LASTNAME,FIRSTNAME,MIDNAME,BUSNAME,GENERAL,SPECIALTY,UPIN,NPI,DOB,ADDRESS,CITY,STATE,ZIP,EXCLTYPE,EXCLDATE,REINDATE,WAIVERDATE,WVRSTATE
"ABBASI","MAAZ","AHMED","","PHYSICIAN (MD, DO)","INTERNAL MEDICINE","","1679754725","19780801","7107 SENTINEL FLS","MISSOURI CITY","TX","77459","1128b7","20200422","20240812","00000000",""
"AUSTIN","TOMEKA","","","MENTAL HEALTH FAC","EMPLOYEE","","0000000000","19750108","30 MONTROSE AVE, APT 18T","BROOKLYN","NY","11206","1128b1","20080520","20240812","00000000",""
"BALLOU","HEATHER","","","EMPLOYEE - PRIVATE S","PERSONAL CARE PROVID","","0000000000","19851112","83 ARNOLD STREET, 2ND FLR","LINCOLN","RI","02865","1128a1","20150618","20240826","00000000",""
"BARNETT","KEVIN","J","","IND- LIC HC SERV PRO","HEALTH CARE AIDE","","0000000000","19740402","729 NOBLE AVE","AKRON","OH","44320","1128a1","20190620","20240815","00000000",""
"BROWN","AUTUMN","","","EMPLOYEE - PRIVATE S","HOME HEALTH AGENCY","","0000000000","19770623","341 BRYANT DRIVE","PITTSBURGH","PA","15235","1128a1","20190820","20240820","00000000",""
"BURGESS","RAYMOND","ODELL JR","","INTER CARE FACILITY","NURSE/NURSES AIDE","","0000000000","19620714","1201 NORTH ALVERNON WAY","TUCSON","AZ","85712","1128a2","20010920","20240819","00000000",""
"COLLINS","LAURA","LOUISE","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","0000000000","19660216","14461 CRAIG ST","BENNINGTON","NE","68007","1128a3","20190320","20240822","00000000",""
"CROFT","REBECCA","","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","0000000000","19740905","411 SHIRLEY ST, APT 1","WINTHROP","MA","02152","1128b4","20180920","20240827","00000000",""
"DE GUZMAN","JERILYN","","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","0000000000","19770217","7135 WEST CAROL COURT","NILES","IL","60714","1128a1","20180719","20240801","00000000",""
"DWIGHT","JONATHAN","BENTON JR","","PHARMACY","PHARMACIST","","1952561250","19531127","1712 PEDREGOSO PL SE","ALBUQUERQUE","NM","87123","1128b14","20180419","20240822","00000000",""
"ESTRADA","DAVID","B","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","0000000000","19860119","452 ANDOVER DR","VALPARAISO","IN","46385","1128a3","20181120","20240812","00000000",""
"FERRIS","JEFFREY","D","","OPTOMETRIC PRACTICE","OPTOMETRY","","1568752822","19580121","1510 EMPIRE RANCH RD","CARSON CITY","NV","89701","1128b14","20000220","20240812","00000000",""
"FORMICOLA","JENNIFER","LEIGH","","IND- LIC HC SERV PRO","SOCIAL WORKER","","1174163026","19910321","10695 CLERMONT ST","THORNTON","CO","80233","1128b4","20220220","20240812","00000000",""
"GREEN","HEATHER","LAYNE","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","0000000000","19860426","300 SOUTH LINCOLN ST","CRESTON","IA","50801","1128a3","20170720","20240812","00000000",""
"GREEN","HEATHER","LAYNE","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","0000000000","19860426","300 SOUTH LINCOLN ST","CRESTON","IA","50801","1128b1","20170119","20240812","00000000",""
"GRUEN","JOSEPH","BENJAMIN","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","0000000000","19770112","11915 NW 12TH ST","PEMBROKE PINES","FL","33026","1128b4","20210819","20240822","00000000",""
"HUBBELL","KYLA","L","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","0000000000","19731015","16 TIBBETTS RD","FREMONT","NH","03044","1128b4","20121220","20240812","00000000",""
