LASTNAME,FIRSTNAME,MIDNAME,BUSNAME,GENERAL,SPECIALTY,UPIN,NPI,DOB,ADDRESS,CITY,STATE,ZIP,EXCLTYPE,EXCLDATE,REINDATE,WAIVERDATE,WVRSTATE
"ABRAMS","JENNIFER","JEAN","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","0000000000","19740628","617 OSBURN DR","DOUGLAS","WY","82633","1128b4","20220620","20250903","00000000",""
"AGNEW","MICHAEL","JOSEPH","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","0000000000","19871019","110 NORTH LAKE AVE","MILES CITY","MT","59301","1128a3","20200720","20250924","00000000",""
"AMIN","MINESH","PIYUSH","","PHYSICIAN (MD, DO)","INTERNAL MEDICINE","","1912153602","19800301","688 CHILDREN'S WAY","HENDERSON","NV","89052","1128a1","20200820","20250903","00000000",""
"AYARKWA","AKOSUA","","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","0000000000","19890521","6832 SHARON COURT","COLUMBUS","OH","43229","1128a2","20200820","20250916","00000000",""
"BAEZ","EDUARDO","","","PSYCHOLOGIC PRACTICE","PSYCHOLOGY","R54371","1235888272","19521119","1013 BO ASOMANTE","AGUADA","PR","00602","1128a1","20000420","20250903","00000000",""
"BAGDASAROVA","ANGELICA","","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","0000000000","19640717","11981 AUDBON AVENUE","PHILADELPHIA","PA","19116","1128a1","20150820","20250903","00000000",""
"BAKARE","OLWATOYIN","","","EMPLOYEE - PRIVATE S","PERSONAL CARE PROVID","","1053661884","19880426","6941 RED CLAY FORGE, 310","ELKRIDGE","MD","21075","1128a1","20150420","20250922","00000000",""
"BAMAN","AJAY","","","DENTAL PRACTICE","DENTIST","","1518077510","19551003","20 SHORN DR","BLAUVELT","NY","10913","1128a1","20080820","20250903","00000000",""
"BEAUPLAN","JEAN","MARC","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","0000000000","19680104","1608 AFTON ST","PHILADELPHIA","PA","19111","1128b4","20250520","20250922","00000000",""
"BELL","CHRISTINE","ANN","","NURSING PROFESSION","NURSE/NURSES AIDE","","0000000000","19670423","2008 3RD AVE NORTH, UNIT 3B","BIRMINGHAM","AL","35203","1128b4","20090618","20250924","00000000",""
"BERGER","ARNOLD","JOSEPH","","IND- LIC HC SERV PRO","DENTIST","","1598085516","19821117","3237 GLASTONBURY DR","VIRGINIA BEACH","VA","23453","1128a4","20200618","20250903","00000000",""
"BROWN","BENJAMIN","III","","INDIVIDUAL (UNAFFILI","PERSONAL CARE PROVID","","0000000000","19871229","4217 PIPPIN STREET","MONROE","LA","71203","1128a1","20200920","20250922","00000000",""
"BROWN","JENNIFER","WALDRON","","INDIVIDUAL (UNAFFILI","NO KNOWN AFFILIATION","","0000000000","19631226","2112 W LAUREL LANE","PHOENIX","AZ","85029","1128a3","20140820","20250924","00000000",""
"BROWNE","ERTER","C","","BUS OWNER/EXEC","DME - GENERAL","","0000000000","19760318","774 NEW JERSEY AVE","BROOKLYN","NY","11207","1128a1","20200820","20250903","00000000",""
"BRUMFIELD","ANTONINETTE","KAREN","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","0000000000","19940526","4611 HARRISON ST","GARY","IN","46408","1128a1","20200820","20250903","00000000",""
"CABELLO-OROZCO","YARED","JAZMINE","","NURSING PROFESSION","NURSE/NURSES AIDE","","0000000000","19800409","2844 EAST VIA BATOLOME","TUCSON","AZ","85706","1128a3","20080120","20250916","00000000",""
