LASTNAME,FIRSTNAME,MIDNAME,BUSNAME,GENERAL,SPECIALTY,UPIN,NPI,DOB,ADDRESS,CITY,STATE,ZIP,EXCLTYPE,EXCLDATE,REINDATE,WAIVERDATE,WVRSTATE
"AURELIO","CHRISTINE","ANN","","PHARMACY","TECHNICIAN","","0000000000","19800505","35 CHARLES ST","EAST PROVIDENCE","RI","02914","1128b4","20030720","20251217","00000000",""
"BROWN","MICHELE","","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","0000000000","19661224","607 JAY STREET, G2","UTICA","NY","13501","1128a2","20140120","20251202","00000000",""
"COMPTON","KYLE","DOUGLAS","","PHYSICIAN (MD, DO)","INTERNAL MEDICINE","","1619168036","19760925","425 LEMON DROP LANE","LEXINGTON","KY","40511","1128a4","20171120","20251210","00000000",""
"DAVIS","DAMEKA","SYCARI","","INDIVIDUAL (UNAFFILI","PERSONAL CARE PROVID","","0000000000","19741013","38711 ALLEGRO COURT","PALMDALE","CA","93552","1128a1","20161020","20251208","00000000",""
"DIXON","DONNA","L","","IND- LIC HC SERV PRO","HEALTH CARE AIDE","","1073902425","19670225","1001 SW LORMAN DR","LEES SUMMIT","MO","64081","1128a1","20201119","20251218","00000000",""
"ESPINDOLA","JUAN","W","","PHYSICIAN (MD, DO)","PULMONOLOGY","H11573","1881703726","19580202","27 UPPER MOUNTAIN AVE, APT 3","MONTCLAIR","NJ","07042","1128a1","20190220","20251209","00000000",""
"FOLISI","SALVATORE","HANSEN","","IND- LIC HC SERV PRO","THERAPIST","","1467509125","19681108","37 SUGAR RIDGE LN","HYDE PARK","VT","05655","1128a2","20090520","20251208","00000000",""
"GARY","MARY","M","","SKILLED NURSING FAC","NURSE/NURSES AIDE","","0000000000","19751130","1204 GRAY AVE, 2ND FL , APT 2H","UTICA","NY","13502","1128a2","20070220","20251208","00000000",""
"GONZALEZ","STACEY","ANN","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","1356667398","19761117","31 JAMES HAWKINS RD","MORICHES","NY","11955","1128b4","20130919","20251209","00000000",""
"GORDON","KENYA","RAZAI","","IND- LIC HC SERV PRO","HEALTH CARE AIDE","","0000000000","19840813","2913 69TH LANE NORTH","MINNEAPOLIS","MN","55430","1128a1","20200820","20251208","00000000",""
"GUZMAN-MOORE","SUZETTE","","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","0000000000","19690309","402 BEACH 25TH ST, APT 2B","FAR ROCKAWAY","NY","11691","1128a3","20150520","20251209","00000000",""
"HADNOT","TEMITRA","LA PEL","","EMPLOYEE - PRIVATE S","COMM MNTL HLTH CNTR","","0000000000","19851107","13403 S WILTON PL","GARDENA","CA","90249","1128a1","20181120","20251208","00000000",""
"HARRIS","BRENDA","FRANKLIN","","IND- LIC HC SERV PRO","THERAPIST","","0000000000","19461017","2405 FRENCH PL","BAYTOWN","TX","77520","1128a1","20080120","20251208","00000000",""
"HARRIS","BRENDA","JOYCE","","BUS OWNER/EXEC","DME - POWER VEHICLES","","0000000000","19461017","2405 FRENCH PL","BAYTOWN","TX","77520","1128a1","20120920","20251208","00000000",""
"JAROSZEWICZ","KATHERINE","","","NURSING PROFESSION","NURSE/NURSES AIDE","","0000000000","19680702","1411 HARPER DRIVE","ERIE","PA","16505","1128b4","20090618","20251218","00000000",""
"JARRETT","JENNIFER","E","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","1851709224","19760427","984 HOMEWOOD AVE SE","WARREN","OH","44484","1128a1","20190820","20251202","00000000",""
"JENKINS","SHANIQUA","KIERA","","EMPLOYEE - PRIVATE S","HOSPITAL","","0000000000","19900825","904 WATKINS PL","JACKSON","MS","39206","1128a3","20200120","20251202","00000000",""
