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', 'W11007617', 'W11007617', 'UTIHC02', 'Consult Liaison', 'P', 'Brent', 'Petersen', 'MD', 'Mental Health', 'Psychiatry', '', NULL, 'O', '100 N Mario Capecchi Dr', 'Salt Lake City', 'Salt Lake', 'UT', '84113', '8015883938', NULL, '100 N Mario Capecchi Dr', 'Salt Lake City', 'Salt Lake', 'UT', '84113', '8015883938', '', '', NULL, NULL, '0.00', '10.00', '0.00', 8, '2008-08-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1306824628', 0, 'N', 0, '2013-02-27', NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W11007423', 'W11007423', 'UTIHC01', 'PCMC Audiology', 'Nanette', 'L', 'Sturgill', 'AUD', 'Audiology', NULL, NULL, NULL, 'O', '100 N Mario Capecchi Dr', 'Salt Lake City', 'Salt Lake', 'UT', '84113', '8016624949', NULL, '100 N Mario Capecchi Dr', 'Salt Lake City', 'Salt Lake', 'UT', '84113', '8016624949', '          ', '', '', '', '0.00', '10.00', '0.00', 8, '2008-08-01', '2009-12-04', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1659387165', 0, 'N', 0, '2012-09-13', NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W11007299', 'W11007299', 'UTIHC01', 'PCMC Rehab Bountiful', 'Lisa', 'Morley', 'Quintana', 'PT', 'Physical Therapy', '', '', NULL, 'O', '100 N Mario Capecchi Dr', 'Salt Lake City', 'Salt Lake', 'UT', '84113', '8016624949', NULL, '100 N Mario Capecchi Dr', 'Salt Lake City', 'Salt Lake', 'UT', '84113', '8016624949', '', '', NULL, NULL, '0.00', '10.00', '0.00', 8, '2008-08-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1538278528', 0, 'N', 0, '2012-04-10', NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W11007620', 'W11007620', 'UTIHC02', 'PCMC Audiology', 'Cache', 'L', 'Pitt', 'AUD', 'Audiology', '', '', NULL, 'O', '100 N Mario Capecchi Dr', 'Salt Lake City', 'Salt Lake', 'UT', '84113', '8016624949', NULL, '100 N Mario Capecchi Dr', 'Salt Lake City', 'Salt Lake', 'UT', '84113', '8016624949', '', '', NULL, NULL, '0.00', '10.00', '0.00', 8, '2008-08-01', '2009-06-03', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1871509356', 0, 'N', 0, '2013-12-02', NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W11007624', 'W11007624', 'UTIHC02', 'Primary Childrens Medical Center', 'Michael', 'David', 'Puchalski', 'MD', 'Pediatric Cardiology', 'Pediatrics', '', NULL, 'O', '100 N Mario Capecchi Dr', 'Salt Lake City', 'Salt Lake', 'UT', '84113', '8015882000', NULL, '100 N Mario Capecchi Dr', 'Salt Lake City', 'Salt Lake', 'UT', '84113', '8015882000', '          ', '', '', '', '0.00', '10.00', '0.00', 8, '2008-08-01', '2011-04-25', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1639258106', 0, 'N', 0, '2012-05-03', NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W11007427', 'W11007427', 'UTIHC01', 'Cardiology', 'Lloyd', 'Y', 'Tani', 'MD', 'Pediatric Cardiology', '', '', NULL, 'O', '100 N Mario Capecchi Dr', 'Salt Lake City', 'Salt Lake', 'UT', '84113', '8015882000', NULL, '100 N Mario Capecchi Dr', 'Salt Lake City', 'Salt Lake', 'UT', '84113', '8015882000', '', '', NULL, NULL, '0.00', '10.00', '0.00', 8, '2008-08-01', NULL, 0, 0, 0, 'Primary Childrens Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1326127994', 0, 'N', 0, '2012-08-21', NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W11007327', 'W11007327', 'UTIHC01', 'PCMC Audiology', 'Jason', 'R', 'Norby', 'AUD', 'Audiology', NULL, NULL, NULL, 'O', '100 N Mario Capecchi Dr', 'Salt Lake City', 'Salt Lake', 'UT', '84113', '8016624949', NULL, '100 N Mario Capecchi Dr', 'Salt Lake City', 'Salt Lake', 'UT', '84113', '8016624949', '          ', '', '', '', '0.00', '10.00', '0.00', 8, '2008-08-01', '2010-03-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1861409047', 0, 'N', 0, '2012-09-13', NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W11007316', 'W11007316', 'UTIHC01', 'PCMC Rehab Ogden', 'Shelley', NULL, 'Nakasone', 'SLP', 'Speech Therapy', 'Speech Language Pathology', NULL, NULL, 'O', '100 N Mario Capecchi Dr', 'Salt Lake City', 'Salt Lake', 'UT', '84113', '8016624949', NULL, NULL, NULL, 'Salt Lake', NULL, NULL, NULL, NULL, '', NULL, NULL, '0.00', '10.00', '0.00', 8, '2008-08-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1649287731', 0, 'N', 0, '2010-01-12', NULL, NULL, 0, 0, NULL, NULL),
