therapy', NULL, NULL, NULL, 'B', '1303 N Main', 'Cedar City', NULL, 'UT', '84720', '4358685000', NULL, NULL, NULL, 'Iron', NULL, NULL, NULL, NULL, '', NULL, NULL, '0.00', '15.00', '0.00', 8, '2008-07-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1750398004', 0, 'Y', 0, '2010-01-12', NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W11023421', 'W11023421', 'UTPEHP2', 'SW Emergency Physicians', 'Gordon', 'L', 'Larsen', 'MD', 'Emergency Medicine', NULL, NULL, NULL, 'O', '1303 N Main', 'Cedar City', NULL, 'UT', '84720', '4358685251', NULL, NULL, NULL, 'Iron', NULL, NULL, NULL, NULL, '', NULL, NULL, '0.00', '15.00', '0.00', 8, '2008-07-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1760479083', 0, 'N', 0, '2010-01-12', NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W11023422', 'W11023422', 'UTPEHP2', 'Valley View Medical Center', 'Barbara', 'A', 'Neuenschwander', 'SLP', 'Speech Therapy', 'Speech Language Pathology', NULL, NULL, 'B', '1303 N Main', 'Cedar City', 'Iron', 'UT', '84720', '4358685000', NULL, NULL, NULL, 'Iron', NULL, NULL, NULL, NULL, '', NULL, NULL, '0.00', '15.00', '0.00', 8, '2008-07-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1235155623', 0, 'Y', 0, '2010-01-12', NULL, NULL, 0, 0, NULL, NULL),
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('942854057', 'W11023428', 'W11023428', 'UTPEHP2', 'SW Emergency Physicians', 'Michael', 'O', 'Tremea', 'MD', 'Psychiatry', 'Emergency Medicine', NULL, NULL, 'O', '1303 N Main', 'Cedar City', 'Iron', 'UT', '84720', '4358685251', NULL, NULL, NULL, 'Iron', NULL, NULL, NULL, NULL, '', NULL, NULL, '0.00', '15.00', '0.00', 8, '2008-07-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1376530782', 0, 'N', 0, '2010-01-12', NULL, NULL, 0, 0, NULL, NULL),
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('270671464', 'W11023441', 'W11023441', 'UT01', 'Turnquest Retreat Inc Beehive Homes', 'Brian', 'J', 'Griffeth', 'DPM', 'Podiatry', '', '', NULL, 'O', '15 W 100 N', 'Elmo', 'Emery', 'UT', '84521', '4356532555', NULL, '15 W 100 N', 'Elmo', 'Emery', 'UT', '84521', '4356532555', '', 'WISESTD', 'WUSTDHCPC5', NULL, '0.00', '35.00', '0.00', 3, '2009-09-15', NULL, 0, 0, 0, 'Castleview Hospital', 'Castleview Hospital', NULL, NULL, 'HCFA|UB|', '1487833406', 0, 'n', 0, '2013-06-19', NULL, NULL, 39.3896, -110.817, NULL, NULL),
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('621801973', 'W11023431', 'W11023431', 'UT01', 'Salt Lake Regional Womens Clinic', 'John', 'S', 'Oglesby', 'MD', 'Obstetrics and Gynecology', '', '', NULL, 'O', '24 S 1100 E Ste 209', 'Salt Lake City', 'Salt Lake', 'UT', '84102', '8012147650', NULL, '24 S 1100 E Ste 209', 'Salt Lake City', 'Salt Lake', 'UT', '84102', '8012147650', '          ', 'WUSTDINT5', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 6, '2009-12-14', '2010-04-30', 0, 0, 0, 'Salt Lake Regional Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1245385962', 0, 'N', 0, '2013-06-13', NULL, NULL, 0, 0, NULL, NULL),
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('411694999', 'W11023451', 'W11023451', 'TX01', 'Roche Insulin Delivery Systems Inc', '', '', 'Roche Insulin Delivery Systems Inc', 'GROUP', 'Durable Medical Equipment', '', '', NULL, 'B', 'PO Box 86 SDS 12-2207', 'Minneapolis', 'Hennepin', 'MN', '55486', '8002807801', '8888100758', 'PO Box 86 SDS 12-2207', 'Minneapolis', 'Hennepin', 'MN', '55486', '8002807801', '8888100758', 'WDISETR', NULL, NULL, '0.00', '30.00', '0.00', 3, '2010-04-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1083880447', 0, 'Y', 0, '2012-09-24', NULL, NULL, 0, 0, NULL, NULL),
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('742944052', 'W11023445', 'W11023445', 'TX01', 'Responsive ID Solutions', 'Robert', 'A', 'Zajac', 'MD', 'Internal Medicine', '', '', NULL, 'O', '150 E Sonterra Blvd Ste 170', 'San Antonio', 'Bexar', 'TX', '78258', '2104812800', NULL, '150 E Sonterra Blvd Ste 170', 'San Antonio', 'Bexar', 'TX', '78258', '2104812800', '', 'TXSURGB', 'TXHCPCS', NULL, '0.00', '50.00', '0.00', 3, '2010-01-01', '2012-08-19', 0, 0, 0, 'North Central Baptist Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1013907963', 0, 'N', 0, '2013-08-22', NULL, NULL, 29.6152, -98.4924, NULL, NULL),
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('411694999', 'W11023452', 'W11023452', 'ID01', 'Roche Insulin Delivery Systems Inc ', '', '', 'Roche Insulin Delivery Systems Inc', 'GROUP', 'Durable Medical Equipment', '', '', NULL, 'B', 'PO Box 86 SDS 12-2207', 'Minneapolis', 'Hennepin', 'MN', '55486', '8002807801', '8888100758', 'PO Box 86 SDS 12-2207', 'Minneapolis', 'Hennepin', 'MN', '55486', '8002807801', '8888100758', 'WDISETR', '', '', '0.00', '30.00', '0.00', 3, '2010-04-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1083880447', 0, 'Y', 0, '2012-09-24', NULL, NULL, 0, 0, NULL, NULL),
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('264333033', 'W11023456', 'W11023456', 'TX01', 'Northeast OB/GYN Associates', 'Joseph', 'R', 'Garza', 'MD', 'Obstetrics and Gynecology', '', '', NULL, 'O', '8715 Village Dr Ste 410', 'San Antonio', 'Bexar', 'TX', '78217', '2106509978', NULL, '8715 Village Dr Ste 410', 'San Antonio', 'Bexar', 'TX', '78217', '2106509978', '', 'TXOBG', 'TXHCPCS', NULL, '0.00', '50.00', '0.00', 3, '2010-01-01', '2012-08-19', 0, 0, 0, 'North Central Baptist Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1144210121', 0, 'N', 0, '2013-05-01', NULL, NULL, 29.5187, -98.4281, NULL, NULL),
('870414618', 'W11023457', 'W11023457', 'UT01', 'Foot and Ankle Institute', 'Brad', 'S', 'Webb', 'DPM', 'Podiatry', '', '', NULL, 'O', '1811 W Royal Hunt Dr', 'Cedar City', 'Iron', 'UT', '84720', '4355862225', NULL, '1811 W Royal Hunt Dr', 'Cedar City', 'Iron', 'UT', '84720', '4355862225', '', 'WURURAL10', 'WUSTDHCPC5', NULL, '0.00', '35.00', '0.00', 3, '2010-01-15', NULL, 0, 0, 0, 'Dixie Regional Medical Center', 'Valley View Medical Center', NULL, NULL, 'HCFA|UB|', '1518900562', 0, 'N', 0, '2011-11-03', NULL, NULL, 37.658, -113.086, NULL, NULL),
('870414618', 'W11023458', 'W11023458', 'UT01', 'Foot and Ankle Institute', 'Brad', 'S', 'Webb', 'DPM', 'Podiatry', '', '', NULL, 'B', '754 S Main St Ste 3', 'St George', 'Washington', 'UT', '84770', '4355862225', NULL, '754 S Main St Ste 3', 'St George', 'Washington', 'UT', '84770', '4355862225', '', 'WURURAL10', 'WUSTDHCPC5', NULL, '0.00', '35.00', '0.00', 3, '2010-01-15', NULL, 0, 0, 0, 'Dixie Regional Medical Center', 'Valley View Medical Center', NULL, NULL, 'HCFA|UB|', '1518900562', 0, 'y', 0, '2011-11-03', NULL, NULL, 0, 0, NULL, NULL),