"JOHNSON","JACOBI","","","EMPLOYEE - PRIVATE S","INTER CARE FACILITY","","0000000000","19910825","1335 BARRETT AVENUE","JACKSON","MS","39204","1128a2","20171120","20251215","00000000",""
"JOHNSON","RONALD","ARTHUR","","INDIVIDUAL (UNAFFILI","PERSONAL CARE PROVID","","0000000000","19660223","P O BOX 2006","BANDON","OR","97411","1128a1","20170720","20251208","00000000",""
"JOHNSON","VICTOR","ELLIOTT LINN","","IND- LIC HC SERV PRO","THERAPIST","","0000000000","19731216","13803 S PREMIERE AVE","BELLFLOWER","CA","90706","1128b4","20140619","20251202","00000000",""
"KRESSER","KATHRYN","","","PRIVATE CIT/ENTITY","EMPLOYEE","","0000000000","19801204","6 GROVELAND ST","BUFFALO","NY","14214","1128a1","20070419","20251208","00000000",""
"MALVIYA","VINAY","","","PHYSICIAN (MD, DO)","GYN/OBS","","1184623514","19530928","9309 ROSSTOWN WAY","HOUSTON","TX","77080","1128b7","20220406","20251210","00000000",""
"MASICLAT","MYLENE","","","BUS OWNER/EXEC","HOME HEALTH AGENCY","","0000000000","19640119","5721 CARIBOU LANE","HOFFMAN ESTATES","IL","60192","1128a1","20200720","20251208","00000000",""
"MONTGOMERY","PATRICIA","ANN","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","1235337387","19800702","701 S BELLFLOWER DRIVE","PUEBLO","CO","81007","1128b4","20250120","20251210","00000000",""
"NEWSOME","CHRISTINA","NGOZI","","BUS OWNER/EXEC","DME - ORTHOTICS","","0000000000","19620102","17300 DASHWOOD CREEK DR","PFLUGERVILLE","TX","78660","1128a1","20130820","20251202","00000000",""
"PAYLAN","CHRISTINA","B","","PHYSICIAN (MD, DO)","GENERAL PRACTICE","","1649442203","19671024","110 PINELLAS WAY NORTH","SAINT PETERSBURG","FL","33710","1128b4","20161020","20251211","00000000",""
"RAMOS","OLIVIA","ISABEL","","INDIVIDUAL (UNAFFILI","PERSONAL CARE PROVID","","0000000000","19790521","122 EAST 'B' ST","WAPATO","WA","98951","1128a1","20160812","20251209","00000000",""
"ROSSMAN","CHRISTY","L","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","0000000000","19750807","15 DAHLIA LN","INDIANAPOLIS","IN","46217","1128b4","20130820","20251202","00000000",""
"SEGOVIA","RICHARD","LAWRENCE","","PRIVATE CIT/ENTITY","HEALTH CARE AIDE","","0000000000","19600914","6555 BOULDER HWY, #10307","LAS VEGAS","NV","89122","1128b4","19990120","20251218","00000000",""
"SKEEN","SEPTEMBER","LYNN","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","0000000000","19770911","2060 1/2 JEWELL ST","MADISONVILLE","KY","42431","1128b4","20210420","20251210","00000000",""
"SMITH","RONALD","EDMOND","","INDIVIDUAL (UNAFFILI","NO KNOWN AFFILIATION","","0000000000","19550214","3803 N DALTON GANG LANE","CAMP VERDE","AZ","86322","1128a1","19900501","19900501","00000000",""
"STEWART","BENJAMIN","DAVID","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","0000000000","19821013","61 TENNILLE WAY","CLEVELAND","GA","30528","1128b4","20181018","20251208","00000000",""
"WEISS","ANDREW","DAVID","","MEDICAL PRACTICE, MD","ANESTHESIOLOGY","E96518","1952908071","19601024","5211 ESPANA AVE","BOYNTON BEACH","FL","33437","1128a4","20060920","20251202","00000000",""
"WILLIS","VERNITA","M","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","1366401978","19660803","22322 HOLLY BRANCH DR","TOMBALL","TX","77375","1128a1","20200720","20251215","00000000",""
"ZELTNER","MARIA","","","EMPLOYEE - PRIVATE S","NURSING FIRM","","1386199503","19610318","304 FLINT ROCK CT","COLLEGEVILLE","PA","19426","1128a3","20170920","20251218","00000000",""