('320186101', 'W11008032', 'W11008032', 'UT01', 'University Health Care', 'Thomas', 'A', 'Pilcher', 'MD', 'Pediatric Cardiology', 'Pediatrics', '', NULL, 'O', '100 N Mario Capecchi Dr', 'Salt Lake City', 'Salt Lake', 'UT', '84113', '8016621000', NULL, '100 N Mario Capecchi Dr', 'Salt Lake City', 'Salt Lake', 'UT', '84113', '8016621000', '', 'WUUPEDS', 'WUSTDHCPC5', '', '0.00', '15.00', '0.00', 3, '2008-07-01', '2012-05-01', 0, 0, 0, 'Primary Childrens Medical Center', '', '', '', 'HCFA|UB|', '1437247582', 0, 'N', 0, '2014-05-22', NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W11007377', 'W11007377', 'UTIHC01', 'PCMC Rehab Taylorsville', 'Amy', 'Jo', 'Rosello', 'OT', 'Occupational Therapy', NULL, NULL, NULL, 'O', '100 N Mario Capecchi Dr', 'Salt Lake City', 'Salt Lake', 'UT', '84113', '8016624949', NULL, NULL, NULL, 'Salt Lake', NULL, NULL, NULL, NULL, '', NULL, NULL, '0.00', '10.00', '0.00', 8, '2008-08-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1801953690', 0, 'N', 0, '2010-01-12', NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W11007373', 'W11007373', 'UTIHC01', 'PCMC Rehab Ogden', 'Tera', 'C', 'Robinson', 'OT', 'Occupational Therapy', NULL, NULL, NULL, 'O', '100 N Mario Capecchi Dr', 'Salt Lake City', 'Salt Lake', 'UT', '84113', '8016624949', NULL, NULL, NULL, 'Salt Lake', NULL, NULL, NULL, NULL, '', NULL, NULL, '0.00', '10.00', '0.00', 8, '2008-08-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1922192798', 0, 'N', 0, '2010-01-12', NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W11007319', 'W11007319', 'UTIHC01', 'Inpatient', 'Patricia', 'Klotz', 'Nations', 'SLP', 'Speech Therapy', NULL, NULL, NULL, 'O', '100 N. Medical Drive', 'Salt Lake City', 'Salt Lake', 'UT', '84113', '8016624980', NULL, NULL, NULL, 'Salt Lake', NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '10.00', NULL, 8, '2000-01-01', '2000-01-01', 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '0000007793', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870645895', 'W11008038', 'W11008038', 'UT01', 'University Health Care', 'Kevin', 'B', 'Jones', 'MD', 'Orthopedic Surgery', NULL, NULL, NULL, 'o', '100 N Mario Capecchi Dr Ste 4550', 'Salt Lake City', 'Salt Lake', 'UT', '84113', '8016625600', NULL, '100 N Mario Capecchi Dr Ste 4550', 'Salt Lake City', 'Salt Lake', 'UT', '84113', '8016625600', '          ', 'WUUPEDS', 'WUSTDHCPC5', '', '0.00', '15.00', '0.00', 3, '2008-08-05', '2012-08-01', 0, 0, 0, 'University Health Care University Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1750599114', 0, 'N', 0, '2012-08-02', NULL, NULL, 0, 0, NULL, NULL),
('870551055', 'W11008039', 'W11008039', 'UT01', 'University Health Care', 'Aditya', NULL, 'Kaza', 'MD', 'General Surgery', 'Cardiovascular Disease', '', NULL, 'o', '100 N Mario Capecchi Dr Ste 2800', 'Salt Lake City', 'Salt Lake', 'UT', '84113', '8016625566', NULL, '100 N Mario Capecchi Dr Ste 2800', 'Salt Lake City', 'Salt Lake', 'UT', '84113', '8016625566', '          ', 'WUUPEDS', 'WUSTDHCPC5', '', '0.00', '15.00', '0.00', 3, '2008-07-01', '2012-09-17', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1891832150', 0, 'N', 0, '2012-09-18', NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W11007320', 'W11007320', 'UTIHC01', 'Inpatient', 'Patricia', 'Klotz', 'Nations', 'SLP', 'Speech Therapy', NULL, NULL, NULL, 'O', '100 N Medical Dr', 'Salt Lake City', 'Salt Lake', 'UT', '84113', '8016624980', NULL, NULL, NULL, 'Salt Lake', NULL, NULL, NULL, NULL, '', NULL, NULL, '0.00', '10.00', '0.00', 