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('911394965', 'W11023486', 'W11023486', 'ID01', 'Pacific Cataract & Laser', 'William', 'D', 'Gruzensky', 'MD', 'Ophthalmology', '', '', NULL, 'O', '2822 S Vista Ave', 'Boise', 'Ada', 'ID', '83705', '2083857576', NULL, '2822 S Vista Ave', 'Boise', 'Ada', 'ID', '83705', '2083857576', '', 'IDSTD', 'WUSTDHCPC5', NULL, '0.00', '30.00', '0.00', 6, '2010-02-01', '2012-08-19', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1992812234', 0, 'n', 0, '2013-10-04', NULL, NULL, 43.5768, -116.213, NULL, NULL),
('911394965', 'W11023487', 'W11023487', 'ID01', 'Pacific Cataract & Laser', 'James', 'P', 'Guzek', 'MD', 'Ophthalmology', NULL, NULL, NULL, 'O', '2822 S Vista Ave', 'Boise', 'Ada', 'ID', '83705', '2083857576', NULL, NULL, NULL, 'Ada', NULL, NULL, NULL, NULL, 'IDSTD', 'WUSTDHCPC5', NULL, '0.00', '30.00', '0.00', 6, '2010-02-01', '2012-08-19', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1104878859', 0, 'n', 0, '2010-01-14', NULL, NULL, 43.5768, -116.213, 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
('911394965', 'W11023488', 'W11023488', 'ID01', 'Pacific Cataract & Laser', 'Gordon', 'E', 'Johns', 'MD', 'Ophthalmology', NULL, NULL, NULL, 'O', '2822 S Vista Ave', 'Boise', 'Ada', 'ID', '83705', '2083857576', NULL, NULL, NULL, 'Ada', NULL, NULL, NULL, NULL, 'IDSTD', 'WUSTDHCPC5', NULL, '0.00', '30.00', '0.00', 6, '2010-02-01', '2012-08-19', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1053358077', 0, 'n', 0, '2010-01-14', NULL, NULL, 43.5768, -116.213, NULL, NULL),
('911394965', 'W11023489', 'W11023489', 'ID01', 'Pacific Cataract & Laser', 'James', 'I', 'McNeill', 'MD', 'Ophthalmology', '', '', NULL, 'O', '2822 S Vista Ave', 'Boise', 'Ada', 'ID', '83705', '2083857576', NULL, '2822 S Vista Ave', 'Boise', 'Ada', 'ID', '83705', '2083857576', '          ', 'IDSTD', 'WUSTDHCPC5', '', '0.00', '30.00', '0.00', 6, '2010-02-01', '2011-09-26', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1134151103', 0, 'N', 0, '2011-11-07', NULL, NULL, 43.5768, -116.213, NULL, NULL),
('911394965', 'W11023490', 'W11023490', 'ID01', 'Pacific Cataract & Laser', 'Ronald', 'K', 'Sugiyama', 'MD', 'Ophthalmology', NULL, NULL, NULL, 'O', '2822 S Vista Ave', 'Boise', 'Ada', 'ID', '83705', '2083857576', NULL, NULL, NULL, 'Ada', NULL, NULL, NULL, NULL, 'IDSTD', 'WUSTDHCPC5', NULL, '0.00', '30.00', '0.00', 6, '2010-02-01', '2012-08-19', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1376650267', 0, 'n', 0, '2010-01-14', NULL, NULL, 43.5768, -116.213, NULL, NULL),
('870399630', 'W11023491', 'W11023491', 'UT01', NULL, 'David', 'D', 'Bell', 'DPM', 'Podiatry', '', '', NULL, 'B', 'PO Box 932', 'Sandy', 'Salt Lake', 'UT', '84091', '4357537000', NULL, 'PO Box 932', 'Sandy', 'Salt Lake', 'UT', '84091', '4357537000', '', 'WiseSTD', 'WUSTDHCPC5', NULL, '0.00', '35.00', '0.00', 3, '2010-01-01', NULL, 0, 0, 0, 'Logan Regional Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1891771465', 0, 'y', 0, '2014-01-21', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11023492', 'W11023492', 'WYBILLINGS', 'Billings Clinic - Endocrinology', 'Kimberly', 'L', 'Ackerman', 'FNP', 'Endocrinology', 'Pediatrics', NULL, NULL, 'O', '801 N 29th St', 'Billings', 'Yellowstone', 'MT', '59101', '4062382501', '4062382413', 'PO Box 37000', 'Billings', 'Yellowstone', 'MT', '59107', NULL, NULL, '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2010-03-01', NULL, NULL, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1922032861', 0, 'N', 0, '2010-01-15', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11023493', 'W11023493', 'WYBILLINGS', 'Billings Clinic - Internal Medicine', 'Jessica', 'M', 'Amsden', 'PA-C', 'Hospitalist', '', '', NULL, 'O', '801 N 29th St', 'Billings', 'Yellowstone', 'MT', '59101', '4062382501', '4062382771', '801 N 29th St', 'Billings', 'Yellowstone', 'MT', '59101', '4062382501', '4062382771', '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2010-03-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1053351411', 0, 'N', 0, '2013-10-03', NULL, NULL, 0, 0, NULL, NULL),
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('810231784', 'W11023572', 'W11023572', 'WYBILLINGS', 'Billings Clinic - Urology', 'Lawrence', 'W', 'Klee', 'MD', 'Urology', '', '', NULL, 'O', '801 N 29th St', 'Billings', 'Yellowstone', 'MT', '59101', '4062382501', '4062382881', '801 N 29th St', 'Billings', 'Yellowstone', 'MT', '59101', '4062382501', '4062382881', '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2010-03-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1568557080', 0, 'N', 0, '2011-08-22', NULL, NULL, 0, 0, NULL, NULL),
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('810231784', 'W11023577', 'W11023577', 'WYBILLINGS', 'Billings Clinic - ENT', 'Stephen', 'A', 'Kramer', 'MD', 'Ear, Nose and Throat', NULL, NULL, NULL, 'O', '801 N 29th St', 'Billings', 'Yellowstone', 'MT', '59101', '4062382501', '4062385043', 'PO Box 37000', 'Billings', 'Yellowstone', 'MT', '59107', NULL, NULL, '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2010-03-01', NULL, NULL, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1225138894', 0, 'N', 0, '2010-01-15', NULL, NULL, 0, 0, NULL, NULL),
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('810231784', 'W11023579', 'W11023579', 'WYBILLINGS', 'Billings Clinic - Neurosurgery', 'Jay', 'M', 'Levy', 'MD', 'Neurosurgery', NULL, NULL, NULL, 'O', '801 N 29th St', 'Billings', 'Yellowstone', 'MT', '59101', '4062382501', '4062385809', 'PO Box 37000', 'Billings', 'Yellowstone', 'MT', '59107', NULL, NULL, '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2010-03-01', NULL, NULL, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1891718144', 0, 'N', 0, '2010-01-15', NULL, NULL, 0, 0, NULL, NULL),
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('810231784', 'W11023583', 'W11023583', 'WYBILLINGS', 'Billings Clinic - Endocrinology', 'James', 'A', 'Mack', 'MD', 'Endocrinology', NULL, NULL, NULL, 'O', '801 N 29th St', 'Billings', 'Yellowstone', 'MT', '59101', '4062382501', '4062382413', 'PO Box 37000', 'Billings', 'Yellowstone', 'MT', '59107', NULL, NULL, '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2010-03-01', NULL, NULL, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1669575445', 0, 'N', 0, '2010-01-15', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11023584', 'W11023584', 'WYBILLINGS', 'Billings Clinic - Same Day Care', 'Sheryl', 'A', 'Malinowski', 'FNP', 'Family Practice', NULL, NULL, NULL, 'O', '801 N 29th St', 'Billings', 'Yellowstone', 'MT', '59101', '4062382501', '4062382868', 'PO Box 37000', 'Billings', 'Yellowstone', 'MT', '59107', NULL, NULL, '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2010-03-01', NULL, NULL, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1790999878', 0, 'N', 0, '2010-01-15', NULL, NULL, 0, 0, NULL, NULL);