"CABRERA","CECILIA","I","","OPTOMETRIC PRACTICE","OPTOMETRY","","0000000000","19631209","2031 SE 18TH ST","HOMESTEAD","FL","33035","1128b14","20081120","20250916","00000000",""
"DAFFRON","DAVID","CARL","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","0000000000","19660419","309 SE 13TH ST","WASHINGTON","IN","47501","1128b4","20150820","20250903","00000000",""
"DELA GUERRA","DE WAYNE","","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","1457695736","19801028","928 N WESTERN AVE, PH 1","LOS ANGELES","CA","90029","1128b4","20201020","20250916","00000000",""
"DUCLE","RICO","","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","0000000000","19690905","649 W ROCKLAND ST","PHILADELPHIA","PA","19120","1128b4","20240820","20250916","00000000",""
"ESSIEN","UKO","EDET","","DME COMPANY","OWNER/OPERATOR","","0000000000","19600306","2821 KINGS GATE DR","CARROLLTON","TX","75006","1128a1","20070820","20250903","00000000",""
"EVERITT","JENNIFER","LYNN","","IND- LIC HC SERV PRO","PHARMACY TECHNICIAN","","0000000000","19850923","116 WEST ESTATE ST","ANDERSON","IN","46013","1128b4","20160620","20250923","00000000",""
"FAUSTINO","ALAN","H","","PHYSICIAN (MD, DO)","GENERAL PRACTICE","","1669482568","19670418","293 TURNPIKE ROAD, APT 116","WESTBOROUGH","MA","01581","1128a4","20190919","20250922","00000000",""
"FLEENER","DANAE","L","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","0000000000","19740204","3806 S VALMORE AVE","BLOOMINGTON","IN","47403","1128a3","20200820","20250903","00000000",""
"FOX","THERESA","ANN","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","1750855169","19820607","171 EAGLEHURST DR","JEROME","MI","49249","1128a2","20200820","20250916","00000000",""
"FRAZIER","JASON","LEE","","IND- LIC HC SERV PRO","COUNSELOR","","1235459611","19800612","1113 PONCA AVENUE","ENID","OK","73703","1128a1","20150618","20250916","00000000",""
"GAMMILL","JOAN","","","NURSING PROFESSION","NURSE/NURSES AIDE","","0000000000","19570506","1980 SCOTTS CROSSING WAY","ANNAPOLIS","MD","21401","1128b4","20061120","20250903","00000000",""
"GARY","KATIE","E","","ADULT HOME","HEALTH CARE AIDE","","0000000000","19830919","426 WASHBURN RD","WASHBURN","ME","04786","1128a2","20091119","20250917","00000000",""
"GIBSON","MARGARET","A","","BUS OWNER/EXEC","DME - GENERAL","","1902299001","19610818","120 ROLLINGWOOD DRIVE","NEWPORT","NC","28570","1128b7","20200120","20250903","00000000",""
"GONYEA","STAYCIE","MICHELLE","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","0000000000","19761216","3 TIFFANY STREET","ATTLEBORO","MA","02703","1128b4","20190120","20250918","00000000",""
"GORDON","TEQUILA","L","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","0000000000","19890510","3018 SW 15TH AVE","CAPE CORAL","FL","33914","1128b4","20150618","20250903","00000000",""
"GREATHOUSE","SHAWNA","MARIE","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","0000000000","19820410","5428 PECOS CT","INDIANAPOLIS","IN","46237","1128a3","20150820","20250916","00000000",""
"GUERRERO AYBAR","KIRABEL","","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","0000000000","19881021","4470 PHILADELPHIA CIRCLE","KISSIMMEE","FL","34746","1128b4","20210318","20250903","00000000",""