8, '2008-08-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '0000007793', 0, 'N', 0, '2008-10-23', NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W11007660', 'W11007660', 'UTIHC02', 'PCMC Rehab Sandy', 'Allison', 'Rae', 'Tanner', 'SLP', 'Speech Therapy', 'Speech Language Pathology', NULL, NULL, 'O', '100 N Mario Capecchi Dr', 'Salt Lake City', 'Salt Lake', 'UT', '84113', '8016624949', NULL, NULL, NULL, 'Salt Lake', NULL, NULL, NULL, NULL, '', NULL, NULL, '0.00', '10.00', '0.00', 8, '2008-08-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1841389947', 0, 'N', 0, '2010-01-12', NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W11007322', 'W11007322', 'UTIHC01', 'Inpatient', 'Patricia', 'Klotz', 'Nations', 'SLP', 'Speech Therapy', NULL, NULL, NULL, 'O', '100 N. Medical Drive', 'Salt Lake City', 'Salt Lake', 'UT', '84113', '8016624980', NULL, NULL, NULL, 'Salt Lake', NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '10.00', NULL, 8, '2000-01-01', '2000-01-01', 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '0000007793', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W11007313', 'W11007313', 'UTIHC01', 'PCMC Rehab Sandy', 'Annette', 'G', 'Myers', 'PT', 'Physical Therapy', NULL, NULL, NULL, 'O', '100 N Mario Capecchi Dr', 'Salt Lake City', 'Salt Lake', 'UT', '84113', '8016624949', NULL, NULL, NULL, 'Salt Lake', NULL, NULL, NULL, NULL, '', NULL, NULL, '0.00', '10.00', '0.00', 8, '2008-08-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1982798930', 0, 'N', 0, '2010-01-12', NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W11007328', 'W11007328', 'UTIHC01', 'PCMC Rehab Taylorsville', 'Eve', NULL, 'Noren', 'OT', 'Occupational Therapy', NULL, NULL, NULL, 'O', '100 N Mario Capecchi Dr', 'Salt Lake City', 'Salt Lake', 'UT', '84113', '8016624949', NULL, NULL, NULL, 'Salt Lake', NULL, NULL, NULL, NULL, '', NULL, NULL, '0.00', '10.00', '0.00', 8, '2008-08-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1285728113', 0, 'N', 0, '2010-01-12', NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W11007363', 'W11007363', 'UTIHC01', 'PCMC Audiology', 'Paula', 'J', 'Rasmussen', 'SLP', 'Speech Therapy', NULL, NULL, NULL, 'O', '100 N Mario Capecchi Dr', 'Salt Lake City', 'Salt Lake', 'UT', '84113', '8016624949', NULL, NULL, NULL, 'Salt Lake', NULL, NULL, NULL, NULL, '', NULL, NULL, '0.00', '10.00', '0.00', 8, '2008-08-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1821015710', 0, 'N', 0, '2010-01-12', NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W11007360', 'W11007360', 'UTIHC01', 'Primary Childrens Medical Center', 'Michael', 'David', 'Puchalski', 'MD', 'Pediatric Cardiology', 'Pediatrics', '', NULL, 'O', '100 N Mario Capecchi Dr', 'Salt Lake City', 'Salt Lake', 'UT', '84113', '8015882000', NULL, '100 N Mario Capecchi Dr', 'Salt Lake City', 'Salt Lake', 'UT', '84113', '8015882000', '          ', '', '', '', '0.00', '10.00', '0.00', 8, '2008-08-01', '2011-04-25', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1639258106', 0, 'N', 0, '2012-05-03', NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W11007331', 'W11007331', 'UTIHC01', 'PCMC Rehab Sandy', 'Wende', 'A', 'OBerg', 'OT', 'Occupational Therapy', NULL, NULL, NULL, 'O', '100 N Mario Capecchi Dr', 'Salt Lake City', 'Salt Lake', 'UT', '84113', '8016624949', NULL, NULL, NULL, 'Salt Lake', NULL, NULL, NULL, NULL, '', NULL, NULL, '0.00', '10.00', '0.00', 8, '2008-08-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1528152485', 0, 'N', 0, '2010-01-12', NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W11007333', 'W11007333', 'UTIHC01', 'Primary Childrens Medical Center', 'Molly', 'A', 'O Gorman', 'MD', 'Pediatric Gastroenterology', '', '', NULL, 'O', '100 N Mario Capecchi Dr', 'Salt Lake City', 'Salt Lake', 'UT', '84113', '8015882000', NULL, '100 N Mario Capecchi Dr', 'Salt Lake City', 'Salt Lake', 'UT', '84113', '8015882000', '          ', '', '', '', '0.00', '10.00', '0.00', 8, '2008-08-01', '2013-07-01', 0, 0, 0, 'Primary Childrens Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1144339391', 0, 'N', 0, '2013-08-29', NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W11007354', 'W11007354', 'UTIHC01', 'PCMC Audiology', 'Cache', 'L', 'Pitt', 'AUD', 'Audiology', '', '', NULL, 'O', '100 N Mario Capecchi Dr', 'Salt Lake City', 'Salt Lake', 'UT', '84113', '8016624949', NULL, '100 N Mario Capecchi Dr', 'Salt Lake City', 'Salt Lake', 'UT', '84113', '8016624949', '', '', NULL, NULL, '0.00', '10.00', '0.00', 8, '2008-08-01', '2009-06-03', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1871509356', 0, 'N', 0, '2013-12-02', NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W11007335', 'W11007335', 'UTIHC01', 'Consult Liaison', 'Anne', 'M', 'O''Melia', 'MD', 'Mental Health', 'Pediatric Psychiatry', 'Pediatric Psychiatry', NULL, 'O', '100 N Mario Capecchi Dr', 'Salt Lake City', 'Salt Lake', 'UT', '84113', '8015883938', NULL, NULL, NULL, 'Salt Lake', NULL, NULL, NULL, NULL, '', NULL, NULL, '0.00', '10.00', '0.00', 8, '2008-08-01', '2009-03-18', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1619022738', 0, 'N', 0, '2010-01-12', NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W11007347', 'W11007347', 'UTIHC01', 'Consult Liaison', 'P', 'Brent', 'Petersen', 'MD', 'Mental Health', 'Psychiatry', '', NULL, 'O', '100 N Mario Capecchi Dr', 'Salt Lake City', 'Salt Lake', 'UT', '84113', '8015883938', NULL, '100 N Mario Capecchi Dr', 'Salt Lake City', 'Salt Lake', 'UT', '84113', '8015883938', '', '', NULL, NULL, '0.00', '10.00', '0.00', 8, '2008-08-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1306824628', 0, 'N', 0, '2013-02-27', NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W11007321', 'W11007321', 'UTIHC01', 'Inpatient', 'Patricia', 'Klotz', 'Nations', 'SLP', 'Speech Therapy', NULL, NULL, NULL, 'O', '100 N. Medical Drive', 'Salt Lake City', 'Salt Lake', 'UT', '84113', '8016624980', NULL, NULL, NULL, 'Salt Lake', NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '10.00', NULL, 8, '2000-01-01', '2000-01-01', 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '0000007793', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W11007392', 'W11007392', 'UTIHC01', 'Consult Liaison', 'L', 'Kristin H', 'Shadow', 'MD', 'Mental Health', 'Pediatric Psychiatry', NULL, NULL, 'O', '100 N Mario Capecchi Dr', 'Salt Lake City', 'Salt Lake', 'UT', '84113', '8015883938', NULL, NULL, NULL, 'Salt Lake', NULL, NULL, NULL, NULL, '', NULL, NULL, '0.00', '10.00', '0.00', 8, '2008-08-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1922028497', 0, 'N', 0, '2010-01-12', NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W11007604', 'W11007604', 'UTIHC02', 'PCMC Audiology', 'Jason', 'R', 'Norby', 'AUD', 'Audiology', NULL, NULL, NULL, 'O', '100 N Mario Capecchi Dr', 'Salt Lake City', 'Salt Lake', 'UT', '84113', '8016624949', NULL, '100 N Mario Capecchi Dr', 'Salt Lake City', 'Salt Lake', 'UT', '84113', '8016624949', '          ', '', '', '', '0.00', '10.00', '0.00', 8, '2008-08-01', '2010-03-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1861409047', 0, 'N', 0, '2012-09-13', NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W11007665', 'W11007665', 'UTIHC02', 'Primary Childrens Medical Center', 'Joel', 'A', 'Thompson', 'MD', 'Pediatric Neurology', 'Neurology', NULL, NULL, 'O', '100 N Mario Capecchi Dr', 'Salt Lake City', 'Salt Lake', 'UT', '84113', '8015882000', NULL, '100 N Mario Capecchi Dr', 'Salt Lake City', 'Salt Lake', 'UT', '84113', '8015882000', '          ', '', '', '', '0.00', '10.00', '0.00', 8, '2008-08-01', '2012-10-01', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1912071093', 0, 'N', 0, '2012-10-10', NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W11007666', 'W11007666', 'UTIHC02', 'Neurology', 'Joel', 'A', 'Thompson', 'MD', 'Pediatric