INSERT INTO `providers_new` (`Provider_Tax_ID`, `Provider_Suffix`, `Provider_Network_ID`, `Provider_Region`, `Provider_Name`, `Provider_Doctor_First_Name`, `Provider_Doctor_Middle_Name`, `Provider_Doctor_Last_Name`, `Provider_Doctor_Degree`, `Provider_Specialty_1`, `Provider_Specialty_2`, `Provider_Specialty_3`, `Provider_Specialty_4`, `Provider_Address_Type`, `Provider_Address`, `Provider_City`, `Provider_County`, `Provider_State`, `Provider_Zip`, `Provider_Phone`, `Provider_Fax`, `Provider_Mailing_Address`, `Provider_Mailing_City`, `Provider_Mailing_County`, `Provider_Mailing_State`, `Provider_Mailing_Zip`, `Provider_Mailing_Phone`, `Provider_Mailing_Fax`, `Provider_Primary_Schedule`, `Provider_Secondary_Schedule`, `Provider_Rate_Sheet`, `Provider_Anes_Rate`, `Provider_Default_Rate`, `Provider_Max_DOS`, `Provider_Min_Match_Value`, `Provider_Effective_Date`, `Provider_Term_Date`, `Provider_Pend`, `Provider_Anes_Minutes`, `Provider_PPO`, `Provider_Hospital_1`, `Provider_Hospital_2`, `Provider_Hospital_3`, `Provider_Hospital_4`, `Provider_Type`, `Provider_NPI`, `Provider_Check_Override`, `Exclude_Dir`, `Audit_Status`, `Last_Change_Date`, `Medicare_ID`, `Provider_Lang`, `Provider_Latitude`, `Provider_Longitude`, `Provider_school`, `Provider_cert`) VALUES
('810231784', 'W11023585', 'W11023585', 'WYBILLINGS', 'Billings Clinic - Rehab', 'Kristine', 'A', 'Roberts', 'DPT', 'Physical Therapy', '', '', NULL, 'O', '801 N 29th St', 'Billings', 'Yellowstone', 'MT', '59101', '4062382501', '4062382978', 'PO Box 37000', 'Billings', 'Yellowstone', 'MT', '59107', NULL, NULL, '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2010-03-01', NULL, NULL, 0, 0, '', '', '', '', 'HCFA|UB|', '1679611602', 0, 'N', 0, '2010-01-15', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11023586', 'W11023586', 'WYBILLINGS', 'Billings Clinic - OB/GYN', 'Clayton', 'H', 'McCracken III', 'MD', 'Obstetrics and Gynecology', NULL, NULL, NULL, 'O', '801 N 29th St', 'Billings', 'Yellowstone', 'MT', '59101', '4062382501', '4062382806', 'PO Box 37000', 'Billings', 'Yellowstone', 'MT', '59107', NULL, NULL, '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2010-03-01', NULL, NULL, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1760589345', 0, 'N', 0, '2010-01-15', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11023587', 'W11023587', 'WYBILLINGS', 'Billings Clinic - Nephrology', 'Heather', 'L', 'McGuire', 'MD', 'Nephrology', NULL, NULL, NULL, 'O', '801 N 29th St', 'Billings', 'Yellowstone', 'MT', '59101', '4062382501', '4062382590', 'PO Box 37000', 'Billings', 'Yellowstone', 'MT', '59107', NULL, NULL, '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2010-03-01', NULL, NULL, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1508806100', 0, 'N', 0, '2010-01-15', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11023588', 'W11023588', 'WYBILLINGS', 'Billings Clinic - Urology', 'Richard', 'B', 'Melzer', 'MD', 'Urology', '', '', NULL, 'O', '801 N 29th St', 'Billings', 'Yellowstone', 'MT', '59101', '4062382501', '4062382881', '801 N 29th St', 'Billings', 'Yellowstone', 'MT', '59101', '4062382501', '4062382881', '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2010-03-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1407953086', 0, 'N', 0, '2011-08-22', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11023589', 'W11023589', 'WYBILLINGS', 'Billings Clinic - Pulmonary', 'Robert', 'K', 'Merchant', 'MD', 'Pulmonary', NULL, NULL, NULL, 'O', '801 N 29th St', 'Billings', 'Yellowstone', 'MT', '59101', '4062382501', '4062382813', 'PO Box 37000', 'Billings', 'Yellowstone', 'MT', '59107', NULL, NULL, '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2010-03-01', NULL, NULL, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1487754057', 0, 'N', 0, '2010-01-15', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11023590', 'W11023590', 'WYBILLINGS', 'Billings Clinic - Internal Medicine', 'Angela', 'M', 'Merrin', 'PA-C', 'Internal Medicine', NULL, NULL, NULL, 'O', '801 N 29th St', 'Billings', 'Yellowstone', 'MT', '59101', '4062382501', '4062382413', 'PO Box 37000', 'Billings', 'Yellowstone', 'MT', '59107', NULL, NULL, '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2010-03-01', NULL, NULL, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1043493802', 0, 'N', 0, '2010-01-15', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11023591', 'W11023591', 'WYBILLINGS', 'Billings Clinic - Geriatrics', 'Miranda', 'J', 'Meunier', 'NP', 'Geriatrics', NULL, NULL, NULL, 'O', '801 N 29th St', 'Billings', 'Yellowstone', 'MT', '59101', '4062382501', '4062382413', 'PO Box 37000', 'Billings', 'Yellowstone', 'MT', '59107', NULL, NULL, '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2010-03-01', NULL, NULL, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1588838213', 0, 'N', 0, '2010-01-15', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11023592', 'W11023592', 'WYBILLINGS', 'Billings Clinic - CV Surgery', 'J Scott', 'Scott', 'Millikan', 'MD', 'Cardiovascular Disease', NULL, NULL, NULL, 'O', '801 N 29th St', 'Billings', 'Yellowstone', 'MT', '59101', '4062382501', '4062382848', 'PO Box 37000', 'Billings', 'Yellowstone', 'MT', '59107', NULL, NULL, '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2010-03-01', NULL, NULL, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1841373693', 0, 'N', 0, '2010-01-15', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11023593', 'W11023593', 'WYBILLINGS', 'Billings Clinic - Same Day Care', 'Michael', 'D', 'Monday', 'MD', 'Family Practice', NULL, NULL, NULL, 'O', '801 N 29th St', 'Billings', 'Yellowstone', 'MT', '59101', '4062382501', '4062382868', 'PO Box 37000', 'Billings', 'Yellowstone', 'MT', '59107', NULL, NULL, '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2010-03-01', NULL, NULL, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1013017680', 0, 'N', 0, '2010-01-15', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11023594', 'W11023594', 'WYBILLINGS', 'Billings Clinic - Neurosurgery', 'Michael', 'A', 'Morone', 'MD', 'Neurosurgery', '', '', NULL, 'O', '801 N 29th St', 'Billings', 'Yellowstone', 