"HUEY","MEREDITH","LAUREN","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","0000000000","19830216","1119 TOWNHOUSE RD","PELHAM","AL","30508","1128b4","20141020","20240815","00000000",""
"HUFFMAN","RHONDA","KAE","","INDIVIDUAL (UNAFFILI","PERSONAL CARE PROVID","","0000000000","19660909","709 S MAIN ST","SIGOURNEY","IA","52591","1128a1","20190820","20240822","00000000",""
"HUNTER","TANISHA","EVON","","NURSING PROFESSION","NURSE/NURSES AIDE","","0000000000","19870302","12441 W 97TH TERRACE, APT 101","LENEXA","KS","66215","1128a3","20090319","20240812","00000000",""
"JACKSON","LATOYA","M","","IND- LIC HC SERV PRO","HEALTH CARE AIDE","","0000000000","19830108","9402 DORAL CT, APT #10","LOUISVILLE","KY","40220","1128a1","20140320","20240812","00000000",""
"JAMES","TAMMIE","LYNN","","NURSING PROFESSION","NURSE/NURSES AIDE","","0000000000","19650403","1719 VAUXHALL DR","LITHONIA","GA","30058","1128b4","20030120","20240819","00000000",""
"JIMENO","ANGELICA","","","IND- LIC HC SERV PRO","LICENSED PRACTITIONE","","0000000000","19831127","800 UNIVERSITY AVE","BURBANK","CA","91504","1128a2","20160818","20240812","00000000",""
"JONES","CHRISTY","LEE","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","0000000000","19810127","918 MCDONALD RD","MURPHY","NC","28906","1128b4","20210819","20240819","00000000",""
"KATRYUK","OLESYA","","","HOME HEALTH AGENCY","HEALTH CARE AIDE","","0000000000","19720609","206 HALES AVE","STATEN ISLAND","NY","10312","1128a1","20100318","20240812","00000000",""
"KUSHNER","WILLIAM","III","","DENTAL PRACTICE","DENTIST","","1679762793","19680815","158 BLACKSTONE DR","DANVILLE","CA","94506","1128b14","20070320","20240812","00000000",""
"MAAF","IHSANULLAH","","","IND- LIC HC SERV PRO","PHARMACIST","","0000000000","19780329","9869 COWDEN ST","PHILADELPHIA","PA","19115","1128a4","20140820","20240820","00000000",""
"MCCLINTON","LLOYD","ELLIOT","","SKILLED NURSING FAC","NURSE/NURSES AIDE","","0000000000","19720331","5481 NW 32ND AVE","MIAMI","FL","33142","1128a2","19970807","20240819","00000000",""
"MEDINA","SHARON","N","","IND- LIC HC SERV PRO","COUNSELOR","","1801069497","19591223","26 PEDDLER HILL RD, APT #2606","MONROE","NY","10950","1128a1","20180520","20240812","00000000",""
"MEYERS","MATTHEW","","","IND- LIC HC SERV PRO","NURSE PRACTITIONER (","","0000000000","19750804","109 DEER POINTE DR","LOBELVILLE","TN","37097","1128a1","20181220","20240820","00000000",""
"OJEDA","OSCAR","","","IND- LIC HC SERV PRO","THERAPIST","","1780935510","19820226","8133 NW 108TH PL","MIAMI","FL","33178","1128a2","20240820","20240820","00000000",""
"ORTENZIO","LOUIS","FRANCIS JR","","MEDICAL PRACTICE, MD","FAMILY PRACTICE","A72151","1790741411","19530415","204 EUCLID AVE","CLARKSBURG","WV","26301","1128a1","20060820","20240819","00000000",""
"PACHAN","MARY","JANE MAE","","IND- LIC HC SERV PRO","HEALTH CARE AIDE","","0000000000","19600117","208 EAST 4TH ST, #305","HASTINGS","MN","55033","1128a1","20180920","20240812","00000000",""
"PATEL","KRINA","","","IND- LIC HC SERV PRO","PHARMACIST","","1962507350","19770522","317 HENMORE BROOK DR","CARY","NC","27519","1128a4","20140725","20240812","00000000",""
"PAUL","WELCH","PRINCE","","IND- LIC HC SERV PRO","COUNSELOR","","1417252784","19820415","59 WATSON ST","CHICOPEE","MA","01020","1128a1","20140820","20240819","00000000",""
"PEARSON","ANDROMEDA","T","","DENTAL PRACTICE","DENTIST","","1225154438","19630327","1569 HARDING RD","NORTHFIELD","IL","60093","1128b14","19980820","20240812","00000000",""
