Provider Name | License Number | NPI Number | Provider Type | Exclusion Effective Date | SSN/FEIN |
ABASSI ANSIR | | | Manager | 03/20/2025 | Verify |
BONSU VANESSA | 00309436 | 1407111529 | Licensed Practical Nurse | 02/25/2025 | Verify |
BOW DENNIS | | | Driver | 02/26/2025 | Verify |
BROADWAY RX ENTERPRISES INC | 00035269 | 1376074005 | Pharmacy | 03/13/2025 | Verify |
CALDIT GLENN PATRICK | 00746716 | | Registered Nurse | 02/25/2025 | Verify |
CASTRO DIANA | 00005687 | 1518993476 | Podiatrist | 03/13/2025 | Verify |
CENCHITZ JENNIFER | 00261086 | | Licensed Practical Nurse | 03/20/2025 | Verify |
CHACKO JISHA CHERIAN | 00539152 | 1073804944 | Registered Nurse | 02/20/2025 | Verify |
CHO WOOJIN | 00270239 | 1275859563 | Physician | 03/09/2025 | Verify |
COLLIER DEBORAH ANN | 00563594 | | Registered Nurse | 03/09/2025 | Verify |
CONTRERAS-MERCED YASNARY | 00028645 | 1598349862 | Massage Therapist | 02/25/2025 | Verify |
CURRAN SARA JANE | 00055786 | 1679857403 | Pharmacist | 03/09/2025 | Verify |
DOYLE TIMOTHY C. | | | Operations Manager | 03/20/2025 | Verify |
EGGLESTON SHAMIKA | | | Case Manager | 02/26/2025 | Verify |
EMPIRE CARE AGENCY LLC | | 1427710953 | Home Care Agency | 03/19/2025 | Verify |
ENU CHRISTOPHER CHUKWUEMEKA | 00109092 | 1679570824 | Physician | 03/09/2025 | Verify |
FAMILY SOCIAL ADULT DAY CARE INC. | | | Adult Day Care | 03/20/2025 | Verify |
FISHBERGER KENNETH I | 00129974 | 1649291451 | Physician | 03/13/2025 | Verify |
FOFFOU GUIDE MBOU AKA/DBA FOFFOU GUIDE MBOU | 00791680 | | Registered Nurse | 02/20/2025 | Verify |
FOLLETTE JAMES W | 00144544 | 1780655704 | Physician | 02/26/2025 | Verify |
GALLO TANYA | | | Counselor | 02/26/2025 | Verify |
GJENASHAJ LORI | 00564167 | 1568883643 | Registered Nurse | 02/25/2025 | Verify |
GRENNAN KIMBERLY DIANE | 00462749 | 1619308012 | Registered Nurse | 03/13/2025 | Verify |
HAMDI OMNEAH | | | Non Medical | 03/20/2025 | Verify |
HASHMI AMRAN | | | Manager | 03/20/2025 | Verify |
HASSAN MOHAMED ALAA | 00060474 | 1245613587 | Pharmacist | 03/09/2025 | Verify |
HOLMAN VARENE SEMONE | 00288570 | | Licensed Practical Nurse | 03/20/2025 | Verify |
Harrison Missibi Ngeah | 00337451 | | Licensed Practical Nurse | 02/20/2025 | Verify |
IBRAHIM JAMIL MD | 00226342 | 1245222587 | Physician | 03/20/2025 | Verify |
ISLAMOV DILSHOD | | | Owner | 03/20/2025 | Verify |
JABBOUR ANNA | 00046225 | 1174910806 | Pharmacist | 02/25/2025 | Verify |
KASTRINOS MICHAEL JOSEPH | 00684800 | | Registered Nurse | 03/20/2025 | Verify |
KESSLER JENNIFER L | 00501972 | | Registered Nurse | 02/25/2025 | Verify |
KHAN AIMAL | 00268030 | 1346456654 | Physician | 02/26/2025 | Verify |
KLIM DEIDRE | 00700842 | | Registered Professional Nurse | 03/20/2025 | Verify |
KWAIZER STEPHANIE | | | Counselor | 02/26/2025 | Verify |
LAI YU JEN | 00211328 | 1083787071 | Physician | 03/20/2025 | Verify |
LAUDAN SEAN | 00325200 | 1033659248 | Licensed Practical Nurse | 02/25/2025 | Verify |
LAVENTURE ROBERT KENDALL | 00523659 | | Registered Nurse | 03/09/2025 | Verify |
MASON PATRICK | | | Direct Support Professional | 02/26/2025 | Verify |
MATTICE CHRISTEL BLUE | 00323858 | | Licensed Practical Nurse | 02/26/2025 | Verify |
MCFARLANE KERI AKA/DBA KERI BENTLEY | 00305230 | 1588688998 | Physician | 02/26/2025 | Verify |
MILLER NATOSHA N | 00292913 | 1649564238 | Licensed Practical Nurse | 02/25/2025 | Verify |
NEWCOMBE SCOTT | | | Billing Consultant | 03/13/2025 | Verify |
PETTWAY LASHEA | | | Employee | 03/20/2025 | Verify |
PFOHL JEAN | 00489883 | | Registered Nurse | 02/25/2025 | Verify |
PICARD PAULIE | | | School Safety Team Staff | 02/26/2025 | Verify |
PORCH JOHNNY | | | Maintenance Worker | 02/26/2025 | Verify |
RAKHRA SHAVETA | 00334987 | | Licensed Practical Nurse | 03/20/2025 | Verify |
REYNOLDS CHEREECE | 00285266 | | Licensed Practical Nurse | 03/20/2025 | Verify |
RIZZO TANIA M | | | Pharmacy President | 03/13/2025 | Verify |
ROSE KENISHA HEIKA | 00800046 | | Registered Professional Nurse | 03/20/2025 | Verify |
SJ HEALTHCARE MANAGEMENT SERVICES, LLC | | | Billing Company | 03/13/2025 | Verify |
SJT DRUG CORP AKA/DBA CORONA CHEMISTS PHARMACY | 00038586 | 1417540840 | Pharmacy | 03/13/2025 | Verify |
SMITH HEATHER MISTINA | | | Supervising Driver | 03/20/2025 | Verify |
SPINNER JESSICA LYNN | 00315192 | | Licensed Practical Nurse | 03/13/2025 | Verify |
TUPER PARKER | | | Direct Support Professional | 03/13/2025 | Verify |
VERTEX MOBILE DIAGNOSTICS INC | WAIVER68 | 1316416126 | Chiropractor Services | 03/20/2025 | Verify |
WHITE ELLA RAE | | | Direct Support Professional | 03/09/2025 | Verify |
WILLIAMS STEFANIE L | 00646317 | | Registered Nurse | 03/09/2025 | Verify |
YOUNG ROBERT | 00026694 | | Massage Therapist | 03/09/2025 | Verify |