'MT', '59101', '4062382501', '4062385809', '801 N 29th St', 'Billings', 'Yellowstone', 'MT', '59101', '4062382501', '4062385809', '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2010-03-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1407954456', 0, 'N', 0, '2012-04-16', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11023595', 'W11023595', 'WYBILLINGS', 'Billings Clinic - Gen Surg', 'Bret', 'T', 'Murray', 'MD', 'General Surgery', NULL, NULL, NULL, 'O', '801 N 29th St', 'Billings', 'Yellowstone', 'MT', '59101', '4062382501', '4062382848', 'PO Box 37000', 'Billings', 'Yellowstone', 'MT', '59107', NULL, NULL, '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2010-03-01', NULL, NULL, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1306853130', 0, 'N', 0, '2010-01-15', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11023596', 'W11023596', 'WYBILLINGS', 'Billings Clinic - Neurology', 'Melody', 'A', 'Murter', 'FNP', 'Neurology', NULL, NULL, NULL, 'O', '801 N 29th St', 'Billings', 'Yellowstone', 'MT', '59101', '4062382501', '4062382805', 'PO Box 37000', 'Billings', 'Yellowstone', 'MT', '59107', NULL, NULL, '', NULL, NULL, '0.00', '17.00', '0.00', 3, '2010-03-01', NULL, NULL, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1306896444', 0, 'N', 0, '2010-01-15', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11023597', 'W11023597', 'WYBILLINGS', 'Billings Clinic - Neurosurgery', 'Haring', 'J', 'Nauta', 'MD', 'Neurosurgery', '', '', NULL, 'O', '801 N 29th St', 'Billings', 'Yellowstone', 'MT', '59101', '4062382501', '4062385809', '801 N 29th St', 'Billings', 'Yellowstone', 'MT', '59101', '4062382501', '4062385809', '', '', '', '0.00', '17.00', '0.00', 3, '2010-03-01', '2014-03-17', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1518066539', 0, 'N', 0, '2014-03-24', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11023598', 'W11023598', 'WYBILLINGS', 'Billings Clinic - CV Surgery', 'Charles', 'Scott', 'Needham', 'MD', 'Cardiovascular Disease', '', '', NULL, 'O', '801 N 29th St', 'Billings', 'Yellowstone', 'MT', '59101', '4062382501', '4062382848', '801 N 29th St', 'Billings', 'Yellowstone', 'MT', '59101', '4062382501', '4062382848', '', '', '', '0.00', '17.00', '0.00', 3, '2010-03-01', '2012-12-01', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1063435899', 0, 'N', 0, '2012-11-30', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W11023599', 'W11023599', 'WYBILLINGS', 'Billings Clinic - Internal Medicine', 'Laurie', 'K', 'Neubauer', 'PA-C', 'Internal Medicine', NULL, NULL, NULL, 'O', '801 N 29th St', 'Billings', 'Yellowstone', 'MT', '59101', '4062382501', '4062382413', 'PO Box 37000', 'Billings', 'Yellowstone', 'MT', '59107', '4062382501', '4062382413', '', '', '', '0.00', '17.00', '0.00', 3, '2010-03-01', '2010-09-01', NULL, 0, NULL, '', '', '', '', 'HCFA|UB|', '1326146374', 0, 'N', 0, '2010-05-26', NULL, NULL, 0, 0, NULL, NULL),
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('742447500', 'W11023714', 'W11023714', 'TX01', 'Cardiology Clinic of San Antonio', 'Stephen', 'S', 'Reich', 'MD', 'Cardiac Electrophysiology Cardiology', '', '', NULL, 'B', 'PO Box 119', 'San Antonio', 'Bexar', 'TX', '78291', '2105825145', NULL, 'PO Box 119', 'San Antonio', 'Bexar', 'TX', '78291', '2105825145', '          ', 'TXSTD', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2010-01-15', '2010-09-01', 0, 0, 0, 'St Lukes Baptist Hospital', NULL, '', '', 'HCFA|UB|', '1992766935', 0, 'N', 0, '2014-03-25', NULL, NULL, 0, 0, NULL, NULL),
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('742743906', 'W11023721', 'W11023721', 'TX01', 'San Antonio Kidney Disease Center', 'Rahul', '', 'Koushik', 'MD', 'Nephrology', '', '', NULL, 'O', '116 Gallery Cir Ste 202', 'San Antonio', 'Bexar', 'TX', '78258', '2104958280', NULL, '116 Gallery Cir Ste 202', 'San Antonio', 'Bexar', 'TX', '78258', '2104958280', '', 'TXSTD', 'TXHCPCS', NULL, '0.00', '50.00', '0.00', 3, '2007-01-01', '2012-08-19', 0, 0, 0, 'North East Baptist Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1275518755', 0, 'N', 0, '2013-04-24', NULL, NULL, 0, 0, NULL, NULL),
('820161600', 'W11023722', 'W11023722', 'ID02', 'Idaho Family Physicians Inc', 'Mont', 'B', 'Tolman', 'DO', 'Family Practice', '', '', NULL, 'O', '130 E Boise Ave', 'Boise', 'Ada', 'ID', '83706', '2083454066', NULL, '130 E Boise Ave', 'Boise', 'Ada', 'ID', '83706', '2083454066', '          ', 'IDACN', '', '', '0.00', '15.00', '0.00', 8, '2009-11-01', '2011-11-07', 0, 0, 1, '', '', '', '', 'HCFA|UB|', '1124069828', 0, 'N', 0, '2012-03-02', NULL, NULL, 0, 0, NULL, NULL),
('870395551', 'W11023723', 'W11023723', 'UT01', NULL, 'Brian', NULL, 'Ewell', 'DC', 'Chiropractic', NULL, NULL, NULL, 'O', '2964 W 4700 S Ste 102', 'West Valley', 'Salt Lake', 'UT', '84118', '8019669100', '8016216158', '867 E 9400 S', 'Sandy', 'Salt Lake', 'UT', '84094', NULL, NULL, 'WLABRAD', 'WUSTDHCPC5', NULL, '0.00', '0.00', '55.46', 3, '2010-02-01', '2010-10-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '0000006174', 0, 'N', 0, '2010-01-20', NULL, NULL, 0, 0, NULL, NULL),
('262211423', 'W11023724', 'W11023724', 'UT01', 'St George Urology', 'Gregory', 'S', 'Taylor', 'MD', 'Urology', '', '', NULL, 'O', '1490 E Foremaster Dr Ste 300', 'St George', 'Washington', 'UT', '84790', '4356882104', NULL, '1490 E Foremaster Dr Ste 300', 'St George', 'Washington', 'UT', '84790', '4356882104', '', 'WiseSTD10A', 'WUSTDHCPC5', NULL, '0.00', '35.00', '0.00', 3, '2010-01-15', NULL, 0, 0, 0, 'Dixie Regional Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1932113743', 0, 'N', 0, '2013-11-07', NULL, NULL, 37.0959, -113.551, NULL, NULL),
('264079351', 'W11023725', 'W11023725', 'UT01', 'Tooele Urology LLC', 'Daniel', 'L', 'Hibbert', 'MD', 'Urology', '', '', NULL, 'O', '196 E 2000 N Ste 106', 'Tooele', 'Tooele', 'UT', '84074', '4358820071', NULL, '196 E 2000 N Ste 106', 'Tooele', 'Tooele', 'UT', '84074', '4358820071', '          ', 'WUSTDSURG5', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 3, '2010-01-25', '2011-10-18', 0, 0, 0, 'Jordan Valley Medical Center', 'Mountain West Medical Center', NULL, NULL, 'HCFA|UB|', '1275647562', 0, 'N', 0, '2012-10-03', NULL, NULL, 0, 0, NULL, NULL),
('264079351', 'W11023726', 'W11023726', 'UT01', 'Tooele Urology ', 'Daniel', 'L', 'Hibbert', 'MD', 'Urology', '', '', NULL, 'B', 'PO Box 410465', 'Salt Lake City', 'Salt Lake', 'UT', '84141', '4358820071', NULL, 'PO Box 410465', 'Salt Lake City', 'Salt Lake', 'UT', '84141', '4358820071', '', 'WUSTDSURG5', 'WUSTDHCPC5', NULL, '0.00', '35.00', '0.00', 3, '2010-01-25', NULL, 0, 0, 0, 'Jordan Valley Medical Center', 'Mountain West Medical Center', NULL, NULL, 'HCFA|UB|', '1275647562', 0, 'y', 0, '2012-10-03', NULL, NULL, 0, 0, NULL, NULL),