"GUTIERREZ","ARACELI","GARCIA","","SKILLED NURSING FAC","NURSE/NURSES AIDE","","0000000000","19730913","8538 LEE STARLING DR","EL PASO","TX","79907","1128a2","19980820","20250916","00000000",""
"GYULBUDAGYAN","ARUS","","","INDIVIDUAL (UNAFFILI","NO KNOWN AFFILIATION","","1063279438","19800115","4527 MORELLA AVE","VALLEY VILLAGE","CA","91607","1128a1","20120620","20250916","00000000",""
"HASSAN","RIHANA","BADRUM","","INDIVIDUAL (UNAFFILI","PERSONAL CARE PROVID","","0000000000","19950730","14592 BISCAYNE AVE WEST","ROSEMOUNT","MN","55068","1128b5","20190520","20250903","00000000",""
"HUTCHINSON","AYANNA","","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","0000000000","19880104","700 MANIDA STREET, APT 4H","BRONX","NY","10474","1128a4","20200618","20250903","00000000",""
"IVERSON","SCOTT","J","","IND- LIC HC SERV PRO","EMERGENCY MED TECH","","0000000000","19630227","4238 16TH AVE, APT D-214","POST FALLS","ID","83854","1128b4","20170518","20250918","00000000",""
"IZZO","JAIME","A","","HOSPITAL","NURSE/NURSES AIDE","","0000000000","19771010","55 WILLIAMSBURG DR","FAIRPORT","NY","14450","1128b4","20070118","20250916","00000000",""
"JOKINES","NEUKENYA","CELESTINE","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","0000000000","19700926","7814 RIVERWOOD OAKS DR","RIVERVIEW","FL","33578","1128b4","20250619","20250903","00000000",""
"KAUCIC","JAMIE","FRANCES","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","1033921507","19810807","2021 WOLOSYN CIRCLE, APT 6","YOUNGSTOWN","OH","44514","1128a3","20120520","20250924","00000000",""
"KLUGMAN","VANESSA","A","","PHYSICIAN (MD, DO)","ENDOCRINOLOGY","F83742","1639169972","19630917","538 ASHLAND AVENUE","RIVER FOREST","IL","60305","1128a3","20170720","20250916","00000000",""
"LANDRY","DANIELLE","MARIE","","SKILLED NURSING FAC","NURSE/NURSES AIDE","","0000000000","19790517","91 MILTON RD","WARWICK","RI","02888","1128b4","20050620","20250903","00000000",""
"LANZA","MARIAH","ASHLEY","","INDIVIDUAL (UNAFFILI","PERSONAL CARE PROVID","","0000000000","19920815","16309 PEARLDALE AVENUE","CLEVELAND","OH","44135","1128a1","20191219","20250924","00000000",""
"LEEK","KALEY","MORGAN","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","0000000000","19890125","107 SOUTH 21ST ST","PADUCAH","KY","42001","1128a4","20161220","20250916","00000000",""
"LEVESQUE","AIMEE","","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","0000000000","19790123","63 ARBORWAY","NORTH EASTON","MA","02356","1128b4","20160120","20250916","00000000",""
"MAJOR","KRISTEN","L","","NURSING PROFESSION","NURSE/NURSES AIDE","","0000000000","19850906","407 ST ALBANS RD","SWANTON","VT","05488","1128b4","20110720","20250916","00000000",""
"MCKIBBINS","SANTA","MARIA","","IND- LIC HC SERV PRO","DENTIST","","1285782045","19620824","686 LAWLER LANE","NOLENSVILLE","TN","37135","1128b4","20231019","20250923","00000000",""
"MEAD","LYNN","M","","NURSING PROFESSION","NURSE/NURSES AIDE","","0000000000","19760117","343 EAST STAHL RD","ASHLEY FALLS","MA","01222","1128b4","20110420","20250916","00000000",""
"MEANS","ARIANE","HILLESLAND","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","0000000000","19800709","31390 CORTE CAMARILLO","TEMECULA","CA","92592","1128b4","20220920","20250922","00000000",""