Neurology', 'Neurology', NULL, NULL, 'O', '100 N Mario Capecchi Dr', 'Salt Lake City', 'Salt Lake', 'UT', '84113', '8015882000', NULL, NULL, NULL, 'Salt Lake', NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '10.00', NULL, 8, '2000-01-01', '2000-01-01', 0, NULL, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1912071093', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W11007669', 'W11007669', 'UTIHC02', 'PCMC Rehab Bountiful', 'Susan', 'J B', 'Tibbitts', 'SLP', 'Speech Therapy', 'Speech Language Pathology', NULL, NULL, 'O', '100 N Mario Capecchi Dr', 'Salt Lake City', 'Salt Lake', 'UT', '84113', '8016624949', NULL, '100 N Mario Capecchi Dr', 'Salt Lake City', 'Salt Lake', 'UT', '84113', '8016624949', '          ', '', '', '', '0.00', '10.00', '0.00', 8, '2008-08-01', '2011-08-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1871500975', 0, 'N', 0, '2012-09-13', NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W11007394', 'W11007394', 'UTIHC01', 'PCMC Rehab Taylorsville', 'Kalomyra "Myra"', 'C', 'Shenk', 'SLP', 'Speech Therapy', 'Speech Language Pathology', NULL, NULL, 'O', '100 N Mario Capecchi Dr', 'Salt Lake City', 'Salt Lake', 'UT', '84113', '8016624949', NULL, NULL, NULL, 'Salt Lake', NULL, NULL, NULL, NULL, '', NULL, NULL, '0.00', '10.00', '0.00', 8, '2008-08-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1700970845', 0, 'N', 0, '2010-01-12', NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W11007671', 'W11007671', 'UTIHC02', 'Cardiology', 'Martin', 'J', 'Tristani-Firouzi', 'MD', 'Pediatric Cardiology', 'Pediatrics', '', NULL, 'O', '100 N Mario Capecchi Dr', 'Salt Lake City', 'Salt Lake', 'UT', '84113', '8015882000', NULL, '100 N Mario Capecchi Dr', 'Salt Lake City', 'Salt Lake', 'UT', '84113', '8015882000', '          ', '', '', '', '0.00', '10.00', '0.00', 8, '2008-08-01', '2011-04-25', 0, 0, 0, 'Primary Childrens Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1669551230', 0, 'N', 0, '2011-11-08', NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W11007672', 'W11007672', 'UTIHC02', 'Neurology', 'Colin', 'B', 'Van Orman', 'MD', 'Pediatric Neurology', 'Neurology', '', NULL, 'O', '100 N Mario Capecchi Dr', 'Salt Lake City', 'Salt Lake', 'UT', '84113', '8015882000', NULL, NULL, NULL, 'Salt Lake', NULL, NULL, NULL, NULL, '', NULL, NULL, '0.00', '10.00', '0.00', 8, '2008-08-01', NULL, 0, 0, 0, 'Primary Childrens Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1225117898', 0, 'N', 0, '2009-11-16', NULL, NULL, 0, 0, NULL, NULL),
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('942854057', 'W11007917', 'W11007917', 'UTIHC03', 'Primary Childrens Medical Center', 'P', 'Brent', 'Petersen', 'MD', 'Mental Health', 'Psychiatry', '', NULL, 'O', '5770 S 1500 W Ste G', 'Taylorsville', 'Salt Lake', 'UT', '84123', '8012653000', NULL, '5770 S 1500 W Ste G', 'Taylorsville', 'Salt Lake', 'UT', '84123', '8012653000', '', '', NULL, NULL, '0.00', '10.00', '0.00', 8, '2008-08-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1306824628', 0, 'N', 0, '2013-02-27', NULL, NULL, 0, 0, NULL, NULL);
INSERT INTO `providers_new` (`Provider_Tax_ID`, `Provider_Suffix`, `Provider_Network_ID`, `Provider_Region`, `Provider_Name`, `Provider_Doctor_First_Name`, `Provider_Doctor_Middle_Name`, `Provider_Doctor_Last_Name`, `Provider_Doctor_Degree`, `Provider_Specialty_1`, `Provider_Specialty_2`, `Provider_Specialty_3`, `Provider_Specialty_4`, `Provider_Address_Type`, `Provider_Address`, `Provider_City`, `Provider_County`, `Provider_State`, `Provider_Zip`, `Provider_Phone`, `Provider_Fax`, `Provider_Mailing_Address`, `Provider_Mailing_City`, `Provider_Mailing_County`, `Provider_Mailing_State`, `Provider_Mailing_Zip`, `Provider_Mailing_Phone`, `Provider_Mailing_Fax`, `Provider_Primary_Schedule`, `Provider_Secondary_Schedule`, `Provider_Rate_Sheet`, `Provider_Anes_Rate`, `Provider_Default_Rate`, `Provider_Max_DOS`, `Provider_Min_Match_Value`, `Provider_Effective_Date`, `Provider_Term_Date`, `Provider_Pend`, `Provider_Anes_Minutes`, `Provider_PPO`, `Provider_Hospital_1`, `Provider_Hospital_2`, `Provider_Hospital_3`, `Provider_Hospital_4`, `Provider_Type`, `Provider_NPI`, `Provider_Check_Override`, `Exclude_Dir`, `Audit_Status`, `Last_Change_Date`, `Medicare_ID`, `Provider_Lang`, `Provider_Latitude`, `Provider_Longitude`, `Provider_school`, `Provider_cert`) VALUES