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('870617733', 'W11023728', 'W11023728', 'UT01', 'Utah Eye Centers', 'Jed', 'T', 'Poll', 'MD', 'Ophthalmology', '', '', NULL, 'O', '1551 S Renaissance Towne Dr Ste 340', 'Bountiful', 'Davis', 'UT', '84010', '8016771122', NULL, '1551 S Renaissance Towne Dr Ste 340', 'Bountiful', 'Davis', 'UT', '84010', '8016771122', '          ', 'WiseSTD', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 6, '2010-01-15', NULL, 0, 0, 0, 'Lakeview Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1376656124', 0, 'N', 0, '2013-07-26', NULL, NULL, 40.8737, -111.888, NULL, NULL),
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('651229319', 'W11023733', 'W11023733', 'UT01', 'Spinal Interventions PLLC', 'Navid', '', 'Farahmand', 'MD', 'Pain Management', '', '', NULL, 'B', 'PO Box 572528', 'Salt Lake City', 'Salt Lake', 'UT', '84157', '8012234860', NULL, 'PO Box 572528', 'Salt Lake City', 'Salt Lake', 'UT', '84157', '8012234860', '          ', 'WISESTD', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 6, '2010-01-15', '2011-10-27', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1790841799', 0, 'N', 0, '2011-11-04', NULL, NULL, 0, 0, NULL, NULL),
('651229319', 'W11023734', 'W11023734', 'UT01', 'Spinal Interventions PLLC', 'Navid', '', 'Farahmand', 'MD', 'Pain Management', '', '', NULL, 'O', '280 W  River Park Dr Ste 200', 'Provo', 'Utah', 'UT', '84604', '8012234860', NULL, '280 W  River Park Dr Ste 200', 'Provo', 'Utah', 'UT', '84604', '8012234860', '          ', 'WISESTD', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 6, '2010-01-15', '2011-10-27', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1790841799', 0, 'N', 0, '2011-11-04', NULL, NULL, 0, 0, NULL, NULL),
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('742447500', 'W11023735', 'W11023735', 'TX01', 'Cardiology Clinic of San Antonio', 'Robert', '', 'Eckart', 'MD', 'Cardiovascular Disease', '', '', NULL, 'B', 'PO Box 119', 'San Antonio', 'Bexar', 'TX', '78291', '2106145400', NULL, 'PO Box 119', 'San Antonio', 'Bexar', 'TX', '78291', '2106145400', '          ', 'TXSTD', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2010-01-15', '2010-08-31', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1366479404', 0, 'N', 0, '2013-10-28', NULL, NULL, 0, 0, NULL, NULL),
('742447500', 'W11023736', 'W11023736', 'TX01', 'Cardiology Clinic of San Antonio', 'Robert', '', 'Eckart', 'MD', 'Cardiovascular Disease', '', '', NULL, 'O', '4411 Medical Dr Ste 300', 'San Antonio', 'Bexar', 'TX', '78229', '2106145400', NULL, '4411 Medical Dr Ste 300', 'San Antonio', 'Bexar', 'TX', '78229', '2106145400', '          ', 'TXSTD', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2010-01-15', '2010-08-31', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1366479404', 0, 'N', 0, '2013-10-28', NULL, NULL, 29.5103, -98.5724, NULL, NULL),
('268400130', 'W11023737', 'W11023737', 'TX01', '', 'Mary', 'J', 'Carr', 'PHD', 'Mental Health', 'Psychology', '', NULL, 'O', '359 E Hildebrawd Ste 100', 'San Antonio', 'Bexar', 'TX', '78212', '2108283624', NULL, '359 E Hildebrawd Ste 100', 'San Antonio', 'Bexar', 'TX', '78212', '2108283624', '          ', 'TXPHD', '', '', '0.00', '0.00', '0.00', 3, '2010-01-15', '2010-07-28', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1710172036', 0, 'N', 0, '2010-01-20', NULL, NULL, 0, 0, NULL, NULL),
('841433992', 'W11023738', 'W11023738', 'UTPEHP', 'Rosenberg Cooley Metcalf', 'Timothy', 'C', 'Beals', 'MD', 'Orthopedic Surgery', '', '', NULL, 'O', '900 Round Valley Dr Ste 100', 'Park City', 'Summit', 'UT', '84060', '4356556600', NULL, '900 Round Valley Dr Ste 100', 'Park City', 'Summit', 'UT', '84060', '4356556600', '', 'WMETCALF', 'WUSTDHCPC5', NULL, '0.00', '35.00', '0.00', 3, '2010-01-15', NULL, 0, 0, 0, 'University Health Care University Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1306936935', 0, 'n', 0, '2013-09-25', NULL, NULL, 0, 0, NULL, NULL),
('841433992', 'W11023739', 'W11023739', 'RCM01', 'Rosenberg Cooley Metcalf', 'Timothy', 'C', 'Beals', 'MD', 'Orthopedic Surgery', '', '', NULL, 'O', '900 Round Valley Dr Ste 100', 'Park City', 'Summit', 'UT', '84060', '4356556600', NULL, '900 Round Valley Dr Ste 100', 'Park City', 'Summit', 'UT', '84060', '4356556600', '          ', 'WMETCALF', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 3, '2010-01-15', '2011-07-31', 0, 0, 0, 'University Health Care University Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1306936935', 0, 'N', 0, '2013-09-25', NULL, NULL, 0, 0, NULL, NULL),
('742447500', 'W11023740', 'W11023740', 'TX01', 'Cardiology Clinic of San Antonio', 'Rachel', '', 'Beck', 'MD', 'Cardiovascular Disease', '', '', NULL, 'B', 'PO Box 119', 'San Antonio', 'Bexar', 'TX', '78291', '2106145400', NULL, 'PO Box 119', 'San Antonio', 'Bexar', 'TX', '78291', '2106145400', '', 'TXSTD', 'TXHCPCS', NULL, '0.00', '50.00', '0.00', 3, '2010-01-15', '2012-08-19', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1053391912', 0, 'y', 0, '2012-10-12', NULL, NULL, 0, 0, NULL, NULL),
('742447500', 'W11023741', 'W11023741', 'TX01', 'Cardiology Clinic of San Antonio', 'Rachel', '', 'Beck', 'MD', 'Cardiovascular Disease', '', '', NULL, 'O', '4411 Medical Dr Ste 300', 'San Antonio', 'Bexar', 'TX', '78229', '2106145400', NULL, '4411 Medical Dr Ste 300', 'San Antonio', 'Bexar', 'TX', '78229', '2106145400', '', 'TXSTD', 'TXHCPCS', NULL, '0.00', '50.00', '0.00', 3, '2010-01-15', '2012-08-19', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1053391912', 0, 'N', 0, '2012-10-12', NULL, NULL, 29.5103, -98.5724, NULL, NULL),
('820161600', 'W11023742', 'W11023742', 'IDREC', 'St Lukes Pediatrics Endocrinology', 'Daniel', NULL, 'Marks', '(Recognized PPO but not contracted pre-auth r', 'Pediatric Endocrinology', NULL, NULL, NULL, 'O', '100 E Idaho St Ste 200', 'Boise', 'Ada', 'ID', '83712', '2083817340', NULL, NULL, NULL, 'Ada', NULL, NULL, NULL, NULL, '', NULL, NULL, '0.00', '0.00', '0.00', 8, '2008-11-01', NULL, 1, 0, 1, NULL, NULL, NULL, NULL, 'HCFA|UB|', '0000007433', 0, 'n', 0, '2010-01-21', NULL, NULL, 43.6123, -116.194, NULL, NULL),