"MENA","ARKYN","LAZARO","","EMPLOYEE - PRIVATE S","SUBSTANCE ABUSE REHA","","1366703951","19720713","16468 SW 99TH LANE","MIAMI","FL","33196","1128a1","20200820","20250903","00000000",""
"MILLER","DIANTHA","","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","1609861590","19651027","10460 PAPAS ST","DAPHNE","AL","36526","1128a3","20150820","20250903","00000000",""
"MILLER","DINA","","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","0000000000","19730521","4241 PENROSE STREET, APT 2W","SAINT LOUIS","MO","63115","1128a3","20200120","20250903","00000000",""
"MILLER","KERRY","K","","IND- LIC HC SERV PRO","PHARMACY TECHNICIAN","","0000000000","19710321","12360 SW MARION ST","PORTLAND","OR","97223","1128b4","20140619","20250903","00000000",""
"MOLINA","SHIRLEY","G","","PHARMACY","TECHNICIAN","","1235118373","19720620","3729 188TH ST NE","ARLINGTON","WA","98223","1128a3","20100720","20250916","00000000",""
"MULDREW","FARRAH","M","","EMPLOYEE - PRIVATE S","PERSONAL CARE PROVID","","0000000000","19770130","3713 N 70TH AVENUE","OMAHA","NE","68104","1128a1","20200220","20250903","00000000",""
"NELSON","MEGAN","MARIE","","IND- LIC HC SERV PRO","HEALTH CARE AIDE","","0000000000","19891008","802 W CHURCH STREET","MARSHALLTOWN","IA","50158","1128b1","20170119","20250916","00000000",""
"NICHOLSON","MACKENZIE","SHEREE","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","0000000000","19980701","630 SOUTH 12TH ST","BURLINGTON","IA","52601","1128a2","20181018","20250922","00000000",""
"NICKENS","ROSALIND","","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","0000000000","19590721","7 ILIAD DRIVE","TINLEY PARK","IL","60477","1128a1","20171120","20250922","00000000",""
"ODIA","OSAGUMWENRO","","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","0000000000","19890819","618 MATHIS ST, APT 618B","GOODFELLOW AFB","TX","76908","1128b4","20241020","20250924","00000000",""
"OLSON","KATHRYN","ANN","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","0000000000","19600826","6628 LACY LN","ELLENTON","FL","34222","1128a2","20200820","20250916","00000000",""
"PATTERSON","KENISHA","","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","1255595161","19790529","2248 EWELL PARK DR","LAWRENCEVILLE","GA","30043","1128a1","20190620","20250918","00000000",""
"PETOYAN","MARINE","","","EMPLOYEE - PRIVATE S","CLINIC","","0000000000","19760324","7924 WOODMAN AVE, UNIT 73","PANORAMA CITY","CA","91402","1128b1","20161020","20250916","00000000",""
"PORTER","LAWANNA","ANITA","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","1144472416","19760104","20277 EMERY RD","CLEVELAND","OH","44128","1128a1","20140420","20250912","00000000",""
"RILEY","KIANTA","LATORRIA","","EMPLOYEE - PRIVATE S","ADULT DAY CARE FACIL","","0000000000","19850721","9313 MARTINIQUE DR","BATON ROUGE","LA","70812","1128a1","20200820","20250903","00000000",""
"RODRIGUEZ","MELANIE","","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","0000000000","19820511","P O BOX 4367","CHATTANOOGA","TN","37405","1128a1","20190620","20250903","00000000",""
"SAITOTI","FRANCIS","S","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","0000000000","19780423","426 WHEELER ROAD","NORTH BRUNSWICK","NJ","08902","1128b4","20250320","20250916","00000000",""