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('942854057', 'W11007355', 'W11007355', 'UTIHC01', 'Center for Counseling', 'Jason', 'L', 'Pola', 'LCSW', 'Mental Health', 'Social Worker', '', NULL, 'O', '5770 S 1500 W Ste G', 'Taylorsville', 'Salt Lake', 'UT', '84123', '8013137770', NULL, '5770 S 1500 W Ste G', 'Taylorsville', 'Salt Lake', 'UT', '84123', '8013137770', '          ', '', '', '', '0.00', '10.00', '0.00', 8, '2008-08-01', '2012-12-01', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1750304515', 0, 'N', 0, '2012-12-26', NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W11007519', 'W11007519', 'UTIHC02', 'Adolescent Residential and Day Treatment', 'Louise', 'D', 'Elliott', 'LCSW', 'Mental Health', 'Social Worker', '', NULL, 'O', '5770 S 1500 W', 'Taylorsville', 'Salt Lake', 'UT', '84123', '8013137770', NULL, '5770 S 1500 W', 'Taylorsville', 'Salt Lake', 'UT', '84123', '8013137770', '          ', '', '', '', '0.00', '10.00', '0.00', 8, '2008-08-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1457544280', 0, 'N', 0, '2010-01-12', NULL, NULL, 0, 0, NULL, NULL),
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('942854057', 'W11007276', 'W11007276', 'UTIHC01', 'Acute Inpatient', 'Isabel', 'P', 'Martinez', 'LCSW', 'Mental Health', 'Social Worker', NULL, NULL, 'O', '5770 S 1500 W', 'Taylorsville', 'Salt Lake', 'UT', '84123', '8012653000', NULL, NULL, NULL, 'Salt Lake', NULL, NULL, NULL, NULL, '', NULL, NULL, '0.00', '10.00', '0.00', 8, '2008-08-01', '2009-09-15', NULL, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '0000007451', 0, 'N', 0, '2010-01-12', NULL, NULL, 0, 0, NULL, NULL),
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('942854057', 'W11007484', 'W11007484', 'UTIHC02', 'Primary Childrens Center for Counseling', 'James', 'C', 'Ashworth', 'MD', 'Mental Health', 'Pediatric Psychiatry', '', NULL, 'O', '5770 S 1500 W', 'Taylorsville', 'Salt Lake', 'UT', '84123', '8013137770', NULL, '5770 S 1500 W', 'Taylorsville', 'Salt Lake', 'UT', '84123', '8013137770', '          ', '', '', '', '0.00', '10.00', '0.00', 8, '2008-08-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1679514988', 0, 'N', 0, '2013-07-09', 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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('870483582', 'W11007058', 'W11007058', 'UT01', 'University of Utah Orthopedic Consultants', 'Clifford', 'D', 'Clark', 'MD', 'Orthopedic Surgery', NULL, NULL, NULL, 'B', 'PO Box 58108', 'Salt Lake City', 'Salt Lake', 'UT', '84158', '8015813998', NULL, NULL, NULL, 'Salt Lake', NULL, NULL, NULL, NULL, 'WUUUMG5', 'WUSTDHCPC5', NULL, '0.00', '25.00', '0.00', 3, '2008-08-01', '2009-07-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1881612653', 0, 'y', 0, '2008-08-04', 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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('942854057', 'W11007211', 'W11007211', 'UTIHC01', 'Logan Regional Hospital', 'Brandon', 'D', 'Greenwood', 'PT', 'Physical Therapy', NULL, NULL, NULL, 'O', '1400 N 500 E', 'Logan', 'Cache', 'UT', '84341', '4357161000', NULL, NULL, NULL, 'Cache', NULL, NULL, NULL, NULL, '', NULL, NULL, '0.00', '15.00', '0.00', 8, '2008-08-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1013023522', 0, 'N', 0, '2010-01-12', NULL, NULL, 0, 0, NULL, NULL),