('710963753', 'W11023743', 'W11023743', 'UT01', NULL, 'June', 'S', 'Chen', 'MD', 'Plastic Surgery', NULL, NULL, NULL, 'O', '7240 S Highland Dr Ste 175', 'Salt Lake City', 'Salt Lake', 'UT', '84121', '8019430401', NULL, '7240 S Highland Dr', 'Salt Lake City', 'Salt Lake', 'UT', '84121', NULL, NULL, 'WISESTD', 'WUSTDHCPC5', NULL, '0.00', '35.00', '0.00', 3, '2010-01-22', NULL, 0, 0, 0, 'St Marks Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1255339255', 0, 'n', 0, '2010-01-25', NULL, NULL, 40.6197, -111.834, 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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('820312175', 'W11023778', 'W11023778', 'ID01', 'Idaho Emergency Physicians PA', 'David', 'T', 'Kim', 'MD', 'Emergency Medicine', '', '', NULL, 'O', '1717 Arlington', 'Caldwell', 'Canyon', 'ID', '83605', '2083221730', '2083221731', '1717 Arlington', 'Caldwell', 'Canyon', 'ID', '83605', '2083221730', '2083221731', 'IDSAMG3', NULL, NULL, '0.00', '10.00', '0.00', 3, '2009-07-01', NULL, 0, 0, 0, 'Saint Alphonsus Regional Medical Center', 'West Valley Medical Center', NULL, NULL, 'HCFA|UB|', '1386681336', 0, 'N', 0, '2012-01-31', NULL, NULL, 43.6542, -116.696, NULL, NULL),
('820312175', 'W11023779', 'W11023779', 'ID01', 'Idaho Emergency Physicians PA', 'Frederick', 'J', 'Klein', 'MD', 'Emergency Medicine', '', '', NULL, 'O', '1717 Arlington', 'Caldwell', 'Canyon', 'ID', '83605', '2083221730', '2083221731', '1717 Arlington', 'Caldwell', 'Canyon', 'ID', '83605', '2083221730', '2083221731', 'IDSAMG3', NULL, NULL, '0.00', '10.00', '0.00', 3, '2009-07-01', NULL, 0, 0, 0, 'Saint Alphonsus Regional Medical Center', 'West Valley Medical Center', NULL, NULL, 'HCFA|UB|', '1144273079', 0, 'N', 0, '2012-10-26', NULL, NULL, 43.6542, -116.696, NULL, NULL),
('820312175', 'W11023780', 'W11023780', 'ID01', 'Idaho Emergency Physicians PA', 'Michael', 'J', 'Lamers', 'MD', 'Emergency Medicine', '', '', NULL, 'O', '1717 Arlington', 'Caldwell', 'Canyon', 'ID', '83605', '2083221730', '2083221731', '1717 Arlington', 'Caldwell', 'Canyon', 'ID', '83605', '2083221730', '2083221731', 'IDSAMG3', '', '', '0.00', '10.00', '0.00', 3, '2009-07-01', '2011-09-15', 0, 0, 0, 'Saint Alphonsus Regional Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1629091491', 0, 'N', 0, '2012-01-30', NULL, NULL, 0, 0, NULL, NULL),
('820312175', 'W11023781', 'W11023781', 'ID01', 'Idaho Emergency Physicians PA', 'Christopher', 'T', 'Lawler', 'MD This Provider will terminate on July 1st', 'Sports Medicine', 'Emergency Medicine', '', NULL, 'O', '1717 Arlington', 'Caldwell', 'Canyon', 'ID', '83605', '2083221730', '2083221731', '1717 Arlington', 'Caldwell', 'Canyon', 'ID', '83605', '2083221730', '2083221731', 'IDSAMG3', '', '', '0.00', '10.00', '0.00', 3, '2009-07-01', '2012-07-01', 0, 0, 0, 'Saint Alphonsus Regional Medical Center', 'West Valley Medical Center', NULL, NULL, 'HCFA|UB|', '1801801576', 0, 'N', 0, '2012-05-31', NULL, NULL, 0, 0, NULL, NULL),
('820312175', 'W11023782', 'W11023782', 'ID01', 'Idaho Emergency Physicians PA', 'Brian', 'W', 'Moss', 'MD', 'Emergency Medicine', '', '', NULL, 'O', '1717 Arlington', 'Caldwell', 'Canyon', 'ID', '83605', '2083221730', '2083221731', '1717 Arlington', 'Caldwell', 'Canyon', 'ID', '83605', '2083221730', '2083221731', 'IDSAMG3', '', '', '0.00', '10.00', '0.00', 3, '2009-07-01', '2012-10-02', 0, 0, 0, 'Saint Alphonsus Medical Center Nampa', 'West Valley Medical Center', '', '', 'HCFA|UB|', '1033384201', 0, 'N', 0, '2012-11-15', NULL, NULL, 0, 0, NULL, NULL),
('820312175', 'W11023783', 'W11023783', 'ID01', 'Idaho Emergency Physicians PA', 'Mike', 'W', 'Pool', 'MD', 'Emergency Medicine', '', '', NULL, 'O', '1717 Arlington', 'Caldwell', 'Canyon', 'ID', '83605', '2083221730', '2083221731', '1717 Arlington', 'Caldwell', 'Canyon', 'ID', '83605', '2083221730', '2083221731', 'IDSAMG3', '', '', '0.00', '10.00', '0.00', 3, '2009-07-01', '2011-12-31', 0, 0, 0, 'Saint Alphonsus Medical Center Nampa', 'West Valley Medical Center', '', '', 'HCFA|UB|', '1154368918', 0, 'N', 0, '2012-02-23', NULL, NULL, 0, 0, NULL, NULL),
('820312175', 'W11023784', 'W11023784', 'ID01', 'Idaho Emergency Physicians PA', 'Jason', 'M', 'Quinn', 'MD', 'Emergency Medicine', '', '', NULL, 'O', '1717 Arlington', 'Caldwell', 'Canyon', 'ID', '83605', '2083221730', '2083221731', '1717 Arlington', 'Caldwell', 'Canyon', 'ID', '83605', '2083221730', '2083221731', 'IDSAMG3', NULL, NULL, '0.00', '10.00', '0.00', 3, '2009-07-01', NULL, 0, 0, 0, 'Saint Alphonsus Regional Medical Center', 'West Valley Medical Center', NULL, NULL, 'HCFA|UB|', '1710978036', 0, 'N', 0, '2012-01-31', NULL, NULL, 43.6542, -116.696, NULL, NULL),
('820312175', 'W11023785', 'W11023785', 'ID01', 'Idaho Emergency Physicians PA', 'Kristen', 'H', 'Saak', 'MD', 'Emergency Medicine', '', '', NULL, 'O', '1717 Arlington', 'Caldwell', 'Canyon', 'ID', '83605', '2083221730', '2083221731', '1717 Arlington', 'Caldwell', 'Canyon', 'ID', '83605', '2083221730', '2083221731', 'IDSAMG3', NULL, NULL, '0.00', '10.00', '0.00', 3, '2009-07-01', NULL, 0, 0, 0, 'Saint Alphonsus Regional Medical Center', 'West Valley Medical Center', NULL, NULL, 'HCFA|UB|', '1821128018', 0, 'N', 0, '2012-01-31', NULL, NULL, 43.6542, -116.696, NULL, NULL),
('820312175', 'W11023786', 'W11023786', 'ID01', 'Idaho Emergency Physicians PA', 'Christopher', 'E', 'Tobe', 'MD', 'Emergency Medicine', '', '', NULL, 'O', '1717 Arlington', 'Caldwell', 'Canyon', 'ID', '83605', '2083221730', '2083221731', '1717 Arlington', 'Caldwell', 'Canyon', 'ID', '83605', '2083221730', '2083221731', 'IDSAMG3', NULL, NULL, '0.00', '10.00', '0.00', 3, '2009-07-01', NULL, 0, 0, 0, 'Saint Alphonsus Regional Medical Center', 'West Valley Medical Center', NULL, NULL, 'HCFA|UB|', '1205889136', 0, 'N', 0, '2012-01-31', NULL, NULL, 43.6542, -116.696, NULL, NULL),
('820312175', 'W11023787', 'W11023787', 'ID01', 'Idaho Emergency Physicians PA', 'Jessica', 'N', 'Wasielewski', 'MD', 'Emergency Medicine', '', '', NULL, 'O', '1717 Arlington', 'Caldwell', 'Canyon', 'ID', '83605', '2083221730', '2083221731', '1717 Arlington', 'Caldwell', 'Canyon', 'ID', '83605', '2083221730', '2083221731', 'IDSAMG3', '', '', '0.00', '10.00', '0.00', 3, '2009-07-01', NULL, 0, 0, 0, 'Saint Alphonsus Regional Medical Center', 'West Valley Medical Center', NULL, NULL, 'HCFA|UB|', '1427126127', 0, 'N', 0, '2012-01-31', NULL, NULL, 43.6542, -116.696, NULL, NULL),
('820312175', 'W11023788', 'W11023788', 'ID01', 'Idaho Emergency Physicians PA', 'Brandon', 'J', 'Wilding', 'MD', 'Emergency Medicine', '', '', NULL, 'O', '1717 Arlington', 'Caldwell', 'Canyon', 'ID', '83605', '2083221730', '2083221731', '1717 Arlington', 'Caldwell', 'Canyon', 'ID', '83605', '2083221730', '2083221731', 'IDSAMG3', NULL, NULL, '0.00', '10.00', '0.00', 3, '2009-07-01', NULL, 0, 0, 0, 'Saint Alphonsus Regional Medical Center', 'West Valley Medical Center', NULL, NULL, 'HCFA|UB|', '1851307367', 0, 'N', 0, '2011-06-29', NULL, NULL, 43.6542, -116.696, NULL, NULL),