"PERALTA","ELIZABETH","J","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","1013347384","19850527","105 ORCHARD DR","CHICKASHA","OK","73018","1128b4","20160120","20240812","00000000",""
"PETER","THERESA","","","DME COMPANY","OWNER/OPERATOR","","0000000000","19631219","15507 MIRA MONTE DR","HOUSTON","TX","77083","1128a1","20090720","20240812","00000000",""
"PETERSON","DONALD","R","","BUS OWNER/EXEC","INFUSION THERAPY CLI","","0000000000","19540827","20227 GRANDVIEW ST","BUCYRUS","KS","66013","1128b7","20190731","20240812","00000000",""
"PETTUS-SMITH","STARR","NEVAUGHN","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","0000000000","19851224","3117 PETRE RD","CHESAPEAKE","VA","23325","1128a1","20140820","20240812","00000000",""
"PRIDDY","JENNIFER","","","DENTAL PRACTICE","BUSINESS MANAGER","","0000000000","19800317","153 LINCOLN RD","FAYETTEVILLE","TN","37334","1128a3","20110620","20240812","00000000",""
"PUTHOFF","SCOTT","DONALD","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","1285073163","19870910","1002 MAGNOLIA ST","SAINT MARYS","OH","45885","1128b4","20190620","20240801","00000000",""
"RILEY","DOUGLAS","MICHAEL","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","0000000000","19701018","9523 NE 100TH ST","KANSAS CITY","MO","64157","1128b4","20170720","20240822","00000000",""
"RUDNET","RYAN","","","EMPLOYEE - PRIVATE S","HOME HEALTH AGENCY","","0000000000","19740105","14 FAIRVIEW LANE","OYSTER BAY","NY","11771","1128a3","20190820","20240820","00000000",""
"SAA","MARIA","DEL PILAR","","IND- LIC HC SERV PRO","THERAPIST","","1225036411","19740627","12568 SHORELINE DR, #401","WELLINGTON","FL","33414","1128b4","20221120","20240812","00000000",""
"SMITH","ERICA","MARIE","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","0000000000","19880528","646 SOUTH WESTWOOD AVENUE","TOLEDO","OH","43609","1128a3","20190820","20240822","00000000",""
"SPECE","SUE","ANN","","EMPLOYEE - PRIVATE S","PERSONAL CARE PROVID","","0000000000","19580329","2587 QUASQUETON DIAGONAL BLVD","INDEPENDENCE","IA","50644","1128a1","20160519","20240812","00000000",""
"STUDAWAY","LASHAUNDA","","","EMPLOYEE - PRIVATE S","HOME HEALTH AGENCY","","0000000000","19841212","6971 APPLETON OAK CIR","KEITHVILLE","LA","71047","1128a1","20130120","20240812","00000000",""
"TOLIVER","SANDRA","ANN","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","0000000000","19730225","1559 BOXWOOD FARM ROAD","AMHERST","VA","24521","1128a1","20161020","20161020","00000000",""
"UMAR","ODA","YUSUF","","BUS OWNER/EXEC","INTERPRETER/TRANS","","0000000000","19780909","3624 133RD LANE NE","ANDOVER","MN","55304","1128a1","20170220","20240812","00000000",""
"VANDAL","LISA","MARIE","","NURSING PROFESSION","NURSE/NURSES AIDE","","0000000000","19790506","1230 EAST THOMPSON RD","INDIANAPOLIS","IN","46227","1128b4","20100218","20240812","00000000",""
"WADHWA","VIC","","","BUS OWNER/EXEC","CLINIC","","0000000000","19761209","1212 ARDMORE CT, APT B1","FREDERICK","MD","21703","1128a1","20190220","20240819","00000000",""
"WALKER","TIARRA","N","","INDIVIDUAL (UNAFFILI","PERSONAL CARE PROVID","","0000000000","19930408","7862 SAINT BRIDGET LANE","DUNDALK","MD","21222","1128a1","20190820","20240820","00000000",""
"WIELAND","TARA","MARIE","","NURSING PROFESSION","NURSE/NURSES AIDE","","0000000000","19790505","1318 34TH AVE S #202","MOORHEAD","MN","56560","1128b4","20100420","20240812","00000000",""