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('942854057', 'W11007446', 'W11007446', 'UTIHC01', 'Logan Regional Hospital', 'Jennifer', 'A', 'Uyematsu', 'AUD', 'Audiology', '', '', NULL, 'O', '1400 N 500 E', 'Logan', 'Cache', 'UT', '84341', '4357161000', NULL, '1400 N 500 E', 'Logan', 'Cache', 'UT', '84341', '4357161000', '', '', NULL, NULL, '0.00', '15.00', '0.00', 8, '2008-08-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1871686311', 0, 'N', 0, '2012-07-23', NULL, NULL, 0, 0, NULL, NULL),
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('942854057', 'W11007439', 'W11007439', 'UTIHC01', 'Logan Regional Hospital', 'Shellie', 'D', 'Thornley', 'SLP', 'Speech Therapy', NULL, NULL, NULL, 'O', '1400 N 500 E', 'Logan', 'Cache', 'UT', '84341', '4357165010', NULL, NULL, NULL, 'Cache', NULL, NULL, NULL, NULL, '', NULL, NULL, '0.00', '15.00', '0.00', 8, '2008-08-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1326154840', 0, 'N', 0, '2010-01-12', 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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('942854057', 'W11007213', 'W11007213', 'UTIHC01', 'Sevier Valley Medical Center', 'Mark', 'William', 'Greenwood', 'MD', 'Family Practice', 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, '2008-08-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1164437067', 0, 'N', 0, '2010-01-12', NULL, NULL, 0, 0, NULL, NULL),
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('942854057', 'W11007406', 'W11007406', 'UTIHC01', 'Emergency Room', 'Daniel', 'C', 'Smith', 'MD', 'Family Practice', '', '', NULL, 'O', '1000 N Main', 'Richfield', 'Sevier', 'UT', '84701', '4358934100', '', '1000 N Main', 'Richfield', 'Sevier', 'UT', '84701', '4358934100', '', '', '', '', '0.00', '15.00', '0.00', 8, '2008-08-01', '2013-12-05', 0, 0, 0, 'Sevier Valley Hospital', '', '', '', 'HCFA|UB|', '1669672366', 0, 'N', 0, '2014-07-23', NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W11007098', 'W11007098', 'UTIHC01', 'Sevier Valley Medical Center', 'Trent', 'J', 'Bell', 'CRNA', 'Anesthesiology', '', '', NULL, 'O', '1100 N Main', 'Richfield', 'Sevier', 'UT', '84701', '4358968271', NULL, '1100 N Main', 'Richfield', 'Sevier', 'UT', '84701', '4358968271', '', '', NULL, NULL, '0.00', '15.00', '0.00', 8, '2008-08-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1669435673', 0, 'N', 0, '2013-12-19', NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W11007349', 'W11007349', 'UTIHC01', 'Sevier Valley Medical Center', 'Devon', 'D', 'Peterson', '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, '2008-08-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1245278035', 0, 'N', 0, '2010-01-12', NULL, NULL, 0, 0, NULL, NULL),
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('942854057', 'W11007388', 'W11007388', 'UTIHC01', 'Sevier Valley Medical Center', 'Spencer', 'Lee', 'Scoville', 'DO', 'Family Practice', '', '', NULL, 'O', '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, '2008-08-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1821192436', 0, 'N', 0, '2012-05-04', NULL, NULL, 0, 0, NULL, NULL),
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('870560763', 'W11007041', 'W11007041', 'UT01', '2 Rainbow Rd Navajo Mt', 'Deirdre', '', 'Piotrowski', 'LCSW', 'Mental Health', 'Social Worker', '', NULL, 'O', 'PO Box 10100', 'Tonalla', 'Coconino', 'AZ', '86044', '9286722498', NULL, 'PO Box 10100', 'Tonalla', 'Coconino', 'AZ', '86044', '9286722498', '', 'ma', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 6, '2008-08-04', '2008-08-04', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1609879998', 0, 'N', 0, '2014-05-12', NULL, NULL, 0, 0, NULL, NULL),
('870560763', 'W11007042', 'W11007042', 'UT01', '2 Rainbow Rd Navajo Mt', 'Earl', 'K', 'Plunkett', 'MD', 'Family Practice', '', '', NULL, 'O', 'PO Box 10100', 'Tonalla', 'Coconino', 'AZ', '86044', '9286722498', NULL, 'PO Box 10100', 'Tonalla', 'Coconino', 'AZ', '86044', '9286722498', '', 'WISESTD', 'WUSTDHCPC5', NULL, '0.00', '35.00', '0.00', 6, '2008-08-04', '2008-08-04', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1225031792', 0, 'N', 0, '2012-01-19', NULL, NULL, 0, 0, NULL, NULL),