('820312175', 'W11023789', 'W11023789', 'ID01', 'Idaho Emergency Physicians PA', 'Christopher', 'C', 'Wyatt', 'MD', 'Emergency Medicine', '', '', NULL, 'O', '1717 Arlington', 'Caldwell', 'Canyon', 'ID', '83605', '2083221730', '2083221731', '1717 Arlington', 'Caldwell', 'Canyon', 'ID', '83605', '2083221730', '2083221731', 'IDSAMG3', NULL, NULL, '0.00', '10.00', '0.00', 3, '2009-07-01', NULL, 0, 0, 0, 'Saint Alphonsus Regional Medical Center', 'West Valley Medical Center', NULL, NULL, 'HCFA|UB|', '1649487430', 0, 'N', 0, '2012-01-31', NULL, NULL, 43.6542, -116.696, NULL, NULL),
('820200895', 'W11023790', 'W11023790', 'ID01', 'Saint Alphonsus Medical Group Occupational Medicine Associat', 'Ralph', 'M', 'Sutherlin', 'MD', 'Occupational Therapy', '', '', NULL, 'O', '6533 Emerald St', 'Boise', 'Ada', 'ID', '83704', '2083674197', '2083678136', '6533 Emerald St', 'Boise', 'Ada', 'ID', '83704', '2083674197', '2083678136', 'IDSAMG2', '', '', '0.00', '10.00', '0.00', 6, '2010-02-01', '2011-03-09', 0, 0, 0, 'Saint Alphonsus Regional Medical Center', '', '', '', 'HCFA|', '1245291772', 0, 'N', 0, '2012-04-03', NULL, NULL, 43.6119, -116.268, NULL, NULL),
('820200895', 'W11023791', 'W11023791', 'ID01', 'Saint Alphonsus Medical Group Garrity Family Medicine', 'Michael', 'J', 'Eastman', 'PA-C', 'Pain Management', '', '', NULL, 'O', '1200 Garrity Blvd', 'Nampa', 'Canyon', 'ID', '83687', '2084669092', '2084665322', '1200 Garrity Blvd', 'Nampa', 'Canyon', 'ID', '83687', '2084669092', '2084665322', 'IDSAMG2', '', '', '0.00', '10.00', '0.00', 6, '2010-01-15', NULL, 0, 0, 0, 'Saint Alphonsus Regional Medical Center', '', '', '', 'HCFA|', '1598741068', 0, 'N', 0, '2014-06-20', NULL, NULL, 43.5867, -116.549, NULL, NULL),
('820200895', 'W11023792', 'W11023792', 'ID01', 'Saint Alphonsus Medical Group Elm Family Medicine', 'Michael', 'J', 'Eastman', 'PA-C', 'Pain Management', '', '', NULL, 'O', '315 E Elm St Ste 100', 'Caldwell', 'Canyon', 'ID', '83605', '2084597415', '2084533307', '315 E Elm St Ste 100', 'Caldwell', 'Canyon', 'ID', '83605', '2084597415', '2084533307', 'IDSAMG2', '', '', '0.00', '10.00', '0.00', 6, '2010-01-15', NULL, 0, 0, 0, 'Saint Alphonsus Regional Medical Center', '', '', '', 'HCFA|', '1598741068', 0, 'N', 0, '2014-06-20', NULL, NULL, 43.6534, -116.695, NULL, NULL),
('820200895', 'W11023793', 'W11023793', 'ID01', 'Saint Alphonsus Medical Group MHP Family Medicine', 'Michael', 'J', 'Eastman', 'PA-C', 'Pain Management', '', '', NULL, 'O', '3025 W Cherry Ln Ste B', 'Meridian', 'Ada', 'ID', '83642', '2083678550', '2083678555', '3025 W Cherry Ln Ste B', 'Meridian', 'Ada', 'ID', '83642', '2083678550', '2083678555', 'IDSAMG2', '', '', '0.00', '10.00', '0.00', 6, '2010-01-15', NULL, 0, 0, 0, 'Saint Alphonsus Regional Medical Center', '', '', '', 'HCFA|', '1598741068', 0, 'N', 0, '2014-06-20', NULL, NULL, 43.6193, -116.431, NULL, NULL),
('820200895', 'W11023794', 'W11023794', 'ID01', 'Saint Alphonsus Medical Group Emerald Family Medicine', 'Michael', 'J', 'Eastman', 'PA-C', 'Pain Management', '', '', NULL, 'O', '6533 Emerald St', 'Boise', 'Ada', 'ID', '83704', '2083674170', '2083678135', '6533 Emerald St', 'Boise', 'Ada', 'ID', '83704', '2083674170', '2083678135', 'IDSAMG2', '', '', '0.00', '10.00', '0.00', 6, '2010-01-15', NULL, 0, 0, 0, 'Saint Alphonsus Regional Medical Center', '', '', '', 'HCFA|', '1598741068', 0, 'N', 0, '2014-06-20', NULL, NULL, 43.6119, -116.263, NULL, NULL),
('820200895', 'W11023795', 'W11023795', 'ID01', 'Saint Alphonsus Express Care, Inc.', 'Michael', 'J', 'Eastman', 'PA-C', 'Pain Management', '', '', NULL, 'O', '4700 N Eagle Rd', 'Boise', 'Ada', 'ID', '83713', '2089384797', NULL, '4700 N Eagle Rd', 'Boise', 'Ada', 'ID', '83713', '2089384797', '', 'IDSAMG2', NULL, '', '0.00', '10.00', '0.00', 6, '2010-01-15', NULL, 0, 0, 0, 'Saint Alphonsus Regional Medical Center', '', '', '', 'HCFA|', '1598741068', 0, 'N', 0, '2014-06-20', NULL, NULL, 43.6474, -116.354, NULL, NULL),
('820200895', 'W11023796', 'W11023796', 'ID01', 'Saint Alphonsus Express Care, Inc.', 'Michael', 'J', 'Eastman', 'PA-C', 'Pain Management', '', '', NULL, 'O', '660 E Boise Ave', 'Boise', 'Ada', 'ID', '83706', '2083451162', NULL, '660 E Boise Ave', 'Boise', 'Ada', 'ID', '83706', '2083451162', '', 'IDSAMG2', NULL, '', '0.00', '10.00', '0.00', 6, '2010-01-15', '2010-04-01', 0, 0, 0, 'Saint Alphonsus Regional Medical Center', '', '', '', 'HCFA|', '1598741068', 0, 'N', 0, '2014-06-20', NULL, NULL, 0, 0, NULL, NULL),
('820200895', 'W11023797', 'W11023797', 'ID01', 'Saint Alphonsus Express Care, Inc.', 'Michael', 'J', 'Eastman', 'PA-C', 'Pain Management', '', '', NULL, 'O', '1515 W State St', 'Boise', 'Ada', 'ID', '83702', '2083456768', NULL, '1515 W State St', 'Boise', 'Ada', 'ID', '83702', '2083456768', '', 'IDSAMG2', NULL, '', '0.00', '10.00', '0.00', 6, '2010-01-15', NULL, 0, 0, 0, 'Saint Alphonsus Regional Medical Center', '', '', '', 'HCFA|', '1598741068', 0, 'N', 0, '2014-06-20', NULL, NULL, 43.6229, -116.209, NULL, NULL),
('820200895', 'W11023798', 'W11023798', 'ID01', 'Saint Alphonsus Express Care, Inc.', 'Michael', 'J', 'Eastman', 'PA-C', 'Pain Management', '', '', NULL, 'O', '2809 Cleveland Blvd', 'Caldwell', 'Canyon', 'ID', '83605', '2084594759', NULL, '2809 Cleveland Blvd', 'Caldwell', 'Canyon', 'ID', '83605', '2084594759', '', 'IDSAMG2', NULL, '', '0.00', '10.00', '0.00', 6, '2010-01-15', '2010-04-01', 0, 0, 0, 'Saint Alphonsus Regional Medical Center', '', '', '', 'HCFA|', '1598741068', 0, 'N', 0, '2014-06-20', NULL, NULL, 0, 0, NULL, NULL),
('820312175', 'W11023799', 'W11023799', 'ID01', 'Idaho Emergency Physicians PA', 'Peter', 'J', 'Angleton', 'MD', 'Emergency Medicine', '', '', NULL, 'B', '2312 N Cole  Ste B', 'Boise', 'Ada', 'ID', '83704', '2083221730', NULL, '2312 N Cole  Ste B', 'Boise', 'Ada', 'ID', '83704', '2083221730', '          ', 'IDSAMG3', '', '', '0.00', '10.00', '0.00', 3, '2009-07-01', '2011-02-21', 0, 0, 0, 'Saint Alphonsus Regional Medical Center', 'West Valley Medical Center', NULL, NULL, 'HCFA|UB|', '1821042334', 0, 'Y', 0, '2012-01-06', NULL, NULL, 0, 0, NULL, NULL),
