LASTNAME,FIRSTNAME,MIDNAME,BUSNAME,GENERAL,SPECIALTY,UPIN,NPI,DOB,ADDRESS,CITY,STATE,ZIP,EXCLTYPE,EXCLDATE,REINDATE,WAIVERDATE,WVRSTATE
"ADEM","ANTOINE","","","PHYSICIAN (MD, DO)","CARDIOLOGY","","1114964442","19700819","413 WYTHE HOUSE CT","SAINT LOUIS","MO","63141","1128a1","20200618","20250626","00000000",""
"ANDERSON","LAURA","MAY","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","0000000000","19821220","1399 EAST POLLINO ST","SAN TAN VALLEY","AZ","85140","1128a3","20130220","20250609","00000000",""
"BELL","ASHLEY","ALON","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","0000000000","19850721","1000 WEST SPRING VALLEY RD, AP","RICHARDSON","TX","75080","1128b4","20130820","20250609","00000000",""
"BODZIAK","VICTORIA","LYNE","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","0000000000","19660925","318 NE 20TH COURT","CAPE CORAL","FL","33909","1128b4","20220320","20250626","00000000",""
"BURCHETTE","KATHRYN","ANN","","IND- LIC HC SERV PRO","PHARMACY TECHNICIAN","","0000000000","19900111","1144 GOLFVIEW WOODS DR","RUSKIN","FL","33573","1128b4","20171120","20250609","00000000",""
"CHERNOVETS","ALEXANDER","","","INDIVIDUAL (UNAFFILI","NO KNOWN AFFILIATION","","0000000000","19641011","4725 BEDFORD AVE, FLR 2","BROOKLYN","NY","11235","1128a1","20101020","20250609","00000000",""
"CHURCH","JEANE","LYNN","","HOSPITAL","TECHNICIAN","","0000000000","19600403","P O BOX 54","GOLDEN","IL","62339","1128b4","20060920","20250617","00000000",""
"CLEMONS","CHRISTEL","S","","AMBULANCE COMPANY","EMERGENCY MED TECH","","0000000000","19710317","311 HANNAH LN","HIXSON","TN","37343","1128b4","20050920","20250624","00000000",""
"COUSTETTE","NICOLETTE","JAMAI","","NURSING PROFESSION","NURSE/NURSES AIDE","","0000000000","19811229","896 MAHOGANY DR. UNIT 202","MINDEN","NV","89423","1128b4","20080520","20250611","00000000",""
"COUTURE","LINDA","HOPE","","IND- LIC HC SERV PRO","THERAPIST","","0000000000","19610706","279 PISGAH DR, UNIT A","CANTON","NC","28716","1128b4","20120419","20250611","00000000",""
"DAMIAN","VICTORIA","MARIE","","BUS OWNER/EXEC","ASSISTED LIVING FACI","","0000000000","19700811","10352 W COUNTRY CLUB TRAIL","PEORIA","AZ","85383","1128a3","20180920","20250616","00000000",""
"ECHOLS","ROBERT","THEODORE","","INDIVIDUAL (UNAFFILI","NO KNOWN AFFILIATION","","0000000000","19850725","2463 N LORRAINE","WICHITA","KS","67219","1128a1","20130320","20250626","00000000",""
"EDOHO-UKWA","GRACE","UDOKA","","DME COMPANY","OWNER/OPERATOR","","0000000000","19620531","3412 DENVER DRIVE","MCKINNEY","TX","75070","1128b15","20050620","20250626","00000000",""
"GIRARDI","DAVID","JAMES","","PHYSICIAN (MD, DO)","FAMILY PRACTICE","","1003000407","19771021","1140 TREASURE LAKE","DUBOIS","PA","15801","1128a3","20200618","20250623","00000000",""
"GONZALEZ","JUAN","CARLOS","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","0000000000","19830814","24456 MARILYN ST","MORENO VALLEY","CA","92553","1128b4","20240820","20250611","00000000",""
"HATER","HEIDI","MICHELLE","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","0000000000","19830723","722 STEVIES TRAIL","INDEPENDENCE","KY","41051","1128a3","20200618","20250623","00000000",""
"HOGAN","ROBERT","TIMOTHY II","","PHYSICIAN (MD, DO)","INTERNAL MEDICINE","","1073808945","19820120","81 GILMORE ST","UNIONTOWN","PA","15401","1128a4","20150618","20250623","00000000",""
"HOLMAN","SANTANNA","DANAE","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","0000000000","19840827","315 HOLLAND ST","LAKE CHARLES","LA","70605","1128b4","20210819","20250609","00000000",""
"ILUNGA","CAROLYN","L","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","0000000000","19631005","2131 CLARKE ST","MURPHYSBORO","IL","62966","1128a2","20130520","20250609","00000000",""
"KIRVEN","ASHLEY","L","","EMPLOYEE - PRIVATE S","COUNSELING CENTER","","0000000000","19901226","206 TREYBURN CIRCLE","IRMO","SC","29169","1128a1","20130820","20250623","00000000",""
"LANGSTON","LADESTINI","XAIESHA","","EMPLOYEE - PRIVATE S","HOSPITAL","","0000000000","19950915","183 MONTE CARLO DRIVE","BRANDON","MS","39042","1128a2","20170820","20250626","00000000",""
"LAWSON","KATRINA","","","INDIVIDUAL (UNAFFILI","NO KNOWN AFFILIATION","","1811268014","19740101","5529 TIMBERCREEK DR","JONESBORO","AR","72404","1128a1","20160120","20250618","00000000",""