('870560763', 'W11007040', 'W11007040', 'UT01', 'Navajo Mountain Community Health Center', 'Terry', 'R', 'Cook', 'DPM', 'Podiatry', '', '', NULL, 'O', '#2 Rainbow Rd', 'Tonalea', 'Coconino', 'AZ', '86044', '9286722498', NULL, '#2 Rainbow Rd', 'Tonalea', 'Coconino', 'AZ', '86044', '9286722498', '', 'WISESTD', 'WUSTDHCPC5', NULL, '0.00', '35.00', '0.00', 6, '2008-08-04', NULL, 0, 0, 0, 'Southwest Memorial Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1285636449', 0, 'N', 0, '2014-03-03', NULL, NULL, 35.9397, -110.866, NULL, NULL),
('942854057', 'W11008101', 'W11008101', 'UTPEHP', 'IHC Home Care Cassia', '', '', 'IHC Home Care Cassia', 'GROUP', 'Home Health Agency', '', '', NULL, 'O', '1501 Hiland', 'Burley', 'Cassia', 'ID', '83318', '2086788844', NULL, NULL, NULL, 'Cassia', NULL, NULL, '2086788844', '', 'HH5', NULL, NULL, '0.00', '10.00', '0.00', 8, '2008-07-01', '2008-12-31', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '0000006833', 0, 'N', 0, '2010-05-26', NULL, NULL, 0, 0, NULL, NULL),
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('134268836', 'W11008112', 'W11008112', 'UTMH1', NULL, 'Deborah', 'A', 'Christensen', 'PHD', 'Mental Health', 'Psychology', '', NULL, 'B', 'PO Box 1705', 'Draper', 'Salt Lake', 'UT', '84020', '8018161801', NULL, 'PO Box 1705', 'Draper', 'Salt Lake', 'UT', '84020', '8018161801', '', 'PHD', NULL, '', '0.00', '35.00', '0.00', 3, '2008-08-08', '2013-02-14', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1033217229', 0, 'y', 0, '2014-05-13', NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W11008107', 'W11008107', 'UTPEHP', 'IHC Home Care of Heber ', '', '', 'IHC Home Care of Heber ', 'GROUP', 'Home Health Agency', NULL, NULL, NULL, 'O', '175 N Main Ste 101', 'Heber City', 'Wasatch', 'UT', '84032', '4356574323', NULL, NULL, NULL, 'Wasatch', NULL, NULL, '4356574323', '', 'HH5', NULL, NULL, '0.00', '10.00', '0.00', 8, '2008-07-01', '2008-12-31', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '0000006835', 0, 'N', 0, '2010-05-26', NULL, NULL, 0, 0, NULL, NULL),
('870218917', 'W11008115', 'W11008115', 'UT01', 'Tanner Memorial Clinic', 'Benjamin', 'R', 'Humphreys', 'DO', 'Physical Medicine and Rehabilitation', 'Pain Medicine', '', NULL, 'O', '380 N 400 W', 'Kaysville', 'Davis', 'UT', '84037', '8017734840', '8017749219', '380 N 400 W', 'Kaysville', 'Davis', 'UT', '84037', '8017734840', '8017749219', 'WUTANNER5', 'WUSTDHCPC5', NULL, '0.00', '35.00', '0.00', 3, '2008-08-08', NULL, 0, 0, 0, 'Davis Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1891728036', 0, 'N', 0, '2011-07-26', NULL, NULL, 41.0412, -111.946, NULL, NULL),
('870218917', 'W11008114', 'W11008114', 'UT01', 'Tanner Memorial Clinic', 'Benjamin', 'R', 'Humphreys', 'DO', 'Physical Medicine and Rehabilitation', 'Pain Medicine', '', NULL, 'O', '2121 Robins Dr', 'Layton', 'Davis', 'UT', '84041', '8017734840', '8017749219', '2121 Robins Dr', 'Layton', 'Davis', 'UT', '84041', '8017734840', '8017749219', 'WUTANNER5', 'WUSTDHCPC5', NULL, '0.00', '35.00', '0.00', 3, '2008-08-08', NULL, 0, 0, 0, 'Davis Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1891728036', 0, 'N', 0, '2011-07-26', NULL, NULL, 41.0893, -111.997, NULL, NULL),
('870218917', 'W11008117', 'W11008117', 'UT01', 'Tanner Memorial Clinic', 'Benjamin', 'R', 'Humphreys', 'DO', 'Physical Medicine and Rehabilitation', 'Pain Medicine', '', NULL, 'B', 'PO Box 337', 'Layton', 'Davis', 'UT', '84041', '8017734840', '8017749219', 'PO Box 337', 'Layton', 'Davis', 'UT', '84041', '8017734840', '8017749219', 'WUTANNER5', 'WUSTDHCPC5', NULL, '0.00', '35.00', '0.00', 3, '2008-08-08', NULL, 0, 0, 0, 'Davis Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1891728036', 0, 'y', 0, '2011-07-26', NULL, NULL, 0, 0, NULL, NULL);