('820312175', 'W11023800', 'W11023800', 'ID01', 'Idaho Emergency Physicians PA', 'Hansel', '', 'Ashby', 'MD', 'Emergency Medicine', '', '', NULL, 'B', '2312 N Cole  Ste B', 'Boise', 'Ada', 'ID', '83704', '2083221730', NULL, '2312 N Cole  Ste B', 'Boise', 'Ada', 'ID', '83704', '2083221730', '          ', 'IDSAMG3', '', '', '0.00', '10.00', '0.00', 3, '2009-07-01', '2011-02-21', 0, 0, 0, 'Saint Alphonsus Regional Medical Center', 'West Valley Medical Center', NULL, NULL, 'HCFA|UB|', '1548213457', 0, 'Y', 0, '2012-01-30', NULL, NULL, 0, 0, NULL, NULL),
('820312175', 'W11023801', 'W11023801', 'ID01', 'Idaho Emergency Physicians PA', 'Randy', 'L', 'Barnes', 'MD', 'Emergency Medicine', '', '', NULL, 'B', '2312 N Cole  Ste B', 'Boise', 'Ada', 'ID', '83704', '2083221730', NULL, '2312 N Cole  Ste B', 'Boise', 'Ada', 'ID', '83704', '2083221730', '          ', 'IDSAMG3', '', '', '0.00', '10.00', '0.00', 3, '2009-07-01', '2011-02-21', 0, 0, 0, 'Saint Alphonsus Regional Medical Center', 'West Valley Medical Center', NULL, NULL, 'HCFA|UB|', '1295811867', 0, 'Y', 0, '2012-01-30', NULL, NULL, 0, 0, NULL, NULL),
('820312175', 'W11023802', 'W11023802', 'ID01', 'Idaho Emergency Physicians PA', 'Dianna', 'L', 'Binnion', 'MD', 'Emergency Medicine', '', '', NULL, 'B', '2312 N Cole  Ste B', 'Boise', 'Ada', 'ID', '83704', '2083221730', NULL, '2312 N Cole  Ste B', 'Boise', 'Ada', 'ID', '83704', '2083221730', '          ', 'IDSAMG3', '', '', '0.00', '10.00', '0.00', 3, '2009-07-01', '2011-02-21', 0, 0, 0, 'Saint Alphonsus Regional Medical Center', 'West Valley Medical Center', NULL, NULL, 'HCFA|UB|', '1073567574', 0, 'Y', 0, '2012-01-31', NULL, NULL, 0, 0, NULL, NULL),
('820312175', 'W11023803', 'W11023803', 'ID01', 'Idaho Emergency Physicians PA', 'Brian', 'M', 'Boesiger', 'MD', 'Emergency Medicine', '', '', NULL, 'B', '2312 N Cole  Ste B', 'Boise', 'Ada', 'ID', '83704', '2083221730', NULL, '2312 N Cole  Ste B', 'Boise', 'Ada', 'ID', '83704', '2083221730', '          ', 'IDSAMG3', '', '', '0.00', '10.00', '0.00', 3, '2009-07-01', '2011-02-21', 0, 0, 0, 'Saint Alphonsus Regional Medical Center', 'West Valley Medical Center', NULL, NULL, 'HCFA|UB|', '1982657896', 0, 'Y', 0, '2012-01-31', NULL, NULL, 0, 0, NULL, NULL),
('820312175', 'W11023804', 'W11023804', 'ID01', 'Idaho Emergency Physicians PA', 'Mark', 'A', 'Burriesci', 'MD', 'Emergency Medicine', '', '', NULL, 'B', '2312 N Cole  Ste B', 'Boise', 'Ada', 'ID', '83704', '2083221730', NULL, '2312 N Cole  Ste B', 'Boise', 'Ada', 'ID', '83704', '2083221730', '          ', 'IDSAMG3', '', '', '0.00', '10.00', '0.00', 3, '2009-07-01', '2011-02-21', 0, 0, 0, 'Saint Alphonsus Regional Medical Center', 'West Valley Medical Center', NULL, NULL, 'HCFA|UB|', '1831397835', 0, 'Y', 0, '2012-01-31', NULL, NULL, 0, 0, NULL, NULL),
('820312175', 'W11023805', 'W11023805', 'ID01', 'Idaho Emergency Physicians PA', 'Matthew', 'B', 'Campbell', 'MD', 'Emergency Medicine', '', '', NULL, 'B', '2312 N Cole  Ste B', 'Boise', 'Ada', 'ID', '83704', '2083221730', NULL, '2312 N Cole  Ste B', 'Boise', 'Ada', 'ID', '83704', '2083221730', '          ', 'IDSAMG3', '', '', '0.00', '10.00', '0.00', 3, '2009-07-01', '2011-02-21', 0, 0, 0, 'Saint Alphonsus Regional Medical Center', 'West Valley Medical Center', NULL, NULL, 'HCFA|UB|', '1790981025', 0, 'Y', 0, '2012-01-31', NULL, NULL, 0, 0, NULL, NULL),
('820312175', 'W11023806', 'W11023806', 'ID01', 'Idaho Emergency Physicians PA', 'Matthew', 'J', 'Conklin', 'MD', 'Emergency Medicine', '', '', NULL, 'B', '2312 N Cole  Ste B', 'Boise', 'Ada', 'ID', '83704', '2083221730', NULL, '2312 N Cole  Ste B', 'Boise', 'Ada', 'ID', '83704', '2083221730', '          ', 'IDSAMG3', '', '', '0.00', '10.00', '0.00', 3, '2009-07-01', '2011-02-21', 0, 0, 0, 'Saint Alphonsus Regional Medical Center', 'West Valley Medical Center', NULL, NULL, 'HCFA|UB|', '1922052448', 0, 'Y', 0, '2012-01-31', NULL, NULL, 0, 0, NULL, NULL),
('820312175', 'W11023807', 'W11023807', 'ID01', 'Idaho Emergency Physicians PA', 'Benjamin', 'L', 'Cornett', 'MD', 'Emergency Medicine', '', '', NULL, 'B', '2312 N Cole  Ste B', 'Boise', 'Ada', 'ID', '83704', '2083221730', NULL, '2312 N Cole  Ste B', 'Boise', 'Ada', 'ID', '83704', '2083221730', '          ', 'IDSAMG3', '', '', '0.00', '10.00', '0.00', 3, '2009-07-01', '2011-02-21', 0, 0, 0, 'Saint Alphonsus Regional Medical Center', 'West Valley Medical Center', NULL, NULL, 'HCFA|UB|', '1821298001', 0, 'Y', 0, '2012-01-31', NULL, NULL, 0, 0, NULL, NULL),
('820312175', 'W11023808', 'W11023808', 'ID01', 'Idaho Emergency Physicians PA', 'James', 'R', 'Davidson', 'MD', 'Emergency Medicine', '', '', NULL, 'B', '2312 N Cole  Ste B', 'Boise', 'Ada', 'ID', '83704', '2083221730', NULL, '2312 N Cole  Ste B', 'Boise', 'Ada', 'ID', '83704', '2083221730', '          ', 'IDSAMG3', '', '', '0.00', '10.00', '0.00', 3, '2009-07-01', '2010-10-15', 0, 0, 0, 'Saint Alphonsus Medical Center Nampa', '', 'West Valley Medical Center', '', 'HCFA|UB|', '1669419693', 0, 'Y', 0, '2012-03-15', NULL, NULL, 0, 0, NULL, NULL),
('820312175', 'W11023809', 'W11023809', 'ID01', 'Idaho Emergency Physicians PA', 'Robert', 'L', 'Davis', 'MD', 'Emergency Medicine', '', '', NULL, 'B', '2312 N Cole  Ste B', 'Boise', '', 'ID', '83703', '2083221730', NULL, '2312 N Cole  Ste B', 'Boise', '', 'ID', '83703', '2083221730', '          ', 'IDSAMG3', '', '', '0.00', '10.00', '0.00', 3, '2009-07-01', '2011-02-21', 0, 0, 0, 'Saint Alphonsus Regional Medical Center', 'West Valley Medical Center', NULL, NULL, 'HCFA|UB|', '1548295249', 0, 'Y', 0, '2012-01-30', NULL, NULL, 0, 0, NULL, NULL),
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('870281028', 'W11023857', 'W11023857', 'UT01', 'Central Utah Clinic', 'David', 'B', 'Young', 'DO', 'Obstetrics and Gynecology', '', '', NULL, 'B', 'PO Box 30079', 'Salt Lake City', 'Salt Lake', 'UT', '84130', '8017565288', '8017567589', 'PO Box 30079', 'Salt Lake City', 'Salt Lake', 'UT', '84130', '8017565288', '8017567589', 'WUUVPN10', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 6, '2009-12-01', '2010-07-14', 0, 0, 0, 'Timpanogos Regional Hospital', '', '', '', 'HCFA|UB|', '1679756852', 0, 'Y', 0, '2013-04-30', NULL, NULL, 0, 0, NULL, NULL),
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('870284475', 'W11023861', 'W11023861', 'UT01', 'Granger Medical Clinic', 'Easton', 'D', 'Jackson', 'MD', 'Urgent Care', '', '', NULL, 'O', '3725 W 4100 S', 'West Valley', 'Salt Lake', 'UT', '84120', '8019653600', NULL, '3725 W 4100 S', 'West Valley', 'Salt Lake', 'UT', '84120', '8019653600', '', 'WUGRANGER5', 'WUSTDHCPC5', NULL, '0.00', '35.00', '0.00', 3, '2010-01-08', NULL, 0, 0, 0, 'Pioneer Valley Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1316049828', 0, 'N', 0, '2014-01-17', NULL, NULL, 40.682, -111.979, NULL, NULL);