"SANDOVAL","ELISEO","JR","","REHAB FACILITY - GEN","OWNER/OPERATOR","","0000000000","19690706","5000 NORTH 1ST LANE, #170","MCALLEN","TX","78504","1128a1","20090319","20250924","00000000",""
"SANTANA","ZORAIDA","","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","0000000000","19661224","3489 CARMAN RD, APT 228","SCHENECTADY","NY","12303","1128a2","20151119","20250903","00000000",""
"SCOTT","BEATRICE","S","","INDIVIDUAL (UNAFFILI","PERSONAL CARE PROVID","","0000000000","19600408","25841 MCCARROLL ROAD","SPRINGFIELD","LA","70462","1128a1","20200920","20250922","00000000",""
"SELDEN","SHANIYA","SOMALIA","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","0000000000","19820707","3822 ALBERMARLE AVE","UPPER DARBY","PA","19082","1128b4","20250820","20250922","00000000",""
"SINKLER","ANNIE","","","BUS OWNER/EXEC","ASSISTED LIVING FACI","","0000000000","19651226","3514 FRANKFORD AVE","BALTIMORE","MD","21214","1128a1","20190620","20250916","00000000",""
"SMITH","CIERA","MALAN","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","0000000000","19950127","12008 SILMOR AVE","CLEVELAND","OH","44108","1128a1","20200920","20250922","00000000",""
"SMITH","DANITA","L","","BUS OWNER/EXEC","LAB - CLINICAL","","1821534298","19760413","11630 HELENOAK DR","FLORISSANT","MO","63033","1128b7","20220901","20250916","00000000",""
"SMITHERS","JOEL","A","","PHYSICIAN (MD, DO)","PAIN MANAGEMENT","","1659639631","19821030","2201 S STERLING STREET","MORGANTON","NC","28655","1128a4","20200720","20200720","00000000",""
"SORENSEN","MARK","","","BUS OWNER/EXEC","DME - GENERAL","","0000000000","19690327","444 W ROSLYN PLACE, APT 5A","CHICAGO","IL","60614","1128a1","20240820","20240820","00000000",""
"STREETER","JEANETTA","","","INDIVIDUAL (UNAFFILI","NO KNOWN AFFILIATION","","0000000000","19630410","1931 TIMBERECREST DRIVE","COLUMBUS","IN","47203","1128a1","20180419","20250903","00000000",""
"SYED","MUBTAGHA","SHAH","","BUS OWNER/EXEC","MARKETING FIRM","","0000000000","19670413","25 MATTBEN DR","WARREN","NJ","07059","1128a1","20190220","20250903","00000000",""
"THOMPSON","GREGORY","LEE-DEXTER","","INDIVIDUAL (UNAFFILI","PERSONAL CARE PROVID","","0000000000","19571209","93 SEWARD ST, APT 708","DETROIT","MI","48202","1128a1","20170420","20250903","00000000",""
"UFOT","EMMANUEL","","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","0000000000","19781007","3229 BAYSWATER CT","FAR ROCKAWAY","NY","11691","1128a2","20200820","20250903","00000000",""
"WEST","CHERYL","LYNN","","NURSING PROFESSION","NURSE/NURSES AIDE","","0000000000","19630108","11716 101ST","LARGO","FL","33773","1128b4","20000820","20250916","00000000",""
"WILLIAMS","JUSTIN","PAUL","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","0000000000","19830930","4139 PRUNETREE LN","SAN JOSE","CA","95121","1128b4","20160218","20250916","00000000",""
"WILSON","MATTHEW","ROBERT","","INDIVIDUAL (UNAFFILI","PERSONAL CARE PROVID","","0000000000","19900219","9505 CHAD COLLEY BLVD, APT 480","FORT SMITH","AR","72916","1128a3","20200920","20250922","00000000",""
"WOLF","SHEILA","MARIE","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","0000000000","19650627","202 14TH AVE NORTHEAST","MIAMI","OK","74354","1128a3","20111220","20250916","00000000",""