"LEARY","THOMAS","EDISON JR","","IND- LIC HC SERV PRO","NURSE PRACTITIONER (","","1679867295","19601214","2660 N HASKELL AVE, APT 1148","DALLAS","TX","75204","1128b3","20220420","20250616","00000000",""
"LINDSAY","ALEXANDRIA","NICOLE","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","0000000000","19891105","765 BIRCH WALK APT G","GOLETA","CA","93117","1128b4","20140820","20250609","00000000",""
"LOCKLEAR","ROBERT","W","","PHYSICIAN (MD, DO)","GENERAL PRACTICE","","1114972262","19710317","355 DOMINIQUE LANE","GREENEVILLE","TN","37743","1128b4","20140720","20250623","00000000",""
"LOCKLEAR","ROBERT","W","","PHYSICIAN (MD, DO)","GENERAL PRACTICE","","1114972262","19710317","355 DOMINIQUE LANE","GREENEVILLE","TN","37743","1128a1","20150618","20250623","00000000",""
"LOFTON","ERIKA","LASHAWN","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","1306239025","19860206","411 COTTAGE ST","ROCHESTER","NY","14611","1128a2","20200618","20250623","00000000",""
"LUONG","ANTHONY","","","IND- LIC HC SERV PRO","CHIROPRACTIC","","0000000000","19790706","8 BONANZA CT","POMONA","CA","91766","1128a2","20120520","20250618","00000000",""
"MAYS","JAMIE","","","EMPLOYEE - PRIVATE S","CLINIC","","0000000000","19941222","1100 MARNE BLVD","HINESVILLE","GA","31313","1128a3","20190718","20250626","00000000",""
"MYRAN","DAKOTA","","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","0000000000","19800116","814 NORTH 16TH ST","BISMARCK","ND","58501","1128b4","20160218","20250609","00000000",""
"OKORO","LATRICIA","RENA","","EMPLOYEE - PRIVATE S","MENTAL/BEHAVIORAL HE","","0000000000","19860517","1007 WASHINGTON ST","WEST MONROE","LA","71292","1128a2","20161120","20250624","00000000",""
"PARTAIN","BREANNA","JEAN","","EMPLOYEE - PRIVATE S","REHAB FACILITY - GEN","","0000000000","19880620","1440 EAST ANDY DEVINE, #138","KINGMAN","AZ","86401","1128a3","20200520","20250626","00000000",""
"PEREZ-ARYAN","ELIA","","","DME COMPANY","OWNER/OPERATOR","","0000000000","19510207","6401 CASABELLA LANE","BOCA RATON","FL","33433","1128a1","20010917","20250616","00000000",""
"PERRY","SIHLE","BRIGHTNESS","","IND- LIC HC SERV PRO","NURSE PRACTITIONER (","","0000000000","19840908","128 STALLION LANE","FORNEY","TX","75126","1128b4","20250420","20250609","00000000",""
"QIN","FENG","","","PHYSICIAN (MD, DO)","GENERAL PRACTICE","","1346324829","19640425","41 HENGSHAN RD, APT T1-19C","SHANGHAI","XX","00000","1128b7","20210225","20250611","00000000",""
"RAMEY","TALLI","MARIE","","EMPLOYEE - PRIVATE S","PERSONAL CARE PROVID","","0000000000","19861031","108 N SUNSHINE LANE","ORIENT","IA","50858","1128a1","20150720","20250616","00000000",""
"REINHERZ","DANIEL","J","","PHARMACY","PHARMACIST","","0000000000","19770201","34 SANDRINGHAM ROAD","BALA CYNWYD","PA","19004","1128a3","20090420","20250612","00000000",""
"ROGERS","KATHRYN","ELIZABETH","","NURSING PROFESSION","NURSE/NURSES AIDE","","0000000000","19700827","1911 BOSQUE LN","ARLINGTON","TX","76006","1128b4","20081020","20250617","00000000",""
"SHAFFER","WES","L","","IND- LIC HC SERV PRO","TECHNICIAN","","0000000000","19690728","818 N 575 EAST","OGDEN","UT","84404","1128b4","20150120","20250609","00000000",""
"ST CLAIR","KRISTEN","M","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","0000000000","19821114","4316 COFFEE MILL RD","PROSPER","TX","75078","1128b4","20160218","20250626","00000000",""
"THOMASON","ROBERT","HAYES","","INDIVIDUAL (UNAFFILI","PERSONAL CARE PROVID","","0000000000","19501105","P O BOX 875136","WASILLA","AK","99687","1128a1","20200618","20250626","00000000",""
"WIJEKOON","CHRISTOPHER","DEEPTHA","","PHYSICIAN (MD, DO)","ANESTHESIOLOGY","","1689094823","19870109","4348 VENTURA CANYON AVE, APT 8","SHERMAN OAKS","CA","91423","1128b4","20230518","20250626","00000000",""
"WILLIAMS","SHANNON","B","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","0000000000","19691101","2677 MCFARLAND RD","RAYMOND","MS","39154","1128b4","20141120","20250618","00000000",""
"WILLIAMS","SHANNON","RENE","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","0000000000","19691101","2677 MCFARLAND RD","RAYMOND","MS","39154","1128a3","20150520","20250618","00000000",""
"ZHIDKOVA","INNA","ALEKLSANDROVNA","","BUS OWNER/EXEC","COMMUNITY HLTH CTR (","","1023269974","19671213","17547 WILLARD ST","NORTHRIDGE","CA","91325","1128a1","20180220","20250611","00000000",""